Misc. Application No. 2002 of 2022 · The High Court · 2025

Presence: Mr. R.S. Sammal, learned counsel with Ms. Sarita Bisht and Mr. Piyush Sammal, learned counsel for Applicants. Mr. S.S. Chauhan, learned Deputy Advocate General for State of Uttarakhand. Criminal Misc. Application Nos.2002 of 2022 ------- Dr. Vishal Hussain vs. State of Uttarakhand & Another with Criminal Misc. Applications Nos.382 of 2023, 385 of 2023 and 1852 of 2023. 1 Ashish Naithani J. Hon’ble Ashish Naithani, J. These four petitions have been instituted under Section 482 of the Code of Criminal Procedure seeking quashing of the charge-sheets, cognizance orders and all consequential criminal proceedings arising out of multiple FIRs relating to alleged fraudulent claim submissions under the Atal Ayushman Uttarakhand Yojana by Jan Seva Hospital, Kashipur, District Udham Singh Nagar. Criminal Misc. Application No. 2002 of 2022 was filed first, followed by Criminal Misc. Applications Nos. 382 of 2023, 385 of 2023 and 1852 of 2023, each arising from the same factual matrix, investigation, and set of allegations. Owing to the common questions of fact and law, all four matters were directed to be heard together.

2. On 10.11.2022, this Court granted interim protection against coercive action in C-482 No. 2002 of 2022, which protection was subsequently extended to the connected petitions. The order-sheets and cognizance orders of the trial courts were summoned to ascertain the nature of proceedings and the manner of service of summons upon the applicants.

3. Jan Seva Hospital, Kashipur, where the applicants were engaged in various administrative and medical capacities, was empanelled as an Empanelled Health Care Provider (EHCP) under the Atal Ayushman Uttarakhand Yojana pursuant to an agreement executed on 18.12.2018. Under the scheme, the State Health Agency (SHA) reimburses treatment costs for eligible beneficiaries based on hospital-submitted claims supported by treatment records and documentation. Criminal Misc. Application Nos.2002 of 2022 ------- Dr. Vishal Hussain vs. State of Uttarakhand & Another with Criminal Misc. Applications Nos.382 of 2023, 385 of 2023 and 1852 of 2023. 2 Ashish Naithani J.

4. During verification of claim submissions, the SHA identified discrepancies concerning treatment sheets, referral slips purportedly issued from PHC Kelakhera, availability of medical specialists, and the genuineness of several diagnostic and treatment documents. Accordingly, a show-cause notice dated 10.06.2019 was issued to the hospital outlining allegations of inflated treatment particulars, manipulated patient records, and misrepresentation in the empanelment and claim process.

5. The hospital submitted a written response; however, upon consideration of the reply and audit findings, the SHA passed an order dated 11.07.2019 determining that a sum of ₹6,66,000 had been wrongly claimed under the scheme. The hospital was directed to deposit the said amount, which was thereafter refunded in two instalments₹2,07,000 on 05.09.2019 and ₹4,59,000 on 04.10.2019.

6. Parallel to the administrative proceedings, criminal law was set into motion. FIR No. 0317 of 2019 was lodged on 26.07.2019 alleging that false, fabricated and forged medical record such as admission papers, diagnostic sheets, treatment charts and discharge summaries had been created and used to raise Ayushman claims. Two additional FIRs pertaining to the same course of conduct were subsequently registered.

7. Investigation into these allegations culminated in the submission of multiple charge-sheets: Charge-sheet No. 76/2021 dated 04.03.2021, Charge-sheet No. 76A/2021 dated 19.08.2021, Charge-sheet No. 77A/2021 dated 19.08.2021, and Charge-sheet No. 267A/2020 dated

28.08.2021, implicating the present applicants for offences under Sections 420, 467, 468 and 471 IPC. Cognizance was taken by the Criminal Misc. Application Nos.2002 of 2022 ------- Dr. Vishal Hussain vs. State of Uttarakhand & Another with Criminal Misc. Applications Nos.382 of 2023, 385 of 2023 and 1852 of 2023. 3 Ashish Naithani J. learned Magistrate on 07.04.2021, 15.09.2021 and 13.10.2021, and summons were issued. The order-sheets reflect that summons were duly served; however, upon non-appearance, bailable warrants were issued.

8. Aggrieved by the initiation and continuation of the aforesaid criminal proceedings, the applicants have approached this Court seeking quashing of the FIRs, charge-sheets, cognizance orders and all consequential proceedings.

9. Shri R.S. Sammal, learned counsel for Applicant Dr. Vishal Hussain, submitted that the allegations forming the basis of the FIRs and charge-sheets arise out of administrative and contractual issues between the hospital and the State Health Agency under the Ayushman scheme. It is contended that the discrepancies pointed out in the show- cause notice dated 10.06.2019 pertain to interpretation of scheme guidelines and documentation protocols, and do not constitute criminal offences.

10. Learned counsel argued that the administrative proceedings concluded with the order dated 11.07.2019, determining the amount recoverable from the hospital, which amount was duly deposited on

05.09.2019 and 04.10.2019. According to learned counsel, once the alleged financial loss to the State has been restituted and the administrative dispute has been resolved, continuation of criminal proceedings would amount to abuse of the process of law.

11. Shri Sammal further submitted that the charge-sheet does not attribute to the applicant any specific overt act connecting him with the preparation of forged documents or uploading of fraudulent claims. It is argued that the applicant, being the Director of the hospital, cannot be saddled with vicarious criminal liability for every procedural lapse Criminal Misc. Application Nos.2002 of 2022 ------- Dr. Vishal Hussain vs. State of Uttarakhand & Another with Criminal Misc. Applications Nos.382 of 2023, 385 of 2023 and 1852 of 2023. 4 Ashish Naithani J. committed by subordinate staff. It is also submitted that several patients were in fact medically treated, and the allegations of fabrication are without factual foundation.

12. Piyush Sammal, learned counsel for Applicant Anurag Rawat in C-482 Nos. 382 of 2023, 385 of 2023 and 1852 of 2023, submitted that the applicant is a Government Pharmacist whose official duties, as reflected in the duty rosters, do not include preparation of Ayushman claims or uploading of treatment records. Learned counsel argues that the applicant’s implication is solely on the basis of his name or signatures appearing on certain treatment sheets, which, according to him, reflects routine hospital duties and not participation in any fraudulent activity.

13. Learned counsel contended that there is no material in the charge- sheets to show that the applicant fabricated any record, manipulated patient details or benefitted from the claims. It is submitted that no patient has alleged non-treatment or misrepresentation against the applicant, and therefore invocation of Sections 420, 467, 468 and 471 IPC is wholly unjustified.

14. It is further argued by Shri Piyush Sammal that the cognizance orders and subsequent bailable warrants are vitiated for want of proper service of summons. Learned counsel submits that the applicant was never served with the initial process, yet the trial court proceeded to issue bailable warrants, thereby violating the procedure prescribed under the Code.

15. Shri V.S. Rathore, learned A.G.A. appearing for the State, opposed the petitions and submitted that the investigation has revealed Criminal Misc. Application Nos.2002 of 2022 ------- Dr. Vishal Hussain vs. State of Uttarakhand & Another with Criminal Misc. Applications Nos.382 of 2023, 385 of 2023 and 1852 of 2023. 5 Ashish Naithani J. deliberate manipulation of hospital records, including fabrication of admission papers, treatment charts, diagnostic reports and discharge summaries, all created with the intention of raising fraudulent claims under the Ayushman scheme. Learned A.G.A. submits that the charge- sheets contain specific instances of forged documents and inflated treatment narratives, supported by documentary evidence obtained during investigation.

16. It is submitted that financial recovery made during administrative proceedings does not absolve criminal liability. Learned A.G.A. emphasises that offences involving misappropriation of public funds and fraudulent use of a government welfare scheme constitute economic offences affecting public interest, and therefore must be dealt with seriously. Even if patients received some form of treatment, the use of forged documents to claim higher reimbursements remains punishable.

17. On the issue of service of summons, Shri Rathore drew attention to the order-sheets of the Magistrate, which, according to him, clearly record that summons were duly served upon the applicants on

15.09.2021 and subsequent dates. The issuance of bailable warrants was necessitated only because the applicants failed to appear despite service. Learned A.G.A. therefore submits that the plea of non-service is untenable.

18. Shri Rathore lastly argued that the contentions raised by the applicants relate to disputed questions of fact such as the authenticity of documents, role of each individual, and whether forgery actually occurred, which cannot be adjudicated in proceedings under Section Criminal Misc. Application Nos.2002 of 2022 ------- Dr. Vishal Hussain vs. State of Uttarakhand & Another with Criminal Misc. Applications Nos.382 of 2023, 385 of 2023 and 1852 of 2023. 6 Ashish Naithani J. 482 Cr.P.C. It is submitted that the charge-sheets disclose a prima facie case, and no ground exists for quashing.

19. Heard learned counsel for the parties and perused the records.

20. The principal contention of learned counsel for the applicants is that the allegations arise out of administrative discrepancies in the operation of the Ayushman scheme and, at their highest, reflect procedural irregularities rather than criminal intent. While it is correct that the relationship between the hospital and the State Health Agency is grounded in a contractual framework, the allegations contained in the FIRs and recorded in the charge-sheets cannot be characterized as purely administrative. The investigation refers to specific patient records, treatment sheets, referral slips and discharge summaries which are alleged to have been created or manipulated for the purpose of claim submission. Whether these documents were in fact fabricated is a matter to be established on evidence; however, the presence of such allegations supported by material in the charge-sheets takes the matter outside the realm of a simple contractual dispute.

21. The submission that recovery of ₹6,66,000 pursuant to the administrative proceedings concludes the matter and negates criminal liability also cannot be accepted at this stage. The administrative determination addressed the issue of wrongful claim amounts and resulted in restitution of funds. Criminal proceedings, on the other hand, concern the legality of the acts through which such claims were allegedly generated. The two processes operate in distinct spheres. Restitution may bear upon the quantum of loss; it does not, by itself, erase or nullify an allegation of forgery or cheating if such acts are otherwise made out. Criminal Misc. Application Nos.2002 of 2022 ------- Dr. Vishal Hussain vs. State of Uttarakhand & Another with Criminal Misc. Applications Nos.382 of 2023, 385 of 2023 and 1852 of 2023. 7 Ashish Naithani J.

22. As regards the role attributed to Applicant Dr. Vishal Hussain, it is correct that criminal liability cannot be fastened solely on the basis of designation or supervisory position. Nonetheless, the charge-sheet attributes to him an overall role in the functioning of the institution under which the questioned claims were generated. Whether he had knowledge of or participation in any alleged fabrication is a matter that requires appreciation of evidence and cannot be conclusively determined in proceedings under Section 482 Cr.P.C. At this stage, the Court is confined to examining whether the material collected during investigation, if accepted at face value, discloses the ingredients of the offences alleged. The charge-sheet, on its face, does so.

23. Insofar as the three petitions filed by Applicant Anurag Rawat are concerned, his primary submission is that, being a Government Pharmacist, he had no responsibility for Ayushman documentation, and that his signatures on treatment sheets reflect routine hospital duties. The nature of his involvement, the capacity in which his signatures appear on specific documents, and whether such involvement indicates knowledge of any irregularity are all questions that require appreciation of evidence. These aspects cannot be adjudicated inherent jurisdiction, which is limited to cases where, even assuming the entire material to be true, no offence is made out.

24. The plea of non-service of summons was also pressed on behalf of Applicant Anurag Rawat. The order-sheets of the learned Magistrate, copies of which were placed on record, indicate that summons were served on 15.09.2021 and thereafter. Whether service was in fact effected is a matter within the factual jurisdiction of the trial court, which has already recorded a finding on service. At any rate, such a ground, by itself, would not justify quashing of proceedings, Criminal Misc. Application Nos.2002 of 2022 ------- Dr. Vishal Hussain vs. State of Uttarakhand & Another with Criminal Misc. Applications Nos.382 of 2023, 385 of 2023 and 1852 of 2023. 8 Ashish Naithani J. particularly when the applicants have already approached this Court and obtained interim protection.

25. The scope of jurisdiction under Section 482 Cr.P.C. is well- settled. The Court does not conduct a mini-trial, weigh the sufficiency of evidence, or determine disputed factual matters. Interference is warranted only in cases where the allegations do not disclose any offence, or where the proceedings are manifestly attended with mala fides, or fall within the limited categories recognised in judicial precedent. The present cases do not satisfy those parameters. The FIRs and charge-sheets disclose specific factual allegations, supported by material collected during investigation, which require examination during trial.

26. In view of the foregoing, this Court is of the opinion that no ground is made out to quash the charge-sheets, cognizance orders or subsequent proceedings in exercise of inherent jurisdiction under Section 482 Cr.P.C. The issues raised by the applicants pertain substantially to disputed questions of fact and must be adjudicated in the course of trial. ORDER For the reasons recorded hereinabove, this Court is satisfied that the FIRs and the charge-sheets in question disclose a prima facie case for the offences alleged and that none of the grounds warranting exercise of inherent jurisdiction under Section 482 of the Code are attracted. The issues raised by the applicants pertain to the genuineness of documents, the nature of their respective roles and the manner in which the claims were processed matters which can be effectively examined only upon evaluation of evidence during trial. Criminal Misc. Application Nos.2002 of 2022 ------- Dr. Vishal Hussain vs. State of Uttarakhand & Another with Criminal Misc. Applications Nos.382 of 2023, 385 of 2023 and 1852 of 2023. 9 Ashish Naithani J. Consequently, Criminal Miscellaneous Application No. 2002 of 2022, Criminal Miscellaneous Application No. 382 of 2023, Criminal Miscellaneous Application No. 385 of 2023, and Criminal Miscellaneous Application No. 1852 of 2023 are dismissed. All interim orders, including the interim protection granted on 10.11.2022 and continued from time to time, shall stand vacated. The applicants shall appear before the concerned trial courts on the dates fixed, or on any date that may be specified by the learned Magistrate. It shall be open to the applicants to move appropriate applications before the trial court, including applications for exemption or bail, which shall be considered in accordance with law and on their own merits.

11.11.2025 Arti Ashish Naithani, J. Criminal Misc. Application Nos.2002 of 2022 ------- Dr. Vishal Hussain vs. State of Uttarakhand & Another with Criminal Misc. Applications Nos.382 of 2023, 385 of 2023 and 1852 of 2023. 10 Ashish Naithani J.