RGHS Pre-Authorisation System Causes 47% Dip in Claims
The TMS of nine hospitals and the doctor IDs of three doctors have been blocked following investigations
UdaipurTimes, Sept 24, 2026 - The pre-authorisation system introduced in Rajasthan under the Mukhyamantri Ayushman Arogya Yojana (RGHS) to increase transparency and curb unnecessary investigations has resulted in a 47 per cent reduction in claims, according to a government press release.
Under this new system, which came into effect on July 15 under the direction of Chief Minister Bhajan Lal Sharma and Medical and Health Minister Gajendra Singh Khimsar, pre-authorisation has been made mandatory for investigations costing more than Rs 2,000.
RGHS Project Officer Dr Nidhi Patel informed that a 47 per cent reduction in claims has been recorded following this. Practices of scheduling investigations on different days to keep investigations costing more than Rs 2,000 outside the scope of pre-authorisation are being identified through digital monitoring. In some cases, patients were called back to the hospital repeatedly on different days within a three-day period for investigations.
As part of this action, the TMS of nine hospitals and the doctor IDs of three doctors have been blocked following investigations.
The TMS of two hospitals in Kota has been blocked. In both cases, it was found the same doctor had worked at both hospitals on the same day. The doctor's ID was also blocked in connection with the case.
At a hospital in Alwar, prescriptions issued in the name of one doctor were found to have different handwriting and signatures. At another hospital in Alwar, several OPD prescriptions were found to have a similar pattern of the doctor's stamp and signature. At a hospital in Jodhpur, two different handwriting styles and two different signature patterns were found on prescriptions issued in the name of a doctor.
In Dausa, a hospital was found to have prescribed investigations without adequate clinical findings and justification, as well as recommending more investigations than necessary. At another hospital in Dausa, irregularities including differences between signatures on digital prescriptions and those on manual prescriptions were found.
At a hospital in Alwar, polyethylene glycol was prescribed in around 65 cases, and in several cases the relevant clinical indication for its use was not recorded. In many cases, serum iron tests were also prescribed without clear symptoms, clinical findings or diagnosis.
The doctor ID of a doctor associated with a hospital in Bikaner has also been blocked. A case was identified in which the same investigations were repeatedly prescribed despite complaints from different patients.
The ID of a doctor associated with a hospital in Jaipur was blocked after different handwriting was found. In addition, the TMS of a hospital in Udaipur has also been blocked in connection with various cases.
