The Special Operations Group (SOG) has arrested two individuals in Sikar, Rajasthan, in connection with a multi-crore fraud under the Rajasthan Government Health Scheme (RGHS), police said Monday. Those detained are Dr Kamal Kumar Agrawal, an associate professor in Orthopaedics at SK Hospital, Sikar, and Dr Banwari Lal, operator of a private diagnostic lab in the same city.

Investigations reveal a collusion between doctors and lab operators to generate fake prescriptions and diagnostic reports, including MRI scans, to claim reimbursements from the state government. Authorities say tests were billed as 'contrast MRI' instead of normal scans, multiple reports were created for single tests, and claims were filed on days when doctors were absent or patients had not visited.

The fraud also involved altering report dates and submitting claims in patients' names without their presence, including one case where a report dated December 4, 2023, was changed to December 5 to secure payment. Referrals from private doctors were manipulated to appear as if issued by government doctors to meet RGHS eligibility criteria.

The case was registered following a complaint from the state health department. Additional Director General of Police (SOG) Vishal Bansal stated the fraud undermined the scheme's integrity and harmed genuine beneficiaries. He confirmed the investigation is expanding to identify other involved personnel.

Further legal action will be taken against all individuals found complicit, police said, as the SOG continues its probe into the network of medical professionals and lab staff linked to the fraudulent claims. The next steps include forensic audit of portal records and cross-verification of patient data.