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Context: The Comptroller and Auditor General of India (CAG) uncovered irregularities in the registration and validation of beneficiaries under the Ayushman Bharat – Pradhan Mantri Jan Aarogya Yojana (PMJAY) scheme.

Details

• The CAG report highlighted the significance of mobile numbers for beneficiary communication and identification, emphasizing the need for accurate data in the system to prevent denial of benefits and improve overall scheme administration.
• The audit report also emphasized the importance of proper validation controls, adherence to eligibility criteria, and coordination between central and state authorities to ensure the effective implementation of the PMJAY scheme and prevent misuse of benefits.

The CAG's audit report highlighted several concerning findings:

• Single Cellphone Number Irregularity: The audit revealed that a significant number of beneficiaries, totalling around 7.5 lahks, were linked to a single cellphone number, which was 9999999999. Furthermore, additional beneficiaries were linked to other single phone numbers such as 8888888888 and 9000000000.
• Invalid Mobile Numbers: The report identified large numbers of beneficiaries who were registered with either the same or invalid mobile numbers. This inconsistency in mobile numbers could lead to difficulties in communication, denial of benefits, and inconvenience for eligible beneficiaries.
• Unrealistic Household Sizes: The audit also noted that there were instances of unrealistic household sizes recorded in the beneficiary database. This indicated a lack of proper validation controls during the beneficiary registration process and the possibility of beneficiaries exploiting ambiguities in family definitions.
• Pensioners benefiting from the Scheme: The audit found that pensioners in various states, including Chandigarh, Haryana, Himachal Pradesh, Karnataka, Maharashtra, and Tamil Nadu, had PMJAY cards and availing medical treatment under the scheme. This led to excess payments of premiums to insurance companies.

In response to these irregularities, the National Health Authority (NHA) acknowledged the audit observations and outlined steps to address the issues. The deployment of Beneficiary Identification System (BIS) 2.0 was expected to resolve some of these concerns by limiting the use of the same mobile number for multiple families. Additionally, the NHA was developing a policy to disable the "Add Member" functionality for beneficiary families with more than 15 members.

Must-Read Articles:

AYUSHMAN BHARAT PRADHAN MANTRI JAN AROGYA YOJANA (AB-PMJAY): https://www.iasgyan.in/daily-current-affairs/ayushman-bharat-pradhan-mantri-jan-arogya-yojana-ab-pmjay

https://indianexpress.com/article/india/pmay-irregularities-cag-report-pmjay-beneficiaries-mjay-performance-audit-8882978/

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