Maharashtra Chief Minister Devendra Fadnavis has ordered the formation of a Special Investigation Team (SIT) to probe alleged irregularities in the implementation of the Mahatma Jyotirao Phule Jan Arogya Yojana (MJPJAY) in Nashik. The decision was announced during a review meeting of the integrated Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) and MJPJAY held at the State Legislature.

According to an official release, the SIT will investigate allegations of fraudulent claims and suspected malpractice involving hospitals empanelled under the state health insurance scheme. The move is part of the government’s efforts to strengthen transparency, improve accountability and safeguard public funds allocated for healthcare.

The announcement follows a series of measures by the Maharashtra government to tighten monitoring of health insurance schemes, including the deployment of flying squads, enhanced audits and the proposed use of artificial intelligence (AI) to detect suspicious claims and billing patterns.

The Mahatma Jyotirao Phule Jan Arogya Yojana, integrated with Ayushman Bharat PM-JAY, provides cashless treatment for secondary and tertiary care to eligible beneficiaries across empanelled public and private hospitals in Maharashtra. The scheme covers treatment for a wide range of serious illnesses, including cardiac diseases, cancer, kidney disorders and major surgeries, helping reduce out of pocket healthcare expenditure.

Healthcare experts said robust fraud detection mechanisms are essential to maintain the credibility and sustainability of public health insurance programmes. They noted that regular audits, digital claim verification and technology driven surveillance can help prevent misuse while ensuring that benefits reach genuine patients.

The SIT investigation reflects Maharashtra’s continued efforts to strengthen governance of its flagship health insurance schemes, improve financial oversight and ensure transparent delivery of quality healthcare services to eligible beneficiaries.