New Delhi
Union Minister of State for Health and Family Welfare, Prataprao Jadhav, shared on Tuesday that Aadhaar authentication and Artificial Intelligence (AI) technologies are effectively preventing misuse in the Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY).
Jadhav explained that the National Health Authority (NHA) follows a strict zero-tolerance policy against fraud. As part of efforts to detect and prevent irregularities, 1,114 hospitals have been removed from the scheme, while 549 hospitals were suspended. Penalties of Rs 122 crore were imposed on over 1,500 hospitals.
To prevent ineligible beneficiaries from benefiting, Aadhaar e-KYC is conducted during card creation and when beneficiaries avail services. This ensures the legitimacy of each beneficiary's identity.
AI technologies, including Machine Learning algorithms, fuzzy logic, and image classification, are used to spot potential fraud. Once misuse is detected through audits and investigations, actions such as deactivating Ayushman Cards, levying penalties, or even legal actions are taken.
The NHA has also launched HEM 2.0, a refined system for private hospital verification, requiring accurate documentation and physical checks. A three-tier grievance system is available at district, state, and national levels to resolve issues, with beneficiaries able to file complaints via multiple platforms, ensuring prompt resolution.