Remember the Fortis medical bill worth Rs 16 lakh? This law will ensure it never happens again
In November last year, FortisNSE -2.11 % Memorial Research Institute (Gurgaon) charged the family of a seven-year-old dengue patient nearly Rs 16 lakh for 15 days in the ICU. The girl died while being shifted from Fortis to Rockland Hospital.
Hospitals in big cities inflate costs of medicine, etc., sometimes 100s of times. According to Satyendar Jain, the health minister of the Delhi state, there have been instances in the past in which private hospitals were found to have charged 1,000 to 1,700% margins on medicines and consumables.
Patients and their relatives will not have to deal with such inflated medical bills in Delhi, if a Bill being prepared by the Delhi government becomes law.
The Delhi government on Monday put the draft prepared by it on capping of profits by private hospitals in the public domain for scrutiny and feedback.After 30 days, the government would make amendments to the Delhi Nursing Homes Registration Act to make the draft policy changes legally binding, state health minister Satyendar Jain told TOI.
Following are the highlights of the draft:
Prescription of NLEM medicine
As per the policy draft, private hospitals and nursing homes will have to preferably prescribe from the National List of Essential Medicines (NLEM), the prices of which are regulated by the central government. For non-NLEM drugs and even disposables, we have decided that hospitals can charge a maximum 50% as mark-up against administrative/handling charges over and above its procurement or maximum retail price (MRP), whichever is lesser.
Fixed mark-up on implants
In the case of implants, too, many consumer groups and patients have been raising the issue of over-pricing and profiteering by private hospitals. The draft policy has fixed a mark-up of not more than 35% above the procurement price for that.
Fixed price for various procedures
The draft policy suggests fixed pricing for packages for various procedures. Also, it suggests that any additional procedure performed on the patient who has opted for a particular package will be charged at 50% of its original rate and that patients should be offered the choice of opting for a high-risk package that covers all possible complications and that it should not cost more than 20% higher.
The Economic Survey 2015-16, prepared by Chief Economic Advisor Arvind Subramanian and tabled in Parliament in February 2016, had pointed out large gap between the cost of government and private healthcare. “NSSO (2015) reports that the average medical expenditure for treatment (excluding child birth) per hospitalized case if treated in private hospital was about four times than that of public hospital during January-June 2014. On an average, Rs 25,850 was spent for treatment per hospitalized case by people in the private facilities as against Rs 6,120 in the public health facilities,” said the survey
The next year Subramanian wrote in the Economic Survey that government should take action, including imposing fines, against hospitals for inflated costs. “There has to be concerted efforts by the Central and State governments to reform the health sector, by addressing quality issues, standardising rates for diagnostic tests, generating awareness about alternative health systems and introduction of punitive measures like fines on hospitals and private health providers for false claims through surgery, medicines, etc.,” he wrote