Now that the ordeal is temporarily halted, I’m going to share what we have been through over the past two months at the hands of a govt that has been sparing no effort to run doctors to the ground while they struggle to manage COVID patients at great personal risk. Thread.
On 21 May 2020, Maharashtra govt issued a circular invoking:
1. Epidemic Act
2. Disaster Management Act
3. ESMA
4. Mumbai Nursing Home Act
and instituted draconian measures to “regulate” charges of treatment at ALL private hospitals for ALL diseases not just COVID.
1. Epidemic Act
2. Disaster Management Act
3. ESMA
4. Mumbai Nursing Home Act
and instituted draconian measures to “regulate” charges of treatment at ALL private hospitals for ALL diseases not just COVID.
Charges for COVID treatment were capped without any discussion with hospitals/doctors/nursing homes. Charges for non COVID treatment too were capped at lowest ward rates and maximum chargeable tariffs were imposed to be followed all medical establishments.
In May 2020, my hospital applied to Panvel Mahanagarpalika for permission to turn into a COVID Hospital. However the next month we were forced to withdraw the application as most of our staff disappeared. I had shared my frustration at this on Twitter at the time as well.
But shortly after this, Panvel Municipal Commissioner Sudhakar Deshmukh called me to his office and directly threatened me and @AnjanaPed that he would put us behind bars if we didn’t convert our hospital to COVID within three days.
No amount of pleading or reasoning would make him change his mind. Hence we again started hunting for doctors and staff. Fortunately two enthusiastic physicians took up the mantle and after some hectic recruitment we were able to start COVID treatment on 4th July.
Within a few days, “audit team” from PMC started visiting our hospital and collecting all bills for “scrutiny” while we were still struggling to get all the complex processes, logistics and reporting etc in place. We prided ourselves on our compliance, which was spot on. 
The same data would need to be entered at several places and sent to different authorities, before specified cut off times each day. Despite the severe staff crunch we made sure everything was executed in time.
Patient care and outcomes are our primary goal of treatment.
And we have delivered excellent results. Out of over 250 patients treated over the past two months, we have lost just three. But for authorities, billing and paperwork seems to be all that matters.
And we have delivered excellent results. Out of over 250 patients treated over the past two months, we have lost just three. But for authorities, billing and paperwork seems to be all that matters.
During this time, two patients mother and small daughter were admitted in semi private room and decided to share a bed on being told there was only one bed available in that section. Both had medical insurance but were asked to reimburse as we didn’t have staff to run cashless.
After discharge, they followed up in OPD, got paperwork completed and submitted their claims to the insurance company for reimbursement with our full cooperation. However within a couple of days a local MNS leader called me and claimed we had over billed them, demanding refund.
This was a ridiculous allegation as the bills were very moderate (50-55k for six days treatment including everything). Additionally we had also waived off one days charges for both patients and extended 50% discount to the daughter on bed charges.
At around the same time, a seriously ill 25-year old was treated by our team and discharged after nine days with complete recovery. What happens next? Audit team leader calls us up threatening to “scrutinise” all our bills if we didn’t refund 60% of this patients bill.
Thereafter it has been an unending saga of harassment. We found out from a media person that “audit team” has released a letter to MNS leader that we had overcharged three patients and action would be taken. They conveniently forgot to inform or intimate us.
On 12th August a huge team from audit department lands up in the middle of our OPD while dozens of patients are awaiting treatment and starts demanding numerous documents, registers, bills and even xerox copies of all indoor case papers. All this too was provided to them.
On 17th August we get a call from PMC claiming that we hadn’t responded to their notice and warning they would take action. When we told them we hadn’t received any notice the officer shared a screenshot of the alleged email. It had wrong email addresses, with typos.
Finally on 17th August from Municipal Commissioner threatening us with cancellation of registration if we didn’t refund these three patients what they deemed had been overcharged, within 48 hours. We met the Municipal Commissioner with a written reply the next day.
However what happened there shook us to our very core. This high ranking official verbally abused and threatened us, berated our reply as “letterbaazi” and warned us to pay the amounts the same day otherwise he would suspend and then cancel our hospital registration.
We tried to point out to the commissioner that these two patients were committing insurance fraud by claiming the bill from insurance company as well as demanding refund via PMC and using MNS leaders influence to execute their plan. But he refused to listen and kept threatening.
Under immense pressure we refunded one patient immediately. However it seems someone from the PMC office tipped off the mother-daughter as thereafter they simply refused to give their bank details for refund since we had put the attempted insurance fraud on record.
On that day we decided to challenge this high handed and arrogant behaviour of this official and the order passed by him. Remember this tweet?
The commissioner openly threatened us that he would cancel the registrations of 2-3 hospitals and the medical license of 3-4 doctors and then everyone would fall in line. This, folks, is what the government thinks of people risking their lives on the frontline of a pandemic.
Thereafter the commissioner goes on to hold press conferences declaring his achievement of controlling “loot maar”, and openly threatens all hospitals in his jurisdiction in a webinar that he would do to them what he had done to Niramaya if they didn’t fall in line.
Within the next few days, “audit teams” land up at over 150 hospitals in PMC jurisdiction, both COVID and non COVID, demanding bills and documents for all treatments given and alleging they weren’t following the 21 st May circular on rates. More press conferences follow.
A couple of days later we get yet another show cause notice threatening us that our hospital registration would be canceled within three days if we didn’t comply. Forcible empanelment with MPJAY scheme under threat of cancellation of registration. More false allegations.
By this time we had realised that going to court was the only way for our survival against a power crazed authority that was going well beyond their jurisdiction. That is why we moved court and obtained a stay against further harassment.
The honourable judges while granting us relief came down harshly on PMC advocate and asked him whether we were living in a police state like Iran. They have noted in their order that the commissioner has no jurisdiction: a complete vindication of our stand.
If a patient has a complaint regarding bill or treatment, the correct forum to get relief is a civil or consumer court. The municipal corporation has no role in this. By assuming the function of the court, it steps beyond its jurisdiction and this has clearly been held illegal.
But the battle will continue next month as we have challenged the legality of the 21 May circular itself. Why have we challenged it? Because NONE of the acts named by the government of Maharashtra in it, give them any power to “regulate” charges of private hospitals.
In Thane, Horizon Prime Hospitals license was suspended for a month. After a month TMC further extended the suspension by another three weeks. Yesterday they too got relief from the High Court. Many hospitals and associations across the state are now planning to file petitions.
Maharashtra govt after assuring IMA and doctors bodies that they would revise the tariffs fixed by them on hospitals once the 21st May circular restriction ends on 31st August, once again shows how they simply cannot be trusted on their words.
