Odisha: CAG finds ₹161 cr excess payment to pvt hospitals for Covid treatment
The CAG report underlined the inept management of resources intended for Covid-19 pandemic response
The Odisha government made irregular/excess payment of at least ₹161 crore to at least a dozen private hospitals in the state that were declared dedicated Covid hospitals between 2019 and 2022 underlining inept management of resources intended for pandemic response, a performance audit of the public health infrastructure and management of health services has found.
The Comptroller and Auditor General (CAG) report that laid in the State Assembly on Saturday said that the Health and Family Welfare department of Odisha received a total of ₹2,868.80 crore from various sources, including the State Disaster Relief Fund and Emergency Covid Response Package, for Covid management between 2019 and 2022. Of this only 64% of the ₹861.97 crore allocated under Emergency Covid Response Package-II was utilised by March 2022, with many activities seeing expenditures below 50% of their budgets.
However, the most significant part of the CAG report was irregularities amounting to at least 8 prominent private hospitals in the state declared as dedicated Covid hospitals that were paid ₹144.88 crore without the bill of the hospitals not properly scrutinised, leading to payments based on incomplete documentation. Citing the case of SUM hospital in Bhubaneswar, the CAG report said it was paid ₹78.6 crore between April 2021 and January 2022 without verification and countersignature by the authorised medical official and the Bhubaneswar Municipal Corporation approved the claims for payment without verifying the actual number of patients admitted, type of beds availed by the patients, and patient-wise claims, etc. Payment was made to the DCH, based on the abstract of the bills.
Similarly, ₹64 crore was paid to Hi-Tech Hospital, Blue-wheel hospital, KIIDS, Sanjeevani Hospital, Aditya Ashwini Hospital and Sparash Hospital though none of them submitted patient-wise documents along with consolidated bills.
Underlining the manipulation of the private hospitals during the Covid crisis, the CAG report said Covid patients at Neelachal Hospital in Bhubaneswar had been discharged from ICU/ HDU beds directly, without them having been transferred to General wards. "Scrutiny of the bills submitted by Neelachal Hospital, for the period from 26 July 2020 to 15 August 2021, indicated that, in 332 cases, patients had been discharged directly from ICU beds/ ICU with Ventilator beds, without having been stepped down to HDU/ General beds, even for a day. In none of these 332 cases, the patients had been referred to any other hospitals. The Audit was unable to derive assurance that these patients had, in fact, occupied ICU/ ICU with ventilator beds and was unable to find any supporting documents," the report said.
The CAG report said as per the SOP issued by the H&FW Department, for the management of patients in Intensive Care Units, in Government and Private hospitals, patients were to be shifted to Wards, once they became normal, and priority was to be given to new emergency patients. The patients, who had become stable, were not to be kept in the ICU, to reduce unnecessary psychological and financial burden, to patients and families. "As the charges for ICU beds per day were higher than the charges for the General beds, the possibility of higher rates, as fixed for ICU or HDU beds, having been claimed cannot be ruled out," the report said.
Similarly, many hospitals were paid excess diet allowance or claimed the allowance for more than the staff deployed in the facilities. Though the health and family welfare department had said the rates were applicable with prospective effect, Ashwini Hospital in Cuttack hospital had claimed ₹74.7 lakh in Diet Allowance of Doctors and Paramedics retrospectively and it was reimbursed. At least 8 other hospitals claimed excess diet allowance of ₹2.6 crore as they did not deploy the doctors and paramedics which they claimed to.
In some hospitals such as Ashwini Hospital, the bills submitted by the hospitals had repetition of bed numbers across multiple patients. In 315 cases, the hospital had submitted bill, in which the same bed numbers and periods of treatment, had been repeated across multiple patients, resulting in excess payment of 2.62 crore. At least 10 hospitals were found to have charged the government for PPE kits though the same were supplied to them from the government free of cost.