NHA Showcases AI Innovations for Transparency in India’s Digital Health System

The National Health Authority (NHA) has unveiled its pioneering use of Artificial Intelligence (AI) to enhance transparency, integrity, and accountability across India's digital health ecosystem. The initiative was presented during a high-level workshop organised by the Central Vigilance Commission (CVC) at Bharat Mandapam, New Delhi, as part of Vigilance Awareness Week 2025.

A Vision for Ethical and Efficient Digital Governance

The workshop, themed "Transforming Public Service Delivery: Potential Applications of AI in Health Systems," brought together senior policymakers, digital governance experts, and public sector innovators to explore how AI can transform public institutions by improving efficiency, promoting ethical conduct, and reducing systemic vulnerabilities.

Participating as a distinguished speaker, Dr. Sunil Kumar Barnwal, IAS, CEO of the NHA, delivered an insightful presentation titled "Fraud Detection in Government Health Schemes using AI." He showcased the NHA's advanced use of AI and Machine Learning (ML) to strengthen integrity management under the flagship Ayushman Bharat Digital Mission (ABDM) and Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB PM-JAY).

AI for Fraud Prevention and Real-Time Vigilance

Dr. Barnwal outlined how AI-driven tools are being used to detect, prevent, and resolve fraudulent activities within large-scale government health schemes. "Artificial Intelligence and Machine Learning are revolutionizing the world's largest public health assurance scheme—shifting the paradigm from reactive fraud detection to proactive integrity management," he said.

He explained that through sophisticated data analytics, anomaly detection models, and predictive algorithms, the NHA can identify irregular claim patterns, duplicate entries, and potential misuse of funds in real time. This ensures that resources are channelled to genuine beneficiaries while deterring malpractice among healthcare providers.

"This transformation is enabling greater transparency, accountability, and equity in every citizen's healthcare journey," Dr. Barnwal noted, adding that AI integration has made fraud prevention a continuous and adaptive process, capable of responding to evolving threats.

Ensuring Efficient Use of Public Resources

Under the AB PM-JAY, which provides health coverage to over 500 million citizens, maintaining integrity is paramount. The NHA's proactive adoption of AI-based monitoring systems has significantly improved operational efficiency, claims validation, and service delivery across hospitals and insurance networks.

The NHA's analytics-driven systems help cross-verify claims against demographic, clinical, and geographical data, allowing investigators to flag anomalies early. This approach minimizes human error and strengthens preventive vigilance mechanisms, ensuring that public funds are used effectively to deliver quality healthcare.

Collaborative Focus on Governance and Integrity

The CVC-organised workshop served as a platform for inter-ministerial collaboration on ethical governance and the use of emerging technologies to combat corruption. The discussions were structured around two key sessions:

1. AI and Emerging Technologies: Past, Present, and Future – exploring the evolution of AI and its integration in governance, health, and finance.

2. Leveraging AI for Operational Efficiency and Preventive Vigilance – focusing on how AI can enhance transparency, improve risk management, and streamline public service delivery.

Senior officials from the Ministry of Health and Family Welfare, the Ministry of Electronics and Information Technology, and other government departments attended, alongside representatives from AI research institutions, start-ups, and data security organisations.

NHA's Commitment to Digital Health Transformation

The NHA, as the implementing agency for the Ayushman Bharat Digital Mission, continues to build a robust, interoperable health data ecosystem that promotes secure and transparent service delivery. By embedding AI into its operational framework, the authority aims to make India's health system more data-driven, citizen-centric, and fraud-resistant.

Dr. Barnwal reaffirmed the NHA's vision of harnessing emerging technologies to enhance governance integrity, improve patient outcomes, and build public trust. "Technology must serve not just efficiency but ethics. Every innovation we adopt must contribute to a more transparent, accountable, and equitable health system," he said.

A Step Toward Smarter, Transparent Governance

The use of AI in public healthcare oversight represents a broader trend in India's governance reform—integrating technology with vigilance to ensure ethical administration and optimal use of taxpayer money.

Experts at the event agreed that the NHA's model could serve as a blueprint for other public sector organisations, demonstrating how AI can be responsibly leveraged to enhance integrity, detect anomalies, and empower oversight mechanisms without compromising citizens' data privacy.

As India continues to expand its digital public infrastructure, the NHA's initiatives stand as a testament to how innovation can reinforce trust in governance while ensuring that healthcare delivery remains efficient, fair, and corruption-free.