The world’s largest insurance scheme, Ayushman Bharat Pradhan Mantri Jan Arogya Yojana, recently became the epicentre of a substantial fraudulent activity. Leveraging artificial intelligence (AI) tools, the scam, involving a staggering 530,000 cards, has been exposed, with a significant recovery of INR 95 million.
Unveiling Fraudulence: The Power of AI
AI technology has played a pivotal role in disclosing the imposter activities associated with the Ayushman Bharat cards. The AI tool utilises complex algorithms that can scrutinise vast amounts of data, identifying suspicious transactions and entities. Post the AI intervention, nearly 530,000 Ayushman Bharat cards have been disabled, and actions against 210 hospitals have been initiated, further de-panelled from the scheme.
The Fraud-Free Aspirations of the National Health Authority
To curb such fraudulent incidents, the National Health Authority (NHA) had earlier released anti-fraud guidelines specifically for the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana. The department also established National Anti-Fraud Units (NAFUs) across states and union territories to monitor potential scams at the state level, maintaining a zero-tolerance approach.
About the Ayushman Bharat Scheme: Aiming for Universal Health Coverage
The Ayushman Bharat Scheme is a laudable initiative by the Indian government, aiming to provide health coverage of up to INR 500,000 to every beneficiary for their treatment at any registered hospital. The scheme mandates the submission of necessary documents and on-bed photos of the patient. Moreover, the benefits of the scheme can only be availed through Aadhaar-based verification, ensuring security and authenticity.
Safeguarding Personal Information: Steering Clear of Fraud
Given the vast health coverage provided by the scheme, it has become a prime target for fraudsters, who can potentially misuse personal information to claim the benefits. To avoid falling prey to such scams, beneficiaries must refrain from sharing their personal, including health-related, information with anyone.
In the light of this recent revelation, it becomes all the more critical for beneficiaries to exercise caution and vigilance, ensuring that the benefits of such extensive health coverage reach the ones who genuinely need it.
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