Centre Notifies Comprehensive Rules to Regulate Use and Billing of High-Cost Ventilators
New Delhi: In a major policy intervention aimed at curbing excessive billing and ensuring ethical critical-care practices, the Central government has issued detailed guidelines to regulate the use, pricing, consent process, billing transparency and duration of high-cost ventilator support in private hospitals, mandating informed consent, usage-based billing, public disclosure of charges, clinical justification for prolonged ventilation, internal review mechanisms and grievance redressal systems to protect patients and their families from financial exploitation.
According to a recent media report in Medical Buyer, the guidelines, issued by the Directorate General of Health Services (DGHS) under the Ministry of Health and Family Welfare, apply to all private hospitals providing mechanical ventilation services. Hospitals are required to obtain explicit and informed consent from patients or their legal representatives before initiating ventilator support. The consent must include a clear explanation of the clinical indication, benefits, risks, expected duration, possible outcomes and limitations of ventilator therapy.
Hospitals must also disclose the daily cost of ventilator use, ICU charges and all associated expenses at the time of consent. The guidelines strictly prohibit arbitrary billing and introduce usage-based charging, allowing hospitals to bill ventilator fees only for the actual duration when the machine is actively used on the patient.
To ensure transparency, private hospitals are mandated to maintain standardised pricing structures and provide itemised bills covering ventilator consumables such as breathing circuits, humidifiers, filters and accessories. These charges must be prominently displayed at billing counters, ICUs and other patient-accessible locations.
The guidelines place strong emphasis on preventing unnecessary or prolonged ventilation. Any ventilator support exceeding 14 days must be justified through an internal clinical audit or review by a multidisciplinary medical committee. Hospitals are required to conduct daily clinical reassessments to determine the continued need for ventilator support, including escalation, continuation or withdrawal based on patient condition.
Detailed documentation of ventilator usage, including duration, mode of ventilation (invasive or non-invasive), and treatment decisions, must be maintained to support billing accuracy and regulatory inspection. Hospitals are also directed to establish a time-bound grievance redressal mechanism to address complaints related to ventilator use, consent or billing disputes.
The guidelines further emphasise ethical responsibility, stating that ventilators should not be used as a revenue-generation tool and must strictly align with clinical necessity. Non-compliance with the guidelines may attract action under applicable regulatory and legal provisions.
The Medical Buyer reports that the move follows repeated concerns over opaque billing practices, inflated ventilator charges and lack of patient awareness in private critical-care settings.
The Centre stated that the guidelines are intended to restore trust in private healthcare, protect patient rights, standardise ventilator practices and ensure that critical-care interventions remain clinically justified and financially transparent.
