Unnecessary procedures for insurance claims: Gujarat hospital CEO among 4 held

The chief executive officer (CEO) of a multi-specialty hospital in Gujarat’s Ahmedabad and four others have been arrested for alleged involvement in a scam related to unnecessary medical procedures for insurance claims under the Pradhan Mantri Jan Arogya Yojana (PMJAY) insurance scheme for people with low income. The procedures included angioplasties and allegedly led to the deaths of at least two patients.
Rahul Jain, 37, the Khyati Multispeciality Hospital CEO, was arrested from Rajasthan’s Udaipur following technical surveillance. The four others, Chirag Rajput, Milind Patel, Pankaj Patel, and Pratik Bhatt, were taken into custody from a farmhouse in Gujarat’s Kapadvanj on Tuesday.
Investigators said Jain was responsible for coordinating audits and working with directors to resolve discrepancies. “Khyati Hospital made ₹11 crore in the last one and a half years. Out of this money, 70% came from PMJAY patients while 30% from those referred by other doctors and hospitals,” said a police officer.
Rajput, the hospital’s marketing and branding director, allegedly pressured patients to undergo unnecessary stent procedures and doctors to comply with his instructions. Investigators said he drew a monthly salary of ₹7 lakh and would personally oversee procedures in the hospital’s catheterisation laboratory.
Milind Patel, who worked as the hospital’s marketing executive for ₹40,000 monthly, organised medical camps in villages to bring in patients. Investigators said Pankaj Patel and Bhatt allegedly threatened patients about potential complications if they refused procedures.
The alleged scam came to light when Nagarbhai Senma, 59, and Mahesh Barot, 45, died following angioplasty procedures at the hospital after a free medical camp in Borisana village in Gujarat’s Mehsana. The camp was allegedly held to exploit the PMJAY scheme which provides health cover of up to ₹5 lakh.
“Of the nineteen villagers brought from the medical camp, 12 underwent angiography procedures at Khyati Hospital…. [the procedures] resulted in the deaths of Senma and Barot on November 11,” said an investigator.
Cardiologist Prashant Vazirani was earlier arrested as the Gujarat health minister Rushikesh Patel ordered an inquiry. Three cases were registered at Ahmedabad Vastrapur police station on November 13. On November 20, police issued lookout circulars against four accused including hospital promoters Sanjay Patolia and Rajshree Kothari.