Lucknow: Hospitals empanelled under the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) in UP will face graded penalties for illegally charging beneficiaries, raising bills without providing treatment and other violations, with action becoming progressively stricter for repeat offences.Informing this on Tuesday, deputy CM Brajesh Pathak said, “Despite orders directing to strictly follow and repeated advisories, many hospitals empaneled under Ayushman Bharat violate the scheme’s anti-abuse guidelines. Now they will face action for their misdeeds.”CEO, SACHIS, Archana Verma said that the guidelines were issued about two months ago and have been circulated to the empanelled hospitals. “The guidelines were reiterated on Tuesday all over again to make hospitals treat the anti-abuse guidelines as part of their routine functioning rather than merely as formal instructions.”Under the penalty framework, a hospital found taking illegal cash from a beneficiary for the first time will have to refund the entire amount and pay a penalty five times the amount illegally recovered. A repeat violation can lead to rejection and suspension, while a third violation can result in de-empanelment or blacklisting.Hospitals raising bills without providing the claimed service will face rejection of the claim and a penalty of up to five times the claim amount for a first violation. For a second violation, the penalty can go up to 10 times the amount along with suspension. A third violation can lead to de-empanelment or blacklisting.For incorrect beneficiary identification, a first violation can attract a penalty of up to five times the amount involved. A second violation can lead to a penalty of up to 10 times the amount and suspension, while a third can result in de-empanelment or blacklisting.Hospitals failing to meet minimum empanelment, quality and service standards will initially be issued a show-cause notice and given an opportunity to rectify deficiencies. Continued violations can lead to penalties and suspension, while a third violation can result in de-empanelment.
