"Our Humble Kanji Is Being Charged At Rs.1300" Kerala High Court Warns Private Hospitals Against Charging Exorbitant Rates On COVID Treatment

Giving strong warning to hospitals for overcharging on Covid-treatment rates, the Kerala High Court on Monday cautioned hospitals to abide by the rates notified by the government in its Order published today.

The Division Bench of Justices Devan Ramachandran and Dr Kauser Edappagath orally cautioned hospitals to charge rates as notified by the State Government today. The Court cited an instance of a hospital in the Ernakulam district which was found to have levied high rates for its Covid treatment, as per the report of the District Medical Officer submitted in Court today.

"We are not taking the name of the hospital...", the Court said. On this theme, the Court said, "we have a list of hospitals that have indulged in profiteering" and emphasised that it would monitor compliance with the Government Order.

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, the Bench urged in its judgment.

The Court took note of the new order enforcing provisions of the Kerala Clinical Establishments Act, 2018 and its Rules, and pointed out that Section 39 and Rule 19 required hospitals to publish the rates of COVID treatment.

The conjoined effect of the statute and rules would require hospitals to publish the rates being charged, the Court notes in its judgment. Accordingly, the Court has required private hospitals to publish their price lists. Prices of drugs and other 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", it was impressed in the judgment.

While the Court was on the subject of exorbitant rates, the Court cited an instance where rice gruel or kanji was charged at Rs 1300. "Our humble kanji is being charged Rs 1300", Justice Ramachandran exclaimed, clarifying that the rate was an extreme, isolated case.

"If Kanji is charged Rs 1300, we may find it difficult to swallow", Justice Ramachandran remarked.

"Kanji is the new caviar," an Advocate quipped.

"Maybe we'll soon have to keep it under wraps and hide it away, like gold", Justice Ramachandran joked in Malayalam.

In its judgment, the Court urges the State Government to set in place its grievance redressal mechanism, with authorities to monitor complaints of overcharging at Private Hopspitals at the district and State level forthwith.

Additionally, after Advocate Ajay M for the Kerala Medical Services Corporation informed the Court that many private hospitals had already appointed Incident Commanders in compliance with the Disaster Management Act, the Court directed that Incident Commanders monitor rates being charged at the hospital level. The Court enjoined incident commanders to inspect purchase bills and other receipts received by patients.

The Court exhorted private hospitals to be partners in the fight against Covid and implement the government's order in letter and spirit.

High Court's concern about economically-challenged patients who did not fall within categories whose expenses were footed by the Government

In this respect, the Court took note of the Government Order wherein the rates of treatment for patients under the Karunya Scheme (KASP) and government-sponsored patients was footed by the government in private hospitals.

"What happens to a BPL patient, patient not under KASP?", the Court asked.

After deliberations with the Counsel, the Court proposed that a patient or his by-stander could ask the private hospital to connect with the District Programme Management and Support Unit (DPSMU) and seek that they be covered post facto under the KASP or be treated as government-sponsored patients, if they met eligibility criteria.

If they were prevented from moving through the private hospital for any reason, they could approach the DPMSU, the Court stated, noting that this system could remain in place till the matter was taken up next for compliance.

First Line Treatment Centers

Taking note of the fact that First Line Treatment Centers were not mentioned in the Government Order, the Court observed that the rates prescribed for General Wards could apply to FLTCs as well, even those maintained by private medical centers. Violations would not be permitted, the Court emphasized.

When the State Attorney pointed out that there were no FLTCs maintained by private hospitals, the Court said that it knew of one being operated by a hospital.

Other directions to private hospitals

All hospitals who were admitting patients after the publication of the Government Order would be bound by the Government Order, the Court underscored.

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, it was again stated.

It was made clear that no private hospital shall be entitled to charge for drugs/PPE kits/essentials/oximeters etc. more than cost price. Actual rates on PPE kits etc. could be charged on a pro rata sharing basis by all patients in ward depending on actual use, the Court said.

When counsel for an association of private hospitals Advocate K Anand raised a concern about the need for subsidizing electricity/water rates, the Court directed him to approach the concerned authority under the government.

Click here to download the Government Order

Click here to download the judgment