Special Operation Group (SOG) carried out an operation to find out the implementation of Rajasthan Government Health Scheme (RGHS). It was found that nexus was being run between doctors and private lab operators leading to losses worth crores. The Additional Director General of Police (SOG) Vishal Bansal said the scam came to the forefront during a detailed probe into the implementation of RGHS (A scheme designed especially for underprivileged and government employees to provide them free and accessible healthcare).

Fake prescription and diagnosis

During the investigation it was found that some government doctors and private lab operators have generated fake prescriptions and even fake diagnostic reports, so that they can claim reimbursements. Police have arrested two accused, Dr Kamal Kumar Agrawal, who is an associate professor in Orthopedics at SK Hospital in Sikar district, and Dr Banwari Lal commonly known as B Lal, who operates a private laboratory.

Investigation revealed that the accused doctor prescribed expensive diagnostic tests and unnecessary medicines. This included MRI scans, and in some cases it was found that the patient was never tested before making a report. And in some cases tests were written without patients being physically present.

Mishandling of RGHS portal

Police have found that normal MRI scans have been falsely billed as “contrast MRI” so that inflated claims can be raised and for single tests multiple reports were generated. Besides, prescriptions have been issued on dates when doctors are on leave. Basically, the finding suggests that dates on the report have been fabricated to process the claims.

One case that has come to the forefront is when a MRI report dated December 4, 2025, has been altered to December 5, in order to secure reimbursement, and strangely on the same date the patient wasn’t in the town. There are some cases where claims have been raised against the name of the patient who has never been admitted in the government hospital. Digging deep into the matter, police investigation revealed that referrals from private doctors have been modified in order to make it appear that it was issued by government doctors.

Police officials said that this fraud practice has affected both the finances and also affected beneficiaries. Currently, a case has been registered and investigation is being done to unearth the wider racket operating.

Long or Short, get news the way you like. No ads. No redirections. Download Newspin and Stay Alert, The CSR Journal Mobile app, for fast, crisp, clean updates!

App Store –  https://apps.apple.com/in/app/newspin/id6746449540 

Google Play Store – https://play.google.com/store/apps/details?id=com.inventifweb.newspin&pcampaignid=web_share