Rs 30 for paracetamol, Rs 1,300 per bowl Kanji: Kerala HC orders Govt to enforce capped COVID treatment rates at private hospitals ASAP
Kochi: Lauding the government for capping the treatment charges in private hospitals in the state, the Kerala High Court has warned the private hospitals against overcharging, further advising them to comply with the rates as notified by the State government in its latest order.
During the hearing yesterday, the division bench comprising of justices Devan Ramachandran and Dr. Kauser Edappagath, discussing the possible measures to control the Covid-19 treatment charges in the private hospitals across the State, expressed its satisfaction over the recent Government order which has dealt with the matter in detail, by calling it "fantastic" and directed the State for setting up grievance redressal mechanism, which would be operated by concerned authorities and monitor the complaints of overcharging at the private hospitals across the State.
The court also expressed its concern over the exorbitant charges being collected by private hospitals for treating COVID-19 patients and observed that the hospitals were looting ordinary citizens by charging high rates for treatment. It pointed out that those PPE kits were priced at Rs. 22,000 and even Kanji (rice gruel) was charged at Rs. 1,300/bowl by some private hospitals. "If the Kanji is charged like this, we may find it difficult to swallow it," observed Justice Devam Ramachandran.
It was also clarified, on the part of the High Court that no private hospital would be allowed to charge for drugs/PPE kits/essentials/oximeters etc. more than the cost price. Actual rates on PPE kits etc. could be charged on a pro-rata sharing basis by all patients in the ward depending on actual use, the Court said.
"All private hospitals in the State of Kerala, with respect to the 50% beds reserved for Covid patients would be bound to offer treatment to such patients strictly as per rates stipulated in the Government Order" stated the judgment.
Meanwhile, the Government Order in question has been made after multiple rounds of discussions held with the Private Hospital Associations by the Principal Secretary Health, State Health Agency and Director of Health Services.
The order mentioned that the rates per day in General Wards of National Accreditation Board for Hospitals & Healthcare Providers-accredited hospitals (NABH hospitals) and non-NABH hospitals would be Rs 2910 and Rs 2645 respectively. It also specified the rates for HDU, ICU, and ICU with ventilator beds in NABH and non-NABH hospitals. These rates would be applied to those patients who are not covered by the government's Karunya Scheme (KASP) or are not Government referred patients.
The expenses mentioned in the order would be inclusive of registration charges, bed charges, nursing and boarding charges, charges for surgeons, anesthetists, medical practitioner, or consultant, medicines and drugs, pathology and radiology tests including X-ray, USG, Hematology etc. would also be covered in these rates.
However, high-end investigations like C.T. chest/ HRCT Chest, PPE kits, Costly Medications like Remdesivir, Tocilizumab have been excluded from it.
"These exclusions shall be governed by the MRP rates of the manufacturer of the drugs and consumables wherever applicable and shall not exceed the same, and the rates for the diagnostics and investigations shall be as per the declared Hospital rates and undertaken as per medical protocols. If the Union Government or the State Government notifies rates of any drug/consumables/diagnostics in public interest, the same shall be made applicable," further mentioned the order.
Submitting the Government Order before the High Court bench, the counsel for the State informed the Court that 50% of beds in government and private hospitals, ESIC hospitals, and medical colleges were reserved for Covid treatment, Live Law has reported.
The counsel for the State further submitted that rates of RT-PCR tests would be as charged in a previous Government Order capping rate at Rs 500.
It has been further mentioned in the order that as per the Clinical Establishment Act, the services given to the public by each and every clinical establishment including rates for the same should be displayed in a visible and accessible place in the organization and/or on its website.
Apart from this, the counsel for the State further submitted that, based on section 14 of Kerala Clinical Establishment (Registration & Regulation) Act 2018, District Medical Officer of Health who is the ex-officio Vice Chairperson for implementation of the Kerala Clinical Establishment (Registration & Regulation) Act 2018, would function as the Grievance Redressal Officer for any grievance in the respective district regarding overcharging by the hospitals.
The Court praised the government for bringing Covid Treatment under the Kerala Clinical Establishments Act. Further terming the order to be fantastic, the judges orally observed that it reduced the Court's burden in this respect to a large extent, adds the daily.
Observing that the PIL could operate for the next two weeks till the Court takes stock of compliance and determines if changes would be necessary, the judgment further mentioned that "We have examined the GO very closely. We are more than pleased with the Government's Order...We find these rates to be extremely reasonable."
Besides praising the Government Order putting a cap on the rates charges for Covid-19 treatment, the Court also gave a strict warning to the Private hospitals for overcharging and at the same time advised them to comply with the rates mentioned in the Government order.
Citing an instance of one Ernakulam-based hospital, which was found to be levying exorbitant rates for Covid-19 treatment, the High Court bench mentioned without taking the name of the hospital, "we have a list of hospitals that have indulged in profiteering". The bench further warned the hospitals that it would monitor whether the Government Order is being complied with or not, reports Live Law.
During the course of discussing exorbitant rates, the Court cited an instance where rice gruel or Kanji was charged at Rs 1300. "If Kanji is charged Rs 1300, we may find it difficult to swallow", Justice Ramachandran remarked during the hearing. The court also said that some private hospitals also charging Rs 20 to Rs 30 for Dolo paracetamol, adds TNIE
When an advocate mentioned that Kanji is the new caviar, Justice Ramachandran further joked, "Maybe we'll soon have to keep it under wraps and hide it away, like gold."
Taking note of the enforcement of Kerala Clinical Establishments Act, 2018 and its Rules in the new order, the court noted that Section 39 and Rule 19 required hospitals to publish the rates of COVID treatment, adds Live Law.
Accordingly, the Court asked the Private hospitals to publish the price list. The division bench further gave directions that the excluded rates would have to be charged in consonance with the Maximum Retail Price or price under the Drugs Control and Essential Commodities Act.
Any violation will visit them with penal consequences", further warned the Court.
During the course of the hearing, the Court was informed about the fact that many private hospitals had already appointed Incident Commanders in compliance with the Disaster Management Act. Thus, the Court directed that Incident Commanders could monitor rates being charged at the hospital level; also inspect purchase bills and other receipts received by patients.
Addressing the patients who belong to the economically weaker section, but do not fall within categories (KASP and the government referred patients) mentioned in the Government Order, the Court asked "What happens to a BPL patient, patient not under KASP?"
After giving this issue much deliberation, the Court suggested that a patient or his by-stander could ask the private hospital to connect with the District Program Management and Support Unit (DPSMU) and seek that they get covered post facto under the KASP or be treated as government-sponsored patients, if they met eligibility criteria, reports the daily.
In case, they faced any obstruction from moving through the private hospital, they could approach the DPMU, further noted the Court.
The division bench further observed that First Line Treatment Centers were not mentioned in the Government Order. Addressing the issue, the court suggested that the rates prescribed for General Wards could apply to FLTCs as well, even those maintained by private medical centers, adding that violations would not be tolerated.
The counsel for an association of private hospitals approached the court with a concern that the rates of electricity or water should be subsidized. In response, the court asked the association to approach the concerned government authorities for the matter.
Finally, requesting the private hospitals to be partners in the fight against the pandemic, the court asked the hospitals to comply with the government order in letter and spirit. The division bench further mentioned that all the hospitals admitting patients after publication of the government, order would be bound to offer treatment strictly in compliance with the order.
The High Court further emphasized the fact that all Kerala-based Private hospitals, with respect to the 50% beds reserved for Covid patients would be bound to offer treatment to such patients strictly as per rates stipulated in the Government Order.
To view the Government Order, click on the link below.