UP Ayushman Card Fraud: Approvals Centralised At SACHIS After 450 Fakes Discovered

In Uttar Pradesh, approval for issuing new Ayushman cards will now be granted exclusively from the office of the State Agency for Comprehensive Health and Integrated Services (SACHIS). This facility will only be available on computers within the SACHIS offices, and approval will no longer be possible from any other computer system.

This decision was made after a case came to light where more than 450 fraudulent Ayushman cards were created by breaching the National Health Authority (NHA) portal.

New Security And Verification Measures

SACHIS Chief Executive Officer, Archana Verma, outlined several new security protocols:

- System Security: The computer system used for approving Ayushman cards has been secured against hacking.

- IP Address Tracking: The IP addresses of users creating new Ayushman cards are being secured, which will allow the main source of any unauthorized activity to be traced.

- Mandatory Biometrics: The National Health Authority (NHA) has implemented mandatory biometric authentication for creating new cards. A beneficiary's card will now only be created after the biometric verification is complete. This two-tier verification will help prevent fraud. 

- Aadhaar e-KYC: The misuse of the entire scheme will be preventable through Aadhaar-based e-KYC.

Two-Level Process For Claims and Treatment

A two-level process has also been implemented for admitting a patient and verifying their treatment claim:

First Stage: The claim is verified by an agency appointed by the central government.

Second Stage: Following this, doctors at SACHIS review the claim.

- Care is also taken to ensure that the treatment claim submitted first for a beneficiary is also approved first, eliminating the possibility of partiality.

- Furthermore, to ensure the quality and proof of treatment, it has been made mandatory to upload a photo of the doctor with the patient with the claim on the portal.

AI-Based Fraud Detection

- The CEO stated that the National Health Authority is investigating irregularities in Ayushman cards and hospital treatment claims using artificial intelligence (AI)-based software.

- In this process, a report prepared by the National Anti-Fraud Unit (NAFU) identifies suspicious activities.

- Identified suspicious cards are then sent to the State Anti-Fraud Unit (SAFU), which conducts a physical verification of the card with officials in the districts.

- Archana Verma stated that the entire process of creating Ayushman cards has been made completely secure against any breach.