Five players in the data and analytics field will compete to detect malpractice in hospitals that are part of the Indian government’s flagship health insurance plan Pradhan Mantri Jan Arogya Yojana under Ayushman Bharat, for a period of six months. The best performer among the five will be taken on board as Ayushman Bharat’s official fraud and abuse detection firm.
The firms are:
LexisNexis, headquartered in New York City
Optum, based in Eden Prairie, MN
SAS Institute, based in Cary, North Carolina
MFX, based in Bridgewater, NJ
Greenojo, headquartered in Bhubaneshwar, India
Dr. Indu Bhushan, chief executive of Ayushman Bharat, said, “These are major companies and among the best in the world. They have a lot of experience in detecting fraud and abuse of such projects. For the first six months, the firms will be working free of cost. Once the best company is taken on board, their team will get outcome-based payment depending on the fraud they have detected.”
While the private sector caters to over 60 percent of the beneficiaries under Ayushman Bharat, there have been reports of a spurt in certain procedures, or certain hospitals getting more number of patients than others. The five firms will help detect such irregularities through different algorithms that can trigger alerts for suspicious transactions.
Healthcare initiatives are prone to fraud, abuse, and leakages, which not only impact the plan but are also a risk to public health. Fraud detection mechanisms are common globally and India’s National Health Agency is studying global best practices before finalizing a partnership pact.
Last updated: December 26th, 2025
