Mumbai: The Maharashtra government on Wednesday announced a series of measures to crack down on fraud in the Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY) and illegal IVF and sonography centres, with Health Minister Prakash Abitkar asserting that those found guilty of malpractice "will not be spared."
AI Integration
Replying to a calling attention motion in the Legislative Assembly, Abitkar said the state has upgraded its health insurance management system by replacing the old Jeevandayee portal with the AI-enabled KMS 2.0 platform, which has already detected suspicious insurance claims and treatment patterns.
"The health department itself initiated action after AI flagged irregularities. Whoever is found guilty, irrespective of who they are, will face strict action," the minister said.
Monitoring Mechanisms
To strengthen oversight of the cashless health insurance scheme, the government will deploy AI-based monitoring systems, flying squads and a real-time dashboard to track implementation and improve transparency. According to Abitkar, most of the irregularities discussed in the Assembly pertained to the earlier Jeevandayee portal, while the new platform is capable of identifying anomalies, including cases where the same patient is shown to have undergone surgeries at multiple hospitals.
The minister reiterated that hospitals empanelled under MJPJAY are prohibited from charging beneficiaries for procedures covered under the scheme. Patients who are denied cashless treatment or asked to make payments can register complaints online, through district coordinators or directly with the state government, with every complaint to be investigated.
IVF Crackdown
In a separate announcement, Abitkar said the government will constitute a Special Task Force (STF) to launch a statewide drive against unauthorised IVF and sonography centres that allegedly exploit patients.
Responding to a question raised by Samajwadi Party MLA Abu Azmi, the minister said the STF would conduct inspections across Maharashtra to identify and shut down illegal centres operating without mandatory approvals.
He also revealed that the government is considering bringing such offences under the ambit of organised crime laws. A Bill to provide a stronger legal framework against such activities is likely to be introduced during the next session of the state legislature.
Abitkar said the proliferation of illegal IVF and sonography centres has become a serious concern and the proposed task force would help regulate the sector while protecting patients from fraudulent medical practices.
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