Overview
- Health Minister Prakash Abitkar told the state assembly on Wednesday that the legacy Jeevandayee portal has been replaced by an AI-enabled KMS 2.0 platform which has flagged suspicious claims and treatment patterns.
- The government has ordered flying squads, a real-time monitoring dashboard and new complaint channels to inspect hospitals and investigate every allegation of patients being charged for procedures covered under the MJPJAY scheme.
- Officials have initiated action and cancelled empanelment for four named hospitals — Shiv Multispeciality Hospital and Critical Care, Rishikesh Hospital, Magnum Multispeciality Hospital, and Sant Krupa Multispeciality and Accident Hospital — while FIRs have been lodged in some cases.
- BJP MLA Rahul Aher has alleged thousands of linked dubious claims, including nearly 9,000 tied to one mobile number, and has demanded Special Investigation Team and Economic Offences Wing probes as the state says broader investigations are under way.
- MJPJAY is a cashless health-insurance programme that depends on hospital empanelment and district coordinators, and officials say the new AI checks are meant to spot duplicate patient records and organised billing schemes which could lead to fund recovery and tighter laws.