A report by the Auditor General and Auditor General of India (CAG) has pointed out data gaps and errors in Ayushman Bharat – Pradhan Mantri Jan Aarogya Yojana (PMJAY). The report, filed at Lok Sabha on Monday, indicates that nearly 7.5k beneficiaries are linked to a single phone number under the health plan.
The PMJAY program aims to provide medical insurance worth Rs 50,000 per family per year on admission to secondary and tertiary care to more than 12 million poor and vulnerable families.
The CAG audit report revealed that a total of 749,820 beneficiaries were linked to this particular mobile number - 9999999999 - in the beneficiary identification system 'BIS'; of the mode.
CAG's findings are based on PMJAY's performance from September 2018 to March 2021. According to the report, a large number of beneficiaries were registered with the same or invalid mobile number.
About 139,300 beneficiaries are linked to the phone number 8888888888 and another 96,046 are linked to the number 9000000000.
"Mobile phone numbers are important for finding records related to any payee in the database who can reach the registrar without ID. In the event of a lost card death, identifying beneficiaries can also become difficult,” the report said.
While agreeing with the audit observation, the National Health Service (NHA) stated that with the implementation of BIS 2.0, the problem will be resolved. The health authority further noted that the BIS 2.0 system was configured to ensure that more than certain families could not use the same mobile phone number.
Another issue highlighted in the report is that household size is not realistic for registered beneficiaries. Analysis of the data revealed that 43,197 households had unrealistic family sizes, ranging from 11 to 201 members.
According to the report, the presence of such impractical members indicates a lack of necessary authentication checks in the beneficiary registration process. It also points to the possibility that recipients are taking advantage of the lack of clear instructions, according to the report. The report also covers the inclusion of pensioners in the scheme from states such as Chandigarh, Haryana, Himachal Pradesh, Karnataka, Maharashtra, and Tamil Nadu. It highlights delays in identifying and removing ineligible beneficiaries from the program, resulting in resource misuse and overpayments to insurers.
