Nitin Jain
Directors, hospital staff booked for conspiracy, cheating; fake records, forged signatures, cash trail under probe; raids uncover organised medical billing fraud network
n a massive crackdown on organised healthcare corruption, the Central Bureau of Investigation (CBI) has unearthed a multi-crore fraud targeting the Ex-Servicemen Contributory Health Scheme (ECHS).
The agency has booked directors of a healthcare firm and doctors of several leading private super-specialty hospitals for allegedly siphoning off government funds through fabricated medical claims.
The CBI has conducted the searches across Chandigarh and Mohali, unearthing crucial evidence pointing to an organised network.
According to a senior CBI official privy to the ongoing investigation, who spoke exclusively to The Tribune on Friday evening, the case has been registered in Chandigarh on the basis of source information regarding large-scale irregularities in ECHS claims.
Named accused in FIR include Dr Vikas Sharma and Dr Rimple Gupta, both Directors of M/s Manthan Health Care, Sector 38, Chandigarh; M/s Manthan Health Care; Dharam Hospital Pvt. Ltd., Sector 15, Chandigarh; Kare Partner Heart Centre, Sector 19, Chandigarh; Manjeet Singh, bill clerk at Kare Partner Heart Centre; Parveen Kumar, bill clerk at Manthan Health Care; and unknown officials of ECHS polyclinics/regional centre.
The FIR, a copy of which is with The Tribune, also notes that the role of other leading hospitals — Amar Hospital, Shalby Hospital, 1H Plus Med Park Hospital in Mohali and Eden Critical Care Hospital in Chandigarh besides several public servants — will be examined during the course of investigation.
The FIR has been registered under Sections 120-B (criminal conspiracy), 420 (cheating) and 471 (using forged documents) of the IPC, with relevant provisions of the Bharatiya Nyaya Sanhita, along with Sections 13(2) read with 13(1)(d) of the Prevention of Corruption Act, 1988.
The case stems from credible source information received by the CBI on February 23, 2026, indicating systematic manipulation of ECHS reimbursement processes between 2018 and 2026. Acting on this, the agency conducted a joint surprise check on February 24 at Manthan Health Care and Dharam Hospital in the presence of ECHS vigilance officials.
The complaint details reveal that the accused allegedly operated a well-organised fraud mechanism by misusing emergency admission provisions, manipulating referral systems, fabricating medical and diagnostic records, and inflating treatment and pharmacy bills to siphon off government funds.
Modus operandi unearthed
Investigations so far indicate that Manthan Health Care, despite not being empanelled under ECHS, was allegedly operating in collusion with empanelled hospitals. The ECHS desk of Dharam Hospital was effectively run from Manthan’s premises, where official stamps, blank letterheads and digital signature credentials of the hospital were found.
CBI sources said claims were processed and uploaded on the ECHS portal in the name of Dharam Hospital from Manthan’s facility, pointing to unauthorised diversion of a regulated system.
The FIR also flags fabrication of documents on a large scale, including emergency admission letters, prescriptions, pathology reports and discharge summaries. Signatures of doctors were allegedly forged, while some diagnostic reports were found fake, with laboratories denying issuance.
Patient routing & fake admissions
The probe has revealed a pattern of abnormal admissions where ECHS beneficiaries were allegedly identified and routed through intermediaries to select hospitals. Many cases were shown as emergencies without adequate clinical basis to secure higher reimbursements.
Specific instances cited in the FIR include repeated admissions of certain patients across hospitals such as Dharam Hospital, Kare Partner Heart Centre and Eden Critical Care Hospital within short intervals for similar ailments, indicating orchestrated hospitalisation for claim generation.
Financial links & commission trail
Investigators have also found evidence of structured financial arrangements, including referral-based commissions and revenue-sharing models. Documents indicate a 50:50 revenue-sharing understanding between Manthan Health Care and Dharam Hospital, along with per-patient payments to intermediaries.
WhatsApp chats recovered during the checks allegedly show prior coordination on patient admissions, discharge timing and preparation of medical records, suggesting post-facto fabrication to support inflated claims.
Raids & recoveries
The CBI conducted extensive searches on Thursday across multiple locations in Chandigarh and Mohali, including residences of the accused and hospital premises. Officials seized mobile phones, unaccounted cash, property documents, and a large volume of medical records, billing files, referral papers and agreements.
Data relating to ECHS beneficiaries, admission patterns and financial transactions between the entities is now under scrutiny to establish the full scale of the alleged conspiracy.
The probe is ongoing, with the CBI looking into the possible involvement of public servants and the extent of financial loss to the exchequer, the official added.