Patna: An alleged irregularity in the processing of Ayushman Bharat claims at the Indira Gandhi Institute of Medical Sciences (IGIMS), Patna, has prompted an internal inquiry and tighter monitoring of the scheme’s claim process.
The matter came to light after a patient complained that an Ayushman Bharat claim had been submitted in their name even though they had not visited IGIMS for treatment.
The inquiry reportedly identified alleged fake claims worth around Rs 45 lakh. An FIR has been registered against four people, while the institution has also removed its chief nodal officer for the Ayushman scheme, according to reports.
Patient Complaint Triggered Inquiry
The complaint was reportedly filed around five months ago, after the patient found that their name and Ayushman card had allegedly been used for a treatment claim despite the patient not having undergone treatment at the institute.
Following the complaint, IGIMS launched an internal investigation into the claim and related records.
The investigation also brought the role of employees associated with an outsourcing agency under scrutiny. The allegation is that patient records and documents in the hospital’s management system were improperly used in the claim process.
The matter is now under investigation following registration of the FIR.
CAG Had Earlier Flagged Rs 13.89 Crore Revenue Loss
The latest allegations come after a separate issue involving Ayushman Bharat claims at IGIMS was flagged by the Comptroller and Auditor General of India (CAG).
According to the report, a CAG communication dated November 28, 2025, referred to a revenue loss of Rs 13.89 crore at IGIMS.
The issue reportedly involved cases where patients had received treatment but the institute did not submit the corresponding Ayushman claims within the prescribed period. This resulted in revenue that could not be recovered through the scheme.
The CAG had sought a response from the institute’s administration on the matter.
The Rs 13.89 crore revenue-loss issue and the alleged Rs 45 lakh fake-claim case are separate matters concerning different aspects of the Ayushman claim process.
IGIMS Introduces Weekly Claim Reviews
Following the latest allegations, IGIMS has constituted a committee to strengthen oversight of Ayushman Bharat claims.
The committee will be headed by the IGIMS director. Under the new arrangement, an Ayushman claim and the corresponding patient records will be reviewed every Friday at 4pm.
The monitoring system will cover six levels of verification, including checking records from admission to discharge, verifying whether claims were submitted within the prescribed period and comparing hospital-management-system records with data on the Ayushman portal.
The process will also include verification of the patient’s treatment, monitoring of outsourcing personnel and financial auditing of pending claims and government funds.
IGIMS Calls Monitoring An Administrative Measure
IGIMS Deputy Director Dr Vibhuti Prasad Sinha described the new monitoring mechanism as part of the institute’s administrative process.
According to him, the objective is to ensure that eligible patients receive treatment without difficulty and that the Ayushman scheme operates in an organised manner.
The investigation will determine the people responsible for the alleged fake claims and whether further action is required based on the findings.
The allegations remain subject to the ongoing investigation and any subsequent proceedings.
