GO on capping leaves scope for private hospitals to overcharge

Updated - June 16, 2020 11:44 pm IST

Published - June 16, 2020 11:36 pm IST - HYDERABAD

Notwithstanding the cap on COVID-19 costs, patients checking into private hospitals may still have to dig deep into their pockets to pay for the treatment.

According to the government order (GO) issued on Monday, charges for treatment in Intensive Care Unit (ICU) is ₹7,500 per day which will go up to ₹9,000 if the patient is provided with ventilator support. For admission in a routine ward, the daily tariff has been fixed at ₹4,000.

However, certain services or products are excluded from the capped prices, leaving scope for additional costs. It includes Personal Protective Equipment (PPE), ₹2,200 for COVID-19 testing, high-end investigations such as CT-Scan, PET Scan, MRI etc., interventional procedures such as central line insertion, bronchoscopic procedures and biopsies.

Looking for loopholes

Doctors, health officials, insurance agents and the general public have remarked that private establishments might find loopholes in the GO to charge more.

“When National Pharmaceutical Pricing Authority capped prices of drug-eluting stents, some corporate hospitals increased rates under other categories even as the price for angioplasty remained the same. We fear something like this might happen after the GO is issued,” said an insurance agent.

The option of getting admitted into the government hospitals is open for all moderate and severe COVID-19 patients while those with mild or no symptoms have been advised to self-isolate at home.

Extra charges

Employees of a few corporate hospitals informed that while some charge ₹3,000 per day for the PPE, others find different ways of billing the disposable product. Usually, patients with moderate to severe infection are admitted for a period of 14 days. Even if a patient is admitted for 10 days in ICU and is provided ventilator support, they will incur an additional ₹30,000 just for the PPE apart from the ₹9,000 daily charges.

Moreover, a COVID-19 test costs ₹2,200 and it is conducted at least twice before a patient can be discharged from the hospital with negative results each time.

The insurance agent said private hospitals may also charge extra for gloves, socks, and other protective gear for doctors and nurses who attend the patient.

Since COVID-19 primarily affects the lungs, doctors may examine the patient’s condition using High Resolution Computerised Tomography (HRCT) scan which costs around ₹3,000 in private diagnostic facilities. Doctors and insurance agents said that charges for the high-end investigations at private hospitals are at least 50% more than what is billed at private diagnostic centres.

Lungs examination

“The HRCT scan helps to know if the architecture of lungs has changed. Abnormalities in it is a common sign that coronavirus has affected lungs. If a COVID-19 patient with respiratory problems is admitted, the HRCT scan is performed at least twice. If required, it may be performed more than twice. So, charges for two scans at corporate hospitals will be at least ₹10,000,” said a government hospital doctor.

Doctors from corporate hospitals in the city also said that the HRCT scan is a must. All these charges may vary depending on severity of the infection in the patient and the tariff set by each private hospital.

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