Monday, February 4, 2013

Jeevandai Aarogya Yojana Scam: Hospital ‘fleeces’ state, cancer patient

A Byculla hospital passed off a middle-class patient as poor one and drew funds from govt insurance scheme, while also billing him

A botched surgery on a 34-yearold man with oral cancer has brought into focus the practice of private hospitals exploiting the state government’s free health insurance programme.

Health Minister Suresh Shetty on Wednesday ordered a probe against Byculla’s Balaji Hospital, which allegedly passed off the middle-class patient as a poor one and drew Rs1.5 lakh from the Rajiv Gandhi Jeevandayi Yojna.

The hospital, the patient claims,also billed him Rs 2.5 lakh for the operation that he underwent last year.

Matunga resident Rajesh Singh was diagnosed with oral cancer by doctors at Raheja Hospital nine months ago. On April 14, 2012, he underwent a surgery at Balaji on the recommendations of a former JJ doctor, Dr T K Shahi.

According to Singh’s complaint to the health minister, Dr Shahi took an advance of Rs75,000 from him and Balaji surgeon Dr Wasim Ansari charged him Rs 70,000. He was not given any receipts for the payments.

“My sister had suggested the name of Dr Shahi, whom she knew as the head of JJ’s surgery department. Dr Shahi called us to her private clinic in Bandra, and asked us to pursue the treatment at Balaji,” Singh said.

Dr Shahi introduced Singh to Dr Ansari as an oral cancer specialist and her former student. “The two doctors took Rs 2.5 lakh from me in cash, but didn’t give me any receipts. They said that they would give the receipts once the treatment was over,” Singh claimed.

Singh sensed something was amiss when the two doctors didn’t ask him to undergo chemotherapy after the surgery. “I went to Tata Memorial for a second opinion in May, and that’s when I realised that Dr Ansari had bungled my surgery,” he said.

Tata Memorial doctors told Singh that he needed only a minor surgery, yet Dr Ansari operated on his upper jaw and teeth, which were notaffected by cancer. They advised him to undergo radiation therapy and chemo immediately.

Already set back by Rs 2.5 lakh, the 34-year-old approached an NGO for financial assistance. The group reviewed his papers, and pointed out that Balaji had declared him as a beneficiary of the Rajiv Gandhi scheme and drawn funds from it.

“The hospital claimed money on my brother’s behalf even though I was not eligible for the free insurance,” said Singh’s sister.

On January 14, Singh wrote to Health Minister Shetty, who on Wednesday ordered a probe in the case by the Economic Offences Wing. He also asked a committee comprising medical experts to conduct an independent inquiry simultaneously.

“These are serious allegations, and I want an in-depth probe,” Shettysaid.

Dr Ramesh Kagzi, chairman, Balaji Hospital, said patients get the money sanctioned under the RGJY and the hospital had nothing to do withit.“Dr Wasin Ansari is a consultant,” he said. “There are 100 such consultants and they bring and manage their own patients.”
Courtesy:
Yogesh Naik and Jyoti Shelar mirrorfeedback@timesgroup.com
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