AI audit triggers action against 31 medical stores in Rajasthan
An AI-powered audit of medicine claims under the Rajasthan Government Health Scheme (RGHS) has triggered strict action against medical stores across the state, with the
An AI-powered audit of medicine claims under the Rajasthan Government Health Scheme (RGHS) has triggered strict action against medical stores across the state, with the Rajasthan government permanently cancelling the drug licences of 31 pharmacies over alleged fraud and financial irregularities. The crackdown follows an investigation by the Rajasthan State Health Assurance Agency, which found that several medical stores allegedly colluded with doctors and beneficiaries to submit fake claims. Officials said forged doctor signatures were used in some cases, while claims were also raised for non-payable items instead of medicines.
Read Full Story The AI-based monitoring system, introduced to strengthen oversight of RGHS claims, identified suspicious patterns including inflated prices, abnormal MRP claims, incorrect pricing, fake claims, improper product mapping and other irregularities. The government said the technology is helping detect fraudulent transactions and improve financial discipline under the scheme. Recent audits also revealed excessive pricing in claims involving medicines such as Exemptia 40 mg, Denberi injection, Terifrac (Teriparatide) and Trulicity 1.5 mg. In several cases, medical stores allegedly claimed prices far above market rates and failed to provide the mandatory minimum discount under RGHS.
Officials said some stores offered discounts of only 12 percent where at least 40 percent was required, while certain claims were found to be two to five times higher than the medicines' purchase cost. Based on the findings, the Drug Control Department permanently cancelled the licences of 31 medical stores. The affected outlets include 11 in Jaipur, nine in Bharatpur, two each in Nagaur and Dholpur, and one each in Hanumangarh, Bhilwara, Sikar, Jodhpur and Alwar. Apart from cancelling licences, the state has initiated recovery of excess payments, temporarily suspended TMS services of 10 medical stores and issued show-cause notices to 13 others.
Rajasthan State Health Assurance Agency CEO Harjeelal Atal said the government is also preparing a new action plan to further curb profiteering and financial irregularities in RGHS medicine claims while ensuring transparent and accountable delivery of medicines to beneficiaries. Ends
The BriefWire