Jaipur: The health dept has removed 69 pharmacies from the empanelled list of the Rajasthan Govt Health Scheme (RGHS) after audits flagged alleged overbilling, suspicious claims, non-supply of medicines and billing of generic drugs as branded products.This covers 58 allopathic and 11 ayurvedic pharmacies.Drug licences of 14 allopathic pharmacies have already been cancelled, with similar action recommended for an additional 44, in addition to 11 ayurvedic outlets.Of the 69, ten pharmacies accused of charging patients above market rates have been temporarily shut. The health dept has also stepped up surveillance to curb inflated pricing, abnormal MRPs, incorrect billing and unverifiable claims.Principal secretary (Health and Medical Education), Gayatri Rathore, said all reimbursement claims submitted by RGHS-empanelled pharmacies must be backed by purchase bills, GST invoices, stock registers and other authentic records. Compliance with mandatory RGHS discounts will also be strictly enforced, she added.Empanelled pharmacies have also been directed to upload manufacturer-approved pack sizes, product codes and MRPs while filing claims. Any excess payments arising from incorrect packaging details or product mapping will be recovered from individual pharmacies, with strict action to be initiated in cases of repeated or serious violations.Rathore said departmental investigations have also found instances of doctors prescribing Ayush medicines worth over Rs 10,000 for common ailments such as constipation and weakness, causing avoidable financial burdens on the state exchequer.Recovery and disciplinary proceedings have been initiated against doctors and pharmacies found guilty of such practices, she added.The health dept is also auditing pharmacies that have been found to supply medicines at unusually high prices. In one case, officials found that a 60mg Denosumab injection (used to treat osteoporosis and skeletal complications) was billed at Rs 18,000, when it is available in the market for around Rs 6,500.Purchase bills and related records have been sought from pharmacies suspected of such pricing and other procurement irregularities.Pharmacies that failed to supply medicines to RGHS beneficiaries have been asked to show cause, while suspension proceedings have been initiated against those that have not supplied medicines under the scheme for over a month.Past claims for such pharmacies will be audited and put through a system-based verification.The health dept added that pharmacies with transparent practices and consistent compliance will be recognised with a ‘Green Flag’ rating.
