Haryana fixes package rates of Covid-19 treatment in private hospitals

The state health department, on Friday, issued an order capping the daily package rates for Covid-19 treatment in private hospitals between ₹8000- ₹18,000. This

The state health department, on Friday, issued an order capping the daily package rates for Covid-19 treatment in private hospitals between ₹8000- ₹18,000. This move reduces the treatment rates by up to 64% after high costs of treating critical Covid-19 patients were heavily criticised in the public domain.

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The new package rates for Covid-19 treatment includes all laboratory investigation, radiological investigation and diagnostic procedures. Additionally, drugs, consumables, including Personal Protective Equipment (PPE), and masks are also covered. It also incorporates monitoring charges, such as doctor’s consultation, nursing care, physiotherapy, etc. Charges of procedures, such as intubation, intra-arterial catheterization, chest tube, cardio-diversion, hemodialysis, echocardiography, among others, are covered by it.

The rates are also inclusive of the cost of medical care of underlying co-morbid conditions. The same rates are applicable for children who are infected with SARS-CoV-2 virus.

The order, however, gives no clarity on whether the rates charged by private hospitals are inclusive of the charges of the facilities provided in the high-end rooms, such as deluxe and super deluxe categories of rooms. The treatment costs also do not include costs of experimental therapies, such Ramdesivir. Pregnant women having either normal or C-section delivery have also been left out of the package. Neo-natal care has also been excluded. In such cases, hospitals can charge extra as per the prevailing Ayushman Bharat packages.

As per the order, the per day rates in hospitals accredited by the National Accreditation Board for Hospitals and Healthcare providers (NABH) are ₹10,000 for isolation beds, ₹15,000 for Intensive Care Unit (ICU) beds without ventilator, and ₹18,000 for ICU beds with ventilator. Likewise, the rates in non-NABH accredited hospitals will be ₹8,000, ₹13,000 and ₹15,000 respectively.

Some of the major hospitals of the city are currently charging over ₹20,000 for general beds, ₹40,000 for ICU beds, and ₹50,000-80,000 for ICU beds with ventilators. There are at least 40 hospitals, including two government hospitals, in the city treating Covid-19 patients.

“The disparity in charges across various private hospitals is hampering access for inpatient hospital care. Therefore, the rates of various facilities in private hospitals or medical colleges need to be standardized for Covid-19 patient (sic),” read the order issued by the director-general of health services.

Rajeev Arora, additional chief secretary, health department, said, “Covid-19 treatment cost is being standardised for the benefit of patients who require hospitalisation. In fixing the package rate for the state, we are going with the recommendations of Dr VK Paul committee. It will be uniformity with other parts of Delhi-NCR.”

Notably, in Union minister of home affairs, in a meeting with officials of Delhi-NCR earlier this week, gave the mandate to consider Delhi-NCR as one unit for Covid-19 management. Earlier this week, the Delhi government too had capped the treatment costs, following the recommendations of the Dr V K Paul committee. Almost similar price packages are being followed in other states of India, such as Tamil Nadu, Maharashtra and Telangana.

The Haryana government, exercising the power under the Epidemic Diseases Act, also said that no hospital or medical college in the state would charge an amount in excess of the prescribed limit.

Reacting to the new rates, Dr Naresh Trehan, founder and CEO of Medanta Medicity, said, “Our priority is to protect the patient. It is certainly a problem that the treatment cost has dropped. We are incurring huge losses. But people need to be saved.” When asked about the charges of deluxe rooms, he said, “There is no clarity on the issue.”

As per the government order, the new rates would be applicable to all Covid-19 beds in private hospitals, up to a maximum capacity of 60% of the total beds. According to a senior government official, privy to the matter, only 60% of the beds can be reserved in private hospitals for Covid-19 patients. “We have reserved 25% beds so far, which can now be exceed up to 35% only,” said the official.

The state government in the last two months has issued a series of orders on fixing the package rates of Covid-19 treatment in private hospitals. As per earlier orders, state government employees, pensioners and their dependents can avail Covid-19 treatment as per the government’s reimbursement policies. Arora said, “Any patient who has public or private health insurance will avail the treatment as per the policy clauses, while the beneficiaries of Ayushman Bharat scheme would be covered under it.”

As per the rates under the Ayushman Bharat scheme, the per day cost of beds is between ₹2,000 and ₹5,000.If a patient does not fit in any of the above-mentioned categories, then the hospitals will charge as per the new fixed rates. The state government would reimburse the expenditure as per Ayushman Bharat scheme. The balance amount will have to paid by the patient. Out of the final medical bill, the details of the portion covered under the Ayushman Bharat scheme will have to be submitted to the civil surgeon. The bills submitted by the private hospitals will be reimbursed to them only after the verification by a committee chaired by civil surgeon (chief medical officer) and district nodal officer.