Rs 400 crore Ayushman Bharat-Himcare scam unravels across 4 states; PGI Chandigarh chemist mastermind denied bail

Chandigarh/Shimla: A sensational Rs 400 crore scam involving the Ayushman Bharat and Himcare health insurance schemes has rocked the healthcare and law enforcement systems across Himachal Pradesh, Punjab, Haryana, and Chandigarh.

Investigations have uncovered a deep-rooted network of fraud centered at PGI Chandigarh, with stolen patient data, forged prescriptions, and fake seals being used to siphon off crores under the guise of medical treatment.

The mastermind, Durlabh Kumar Jatav, operator of Brothers Chemist Shop within the PGI campus, has been arrested by the Crime Branch.

On Friday, his bail plea was rejected by the court of Additional Sessions Judge, reinforcing the seriousness with which agencies are now pursuing the case.

Notably, police initially kept the arrest under wraps, hinting at the political and institutional sensitivities involved.

The scam first came to light in February 2025, when a man tried to procure medicines worth Rs 60,000 from Amrit Pharmacy inside PGI using an Ayushman card. Though the medicines were issued, he was intercepted by security.

A search of his belongings revealed dozens of forged prescription seals, indents, and documents bearing the names of doctors and department heads.

Police investigation traced the scam back to Jatav, who orchestrated the operation by collaborating with Ajay Kumar, a data operator at PGI who had access to sensitive patient records.

Together, they exploited the identities of patients already treated under Ayushman and Himcare schemes. Using duplicate cards and fake prescriptions, they repeatedly withdrew expensive medicines and resold them through Brothers Chemist at a 10-15 per cent discount.

Further, it was revealed that Raman, a resident of Kangra, was used as a mule to collect medicines using forged prescriptions. The loot was funneled back to Jatav, who allegedly shared profits with all gang members, including insiders from Amrit Pharmacy. The organised nature of the fraud and the use of hospital infrastructure raises serious questions about oversight and auditing mechanisms within PGI.

So far, seven arrests have been made in connection with the scam. Sources claim that during the course of the probe, pressure was exerted by an RSS-linked individual on the former DGP of UT Police to shield one of the accused, suggesting potential political protection.

Now PGI Chandigarh has also footed bills of Himcare to Himachal Pradesh Government as the Hospital administration has not released the high amount by the state and centre government.

This matter was brought to light during the PGI Governing Body meeting held on February 26, where it was disclosed that the MoU with the Himachal Pradesh government was signed in February 2024, with full-scale operations starting in June 2024.

However, the required approval from the Standing Finance Committee (SFC) was not obtained before the agreement, raising procedural and audit concerns. The Governing Body reprimanded PGI authorities for bypassing the SFC and demanded that all future financial agreements follow proper channels.

Adding pressure to the matter, the Union Health Ministry has now directed PGI to send monthly status reports of pending payments under the Himcare scheme, including the outstanding amounts and funds received.

Chief Minister Sukhvinder Singh also directed the state government to clear all the liabilities of contractors and health institutions, including PGI Chandigarh, IGMC Shimla, and Dr. Rajendra Prasad Medical College, Tanda.

The Chief Minister instructed the Finance Department to settle all pending bills by April 30, 2025, and to release overdue installments under the Sahara Scheme as well.