SOG arrests 2 docs over 'gaps' in RGHS, medical staff protest
Jaipur/Bharatpur, May 6 -- The Rajasthan Special Operations Group (SOG) has arrested two government doctors in Sikar following a raid at the district's Shri Kalyan (SK) Hospital in connection with large-scale irregularities in the Rajasthan Government Health Scheme (RGHS).
The action triggered protests across the district, with a large number of medical staff boycotting work since Tuesday morning and calling the move a "conspiracy".
Additional director general of SOG Vishal Bansal said the agency acted on a formal complaint from the health department alleging fraudulent activities in the implementation of RGHS across multiple hospitals.
"The department identified at least 10 to 15 doctors involved. After a preliminary investigation, we conducted a search operation at SK Hospital in Sikar and arrested two doctors, while four others fled. We are searching for them," he said.
The arrested have been identified as Dr Kamal Kumar Agrawal, an associate professor (Orthopaedics) at SK Hospital, and Dr Banwari Lal alias B Lal, an operator of a private laboratory in Sikar. A special SOG team is searching for the remaining accused.
According to Bansal, investigators have uncovered a nexus involving certain doctors, pharmacies and diagnostic laboratories. The accused allegedly generated fake prescriptions and diagnostic reports to claim reimbursements under RGHS, causing substantial losses to the state exchequer. He said doctors prescribed unnecessary tests, including expensive MRI scans, often without examining patients or even in their absence.
"In some cases, normal MRI scans were billed as 'contrast MRI' to inflate claims, while in others multiple reports were generated for a single test. Fake reports were uploaded on the RGHS portal to claim payments. We also found prescriptions issued on days when the doctors were not present, and report dates manipulated," Bansal said.
He cited an instance where an MRI report dated December 4, 2023, was altered to December 5 to secure reimbursement, even though the patient had not visited Sikar on that day. Police said a case has been registered and an investigation is underway.
Officials added that the fraud not only caused financial losses but also affected genuine beneficiaries and undermined the credibility of the scheme. In several instances, referrals from private doctors were allegedly altered to appear as if issued by government doctors to make them eligible under RGHS.
A health department official said an AI-based monitoring team has been set up to scrutinise all RGHS claims over the past five years. "At least 64 medical staff, including 14 doctors, have been suspended after their involvement came to light. An FIR has been registered against 19 hospitals, of which eight have been de-empanelled. Around 200 more hospitals are under suspicion," the official said, adding that the irregularities surfaced during an audit by the Quality Control and Performance Audit Cell (QC&PA Cell), which has been reviewing the scheme since 2021.
Meanwhile, protests intensified in Sikar as over 300 doctors and medical staff gathered at SK Hospital and boycotted work. Private practitioners also joined the strike in support of government doctors. "Resident doctors have been deployed to ensure patient care continues, but this is a conspiracy against us and an unconstitutional action," said Dr Shivpal Kudi, one of the protesting doctors.
"The government should develop an app to provide patient details under RGHS for transparency. Our protest will continue until the arrested doctors are released," he added....
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