34 Gurugram private hospitals under scrutiny over alleged extra charges under Govt Health schemes

Gurugram: Thirty-four private hospitals empanelled under government health schemes in Gurugram have been directed to submit treatment bills and discharge records for scrutiny following a Punjab and Haryana High Court order on compliance with prescribed treatment package rates.

The verification exercise is intended to determine whether private hospitals are charging beneficiaries in accordance with government-notified rates or levying additional amounts for services and medical items already covered under approved packages. The Civil Surgeon’s office has sought bills, discharge summaries and undertakings from patients’ attendants, along with details of the explanations hospitals provided regarding applicable scheme rates and charges.

The action follows a May 5 judgment in the case of Hukam Singh vs State of Haryana, which involved an 85-year-old retired Haryana government employee who underwent treatment for a heart condition at a private hospital in Panchkula in April 2023. He received a bill of Rs 7.4 lakh and challenged the reimbursement, alleging that the hospital had separately charged him for medicines, consumables and medical devices that were supposed to be included in the government-approved treatment package. 

While directing the state government to reimburse the entire bill with 6% interest, the High Court also asked the health department to examine whether all empanelled private hospitals were adhering to notified package rates and to take corrective action wherever violations were detected. The court directed the Director General of Health Services (DGHS) to conduct the verification, either directly or through authorised civil surgeons, TOI reported. 

According to TOI, the Gurgaon Civil Surgeon’s office has initiated the process by seeking records from 34 empanelled hospitals. The list includes Medanta, Artemis Hospitals, Fortis Memorial Research Institute, Paras Hospital, Park Hospital, Signature Hospital, Manipal Hospital, SG T Medical College Hospital and Research Institute, and Narayana Superspeciality Hospital, among others.

The hospitals have been instructed to submit their reports through a special messenger to the account branch of the Civil Surgeon’s office for onward transmission to higher authorities. The Chief Medical Officer confirmed that the exercise was underway and that details had already been received in some cases.

The scrutiny will help officials determine whether beneficiaries have been charged beyond the rates permitted under government health schemes and whether hospitals have adequately informed patients and their attendants about the applicable treatment packages.

Separately, the Ayushman Bharat-Haryana Health Protection Authority (AB-HHPA), in an October 9 communication, called for uniform implementation of the Comprehensive Cashless Health Facility (CCHF) scheme across Haryana. The communication referred to directions issued by the Haryana Human Rights Commission on August 31, which stressed the need to ensure that eligible beneficiaries are identified, verified and mapped in the relevant human resource management system or database. Officials have also been asked to facilitate the issuance of CCHF e-cards, particularly for senior citizens, widow pensioners, persons with disabilities, rural residents and those facing difficulties accessing digital services.

The authority further called for accessible and time-bound grievance redressal systems so that beneficiaries are not forced to visit multiple offices repeatedly to complete enrolment or access scheme benefits.