Health scheme fraud worth crores exposed in Rajasthan, doctor and lab operator arrested

The Special Operations Group uncovers a nexus between doctors and lab operators exploiting the Rajasthan Government Health Scheme through fake prescriptions and inflated diagnostic claims

PGurus Newsdesk

May 5, 2026

Rajasthan SOG busts crores-worth RGHS fraud, arrests two

A case has been registered following a complaint from the health department, and further investigations are underway

A major fraud involving the Rajasthan Government Health Scheme (RGHS) has been uncovered by the Special Operations Group, with authorities alleging financial losses worth crores to the state exchequer.

According to Additional Director General of Police Vishal Bansal, the irregularities surfaced during an investigation into the implementation of the flagship healthcare scheme, which is designed to provide free and accessible treatment to citizens and government employees.

Fake prescriptions and inflated claims

Investigators found that the fraud was orchestrated through a nexus between certain doctors and private laboratory operators. The accused allegedly generated fake prescriptions and diagnostic reports to claim reimbursements from the government.

Two individuals have been arrested in connection with the case:

Kamal Kumar Agrawal, an associate professor of orthopaedics at SK Hospital in Sikar
Banwari Lal, a private lab operator how the scam worked.

Police said the accused prescribed unnecessary diagnostic tests—including expensive MRI scans—often without examining patients or even in their absence.

Fake reports were then uploaded to the RGHS portal to claim reimbursements. In several cases:

Standard MRI scans were falsely billed as “contrast MRI” to inflate costs
Multiple reports were generated for a single test to increase claims
Prescriptions were issued on days when doctors were not present
Dates on reports were manipulated to secure payments

In one instance, an MRI report dated December 4, 2023, was altered to December 5 to enable reimbursement, despite the patient not being present in Sikar on that day. In another case, claims were filed in the name of a patient admitted to a different hospital.

Officials also found that referrals from private doctors were altered to appear as if they were issued by government doctors, making them eligible under the scheme.

Impact and investigation

Authorities said the fraudulent practices not only caused significant financial losses but also deprived genuine beneficiaries and undermined trust in the scheme.

“The fraudulent practices have not only caused significant financial losses to the state but have also affected genuine beneficiaries and undermined the credibility of the scheme,” Bansal said.

A case has been registered following a complaint from the health department, and further investigations are underway to identify additional individuals involved. Police have indicated that strict legal action will be taken against all those found guilty.

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