Chandigarh: The Central Bureau of Investigation (CBI), probing an alleged major fraud in the Ex-Servicemen Contributory Health Scheme (ECHS), has uncovered several startling details. According to the investigating agency, fraudulent medical records and allegedly inflated bills were used to obtain medical reimbursements from the government. The preliminary investigation suggests that the alleged scam could be worth more than ₹100 crore.
The investigation has found allegations that patients were shown as admitted to hospitals even when hospitalization was not required. In some cases, the same patient was allegedly shown as admitted to different hospitals on different dates. Fake test reports, medical documents and inflated medicine bills were allegedly prepared and submitted to claim reimbursements under the ECHS.
The CBI has registered a case against eight accused, including Manthan Healthcare, Dharam Hospital, Care Partner Heart Centre and two billing clerks. The agency is now preparing to file a chargesheet in the case. During the investigation, the role of Manthan Healthcare directors Dr. Vikas Sharma and Dr. Rimple Gupta has also been examined, with the agency allegedly identifying them as key figures behind the suspected fraud.
According to the investigating agency, Manthan Healthcare, located in Sector 38, was not itself empanelled under the ECHS. Despite this, its directors allegedly worked in coordination with other hospitals to prepare fabricated patient records and use them to obtain medical reimbursements under the scheme. The role of the ECHS desks at Dharam Hospital in Sector 15 and Care Partner Heart Centre in Sector 19 is also under investigation.
Alleged manipulation from emergency admission to referral
The investigation has indicated the possibility of an organised network operating through hospital admission and referral procedures. Patients were allegedly shown as emergency admissions even when such hospitalization was not necessary. Records were subsequently prepared showing referrals to other hospitals, where further treatment was allegedly documented.
Medical examinations, diagnostic reports and medicine bills were then allegedly generated as part of the reimbursement claims submitted under the ECHS.
According to renowned cybercrime expert and former IPS officer Prof. Triveni Singh, digital health records and billing data can play an important role in identifying organised fraud of this nature. He said unusual patterns in patient admissions, diagnostic tests, medicines and payments across different institutions can help investigators identify links between multiple entities. Systematic data matching can also help establish whether records represent genuine treatment or repeated use of patient details for fraudulent claims.
Same patients allegedly shown admitted at multiple hospitals
During the investigation, records relating to several patients, including Hemadevi, Baldev Ram, Tek Chand and Sandhya Devi, have reportedly emerged. These patients were allegedly shown as being admitted to different hospitals on multiple occasions. The CBI is now matching hospital records with the relevant dates to determine whether the patients were actually admitted or whether their identities were allegedly used only to obtain reimbursements.
The investigating agency has also recovered an alleged agreement between Manthan Healthcare and Dharam Hospital. Although the document reportedly does not carry signatures, it allegedly contains a provision for dividing the proceeds from the suspected fraudulent claims equally between the parties. The CBI is examining the authenticity of the document, possible financial transactions and the role of the people associated with it.
The investigation is expected to establish the actual scale of the alleged fraudulent claims and determine whether other hospitals, employees or individuals were involved. The scope of the case is likely to become clearer once the CBI files its chargesheet and places the evidence collected during the investigation before the court.
About the author — Suvedita Nath is a science student with a growing interest in cybercrime and digital safety. She writes on online activity, cyber threats, and technology-driven risks. Her work focuses on clarity, accuracy, and public awareness.
