SIT to probe MJPJAY fraud in Nashik: Maharashtra CM Fadnavis orders inquiry
Synopsis
Over 9,500 suspicious health insurance claims concentrated in a single district — Nashik — have forced Maharashtra CM Devendra Fadnavis to order an SIT probe into MJPJAY, with AI set to scan 13 lakh potentially fraudulent cases. The scale of alleged fraud, and the speed of the political response, signals how deeply public health funds may have been compromised.
Key Takeaways
Maharashtra CM Devendra Fadnavis ordered an SIT on 10 July to probe alleged fraud in the Mahatma Jyotirao Phule Jan Arogya Yojana (MJPJAY) in Nashik district .
A state audit flagged approximately 16,000 suspicious claims statewide; 9,500 of those were in Nashik alone.
Nashik Regional Commissioner Praveen Gedam will head the SIT, which includes multi-department experts.
Five hospitals in Nashik have already been de-panelled and de-registered following initial findings.
AI and advanced analytics will be used to scrutinise around 13 lakh potentially fraudulent claims ; the Maharashtra Cyber Police will also be integrated.
Dedicated fraud-prevention units are to be set up in every district, supported by a real-time monitoring dashboard.
Maharashtra Chief Minister Devendra Fadnavis on Friday, 10 July ordered the formation of a Special Investigation Team (SIT) to probe alleged malpractices in the Mahatma Jyotirao Phule Jan Arogya Yojana (MJPJAY) in Nashik district, after a state audit flagged nearly 9,500 suspicious claims concentrated in the region alone. The announcement came during a high-level joint review meeting of the Ayushman Bharat–Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) and MJPJAY held at the State Legislature in Mumbai.
Scale of the Alleged Fraud
A routine inspection conducted by the State Health Assurance Society covering the period 2024 to 2026 flagged approximately 16,000 suspicious claims and surgeries across Maharashtra. Of these, 9,500 cases — more than half — were detected in Nashik district alone, pointing to a concentrated pattern of alleged misuse. Acting swiftly on initial findings, the state government has already de-panelled and cancelled the registration of five hospitals in Nashik.
The detailed briefing on Nashik irregularities was presented to the House by MLA Rahul Aher, which reportedly prompted rapid intervention from the Chief Minister's office.
Who Will Lead the SIT
Nashik Regional Commissioner Praveen Gedam will head the SIT, which will include experts drawn from various government departments. The probe team will have a clear mandate: conduct a thorough investigation, take strict action against those found guilty, recover misappropriated funds, and put in place robust safeguards to prevent future fraud.
The meeting was attended by Revenue Minister Chandrashekhar Bawankule, Public Health Minister Prakash Abitkar, Minister of State for Public Health Meghna Sakore Bordikar, MLA Rahul Aher, DGP Sadanand Date, and senior health department officials.
Technology Deployed to Clean Up the System
Beyond the SIT, the state government has outlined a technology-driven overhaul of the health insurance framework. Artificial intelligence (AI) and advanced analytical tools will be used to scrutinise around 13 lakh potentially fraudulent claims. The Maharashtra Cyber Police will be integrated into the system to monitor and crack down on digital fraud within healthcare transactions.
High-value medical claims and flagged accounts will undergo forensic accounting and independent audits. Dedicated fraud-prevention units will be established in every district, backed by an advanced dashboard for real-time monitoring and swift action against anomalies.
Healthcare Infrastructure Expansion Also on the Agenda
Separately, the Legislature also took up the demand to upgrade Primary Health Centres (PHCs) in Mahuli, Jahangir, Ner, and Pingalai in Amravati district, raised through a calling-attention motion by MLA Rajesh Wankhede. MLA Harish Pimpale also participated in the discussion.
Health Minister Prakash Abhitkar noted that the current criteria for establishing PHCs, taluka and district hospitals, and sub-hospitals were fixed in 2013 based on the 2001 census — a framework now significantly out of step with population growth. He assured the House that the PHC upgradation demand for Amravati would receive positive consideration in the comprehensive master plan being drafted.
CM Fadnavis has separately articulated a vision to make quality healthcare facilities available within every five kilometres across Maharashtra, with the Public Health Department currently preparing a state-wide master plan aligned to this goal.
What Comes Next
With the SIT constituted and AI-driven scrutiny of 13 lakh claims underway, the coming weeks will test whether Maharashtra's response translates into recoveries and convictions — or remains at the level of administrative reshuffling. CM Fadnavis stated unequivocally that no corruption in public health schemes will be tolerated, and that quality, transparent healthcare for poor and needy citizens remains the state government's top priority.
Point of View
500 suspicious claims in a single district — Nashik — out of 16,000 flagged statewide is not a statistical anomaly; it suggests organised, localised exploitation of a scheme designed for the poorest citizens. The de-panelling of five hospitals is a start, but de-panelling without criminal prosecution has historically served as a pressure valve rather than a deterrent. The real test is whether the SIT produces charge-sheets and recoveries, not just administrative cancellations. Maharashtra's decision to deploy AI across 13 lakh claims is ambitious, but the state's track record on technology-driven healthcare governance remains unproven at scale.
NationPress
10 Jul 2026
Frequently Asked Questions
What is the MJPJAY fraud case in Nashik that triggered the SIT probe?
A routine audit by the State Health Assurance Society covering 2024 to 2026 flagged approximately 16,000 suspicious claims and surgeries across Maharashtra, with 9,500 of those concentrated in Nashik district alone. The scale of alleged malpractice in the Mahatma Jyotirao Phule Jan Arogya Yojana (MJPJAY) prompted Maharashtra CM Devendra Fadnavis to order an SIT probe on 10 July.
Who will lead the SIT and what is its mandate?
Nashik Regional Commissioner Praveen Gedam will head the SIT, which will include experts from various government departments. The team is mandated to investigate, take action against the guilty, recover misappropriated funds, and recommend preventive measures.
Which hospitals have been penalised so far?
Five hospitals in Nashik have already been de-panelled and had their registrations cancelled following the initial findings of the state audit. Further action is expected as the SIT investigation progresses.
How will technology be used to tackle the fraud?
The Maharashtra government plans to use AI and advanced analytical systems to scrutinise around 13 lakh potentially fraudulent claims. The Maharashtra Cyber Police will monitor digital fraud in healthcare transactions, and high-value claims will undergo forensic accounting and independent audits.
What is the broader healthcare reform plan announced alongside the fraud probe?
CM Fadnavis has outlined a vision to make quality healthcare available within every five kilometres across Maharashtra. The Public Health Department is drafting a comprehensive master plan, which will also consider upgrading Primary Health Centres in Mahuli, Jahangir, Ner, and Pingalai in Amravati district — a demand raised in the Legislature by MLA Rajesh Wankhede.
