More than 200 hospitals across Andhra Pradesh, empanelled under the Dr. NTR Vaidya Seva scheme, have been pulled up for various irregularities in providing health services to patients over the past two years.
According to a release from the Department of Health, Medical and Family Welfare, the NTR Vaidya Seva Trust imposed fines totalling ₹34.39 crore on 203 hospitals and initiated disciplinary action against 44 hospitals.
This includes 25 suspensions, 13 stoppages of payments, removal of five hospitals from the network and cancellation of recognition for one hospital.
Some of these hospitals were charging for treatments that should be provided free to beneficiaries under the scheme.
Other complaints included denying cashless treatment to eligible beneficiaries, delaying treatment, failing to follow prescribed medical protocols and neglecting patient care.
The Trust investigated these complaints and took action against the erring hospitals. NTR Vaidya Seva Trust CEO Dr. Padmavathi submitted a report on these measures to Minister for Health, Medical and Family Welfare Satya Kumar Yadav.
According to the release, officials analyse hospital bills and pre-authorisation requests to identify unusual patterns, excessive use of treatment packages and suspicious transactions.
The process also helps detect duplicate billing, alterations to medical records and misuse of the scheme.
The NTR Vaidya Seva Trust is using artificial intelligence (AI)-based systems to accelerate bill verification, ensure uniformity in audits and clear pending bills.
Bills flagged by AI as suspicious are not treated as fraudulent automatically; the final decision on disciplinary action is taken only after the district and State officers conduct an investigation, examine medical records and find sufficient evidence.
