ED raids Himachal Pradesh Congress MLA in Ayushman Bharat fraud case

The money laundering case stems from a January 2023 FIR registered by the state vigilance and anti-corruption bureau against Kiran Soni, Una-based Shri Banke Bihari Hospital and others for generating fake AB-PMJAY (Arogya Bharat-Pradhan Mantri Jan Arogya Yojna) cards.

Shimla: The Enforcement Directorate on Wednesday raided the premises of Himachal Pradesh Congress MLA R S Bali, some private hospitals and their promoters as part of a money laundering probe linked to the alleged Ayushman Bharat scheme fraud, officials said.

About 19 locations in Shimla, Kangra, Una, Mandi and Kullu districts of the state apart from those in Delhi, Chandigarh and Punjab are being searched since morning, they said.

The premises of Bali, a legislator from Nagrota assembly seat, Fortis Hospital in Kangra (promoted by Bali's company Himachal Healthcare Pvt Ltd.), Balaji Hospital in Kangra and its promoter Rajesh Sharma are being raided.

Sharma, according to the officials, is a "close associate" of Chief Minister Sukhvinder Singh Sukhu. He gave up his ticket for the recent Dehra assembly bypoll for Sukhu's wife Kamlesh Thakur. She won the bypoll.

Bali is also the chairman of Himachal Pradesh Tourism Development Corporation and the vice-chairman of the Himachal Pradesh Tourism Development Board.

The money laundering case filed on July 16 stems from a January 2023 FIR registered by the state vigilance and anti-corruption bureau against one Kiran Soni, Una-based Shri Banke Bihari Hospital and others for allegedly generating "fake" AB-PMJAY (Ayushman Bharat-Pradhan Mantri Jan Arogya Yojna) cards.

The ED has alleged that many medical bills were generated on such "fake" cards, causing a loss to the exchequer and the public with the total "proceeds of crime" in this case estimated to be around Rs 25 crore.

The agency found that a total of 8,937 Ayushman Bharat golden cards have been scrapped in the state for alleged violation of the AB-PMJAY scheme till now.

It alleged that Bankey Bihari Hospital, Fortis Hospital, Shri Balaji Hospital, Sood Nursing Home and Sri Harihar Hospital among others availed "illegal benefits" under the AB-PMJAY scheme.

As many as 373 fake Ayushman cards have been identified and claims of Rs 40,68,150 were made for reimbursement from the government in the name of treatment given to some Ayushman Bharat beneficiaries, the agency found.

List of such "fake" beneficiaries included one Rajnish Kumar and Pooja Dhiman who "denied" possession or any information of a PMJAY card issued to them, the ED found.

They never underwent any such treatment in any of these hospitals, the ED claimed.

The accused hospitals made claims for treatments, surgery, admission which were actually never given or performed upon the patients, it said.

In an another instance, Raksha Devi was "denied" admission in the hospital and her package was "dishonestly and illegally" blocked.

The accused hospitals were "de- empanelled" from the Ayushman Bharat scheme for illegal practices and non-compliance of procedures and guidelines, the agency claimed.