The panel appointed by the government to check overbilling of COVID-19 patients by private hospitals in Pimpri-Chinchwad has found out that many hospitals have been violating the government guidelines. Here are few excerpts from an interview of Joint Income Tax Commissioner Nelapatla Ashok Babu, who is heading the panel said that regular inspection of the hospital bills is acting as a deterrent in these practices.

Explain the role of your committee.

The committee curbs and controls the exorbitant bill amounts that are charged to COVID-19 patients and their families, and also ensures that the extra amount is being refunded. Teams personally visit private hospitals and verify the bills. They take up complaints that are made by the relatives of the patients. The bill inspection is done according to three government notifications that were issued on 19th May, 21st May and 31st August. The 21st May notification had a minor revision to the 19th May notification.

How many hospitals are found overbilling COVID-19 patients?

Many hospitals in Pimpri-Chinchwad are following the practice of overbilling. Patients were charged for things they were not supposed to be charged. Also, they found that hospitals were not even keeping any proper records of patients, doctors, nurses and other healthcare staff. They have issued show-cause notices to hospitals indulging in unnecessary billing and for violating government guidelines.

Are the hospitals responding after the committee issues a show-cause notice?

As per the government notification if any hospital is found violating the norms, then their registration will be cancelled. They would also be penalised under an offence under Indian Penal Code. Firstly, they used to give them 7 days’ time but now after discussing with the PCMC commissioner, they are giving them 48 hours to answer. They will follow the natural principles of justice before taking any action against them.

How much extra amount has been refunded by private hospitals on your instructions?

They have raised objections of around Rs 1.20 crore. Private hospitals have refunded Rs 37 lakh to patients till now. The patients have received the amount. Few hospitals have refunded or decreased the amount the moment they came to know that the patient’s relatives had complained to the committee.

Can you tell what is included and excluded in the bills?

Family members of patients and also the patients should know that the hospitals cannot charge them for ECG, 2D-Echo, HIV test, routine urine investigation, creatinine test etc. The hospital is allowed to charge Rs 800 for an antigen test and Rs 1,200 for a RT-PCR test. In a general ward, the per day charge is Rs 4,000, Rs 7,500 for an ICU bed without a ventilator or oxygen bed, and Rs 9,000 for an ICU bed along with a ventilator and oxygen bed. They can charge the patients for intervention procedures, high-end investigation, high-end drug, CT scan or MRI procedures. For the PPE kits, the charges are divided by the number of patients attended by the concerned doctor. The rates have been given in annexure C of the government notifications that was issued in May.

What is the penalty amount forced on hospitals who do excessive billing?

According to the government norms, the penalty is Rs 5,000 or 5 per cent of the extra bill charged. The amount might be less but mere imposition of the penalty can spoil their track record and their image.

Would the paltry fine amount can act as a deterrent?

The inspection of bills is acting as a deterrent. Initially, the hospitals refused to admit patients until an advance payment was done. Now they are not resorting to such practices. They first have to admit the COVID-19 patient and can’t delay their admission. The panel member’s frequent visits to hospitals are keeping them to avoid such practices.

What action have you recommended against the hospitals violating the norms?

They have found that Desai Hospital in Bhosari was operating without permission and was not even maintaining proper records. They suggested the Divisional Commissioner and PCMC commissioner to sealthe hospital. It is now up to them to take strict action against the hospital. They do take similar action if hospitals are found violating the norms.

Source: The Indian Express