Staff Reporter ;
TUKARAM Mundhe, Municipal Commissioner, has fixed the rate-chart for private hospitals in Nagpur city ‘as per the directives of the State Government’. The rates as fixed by the civic administration will be applicable to private and charitable hospitals till August 31. The hospitals violating the directives in this regard will face action. Mundhe issued the orders in this regard on June 4. The orders indicate rate to be charged by the private hospitals in the city for treatment of cardiac ailments, cancer, gynaecological and pregnancy related problems, and COVID-19.
The rates have been fixed in accordance with the Government orders relating to fixing of charges. People having any grievance/complaint in case of over-charging by the hospitals, may register the same by calling on telephone number 0712-256721 or mobile number 9923609992. Mundhe told ‘The Hitavada’ that the directives regarding the rates were applicable to private and charitable hospitals in the city. “The hospitals cannot go beyond these rates for surgeries or various treatments specified in the State Government order. Else, they will face action under relevant provisions of law. We have asked the hospitals to display these rates fixed by the State Government,” he said.
Many healthcare providers in Nagpur have specific agreements/understanding with General Insurance Public Sector Associations (GIPSA) as a member of Preferred Private Network (PPN) regarding rates of various treatment packages. But, several are not part of GIPSA-PPN, and have their own specific agreements/understanding with various third party administrators (TPAs) in this regard. In such cases, each healthcare provider may have different rates for same treatment packages among various TPAs, stated the order issued by the Municipal Commissioner. Some hospitals in Nagpur city are neither part of GIPSA-PPN nor have agreements/understanding with any TPA.
People having insurance cover get their expenses covered. However, the persons not covered by any health insurance product or who have exhausted their health insurance cover are being charged exorbitantly causing hardship to public in general during COVID-19 pandemic situation. Citing that a large number of grievances regarding exorbitant amount of money being charged by health providers causing hardship to general public during the pandemic situation, Mundhe stated in the order that fixed the rates for various treatments and COVID-19 care facilities for the said hospitals in Nagpur city. State Government order has categorised hospitals that are not part of GIPSA-PPN or have no agreement with any TPA, in three categories -- those having more than 100 beds, 50-99 beds, and less than 50 beds. As far as Nagpur is concerned, for a particular package, hospitals with more than 100 beds shall not charge more than 75 per cent of the rate prescribed.
Hospitals having 50-99 beds shall not charge more than 67.5 per cent of the rates prescribed. And, the hospitals with less than 50 beds shall not charge more than 60 per cent of the prescribed package rate. The rates prescribed will regulate 80 per cent of the total operational bed capacity (excluding beds of PICU, NICU, daycare, maintenance hemodialysis). Healthcare providers may charge their rack rates to the remaining 20 per cent beds, states the order. If hospital rack rates as on December 31, 2019 are found to be lower than the rates prescribed in the latest order, then lower rates will be applicable, it clarifies. Further, it states, no service charge/surcharge/ emergency charge will be applicable.
Maximum charges for COVID-19 patients For COVID-19 patients in private and charitable hospitals, maximum rates have been specified by Municipal Commissioner as per the orders of State Government. As per the order, the rates for COVID-19 patients include monitoring and investigations like CBC, Urine Routine, HIV Spot, Anti-HCV, Hbs, Ag, Serum Creatinine, USG, 2D Echo, X-ray, ECG, drug consultations, bed charges, nursing charges, meals, procedures like Ryles tube insertion, urinary tract catheterisation. The maximum charges for routine ward and isolation have been fixed at Rs 4,000/- per day. The maximum charges for ICU without ventilator and isolation are fixed at Rs 7,500/- per day. And, as per the order, maximum charges for ICU with ventilator and isolation are Rs 9,000/- per day.
The maximum rates specified for COVID-19 patients, however, do not include charges for PPE; interventional procedures like, but not limited to, Central Line Insertion, Chemoport Insertion; bronchoscopic procedures, biopsies, ascitic/pleural tapping etc which may be charges at the rack rate as on December 31, 2019; COVID testing to be done as per actual cost. High-end drugs like Immunoglobulins, Meropenem, Parentral Nutrition, Tocilizumab etc will be charged at MRP. Further, high-end investigations like CT scan, MRI, PET scan or any laboratory investigation has not been included.