Thread by @barandbench

Kerala HC to shortly take up a plea on overpricing of medical treatment in private hospitals amid the COVID-19 pandemic.

The matter has been listed for judgment at 1:45 pm today.

#CovidIndia
#COVID19
#privatehospitals

A Division Bench of Justices Devan Ramachandran and Kauser Edappagth will hear the matter.

#CovidIndia
#COVID19

Find out what happened in the previous hearing here:

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#CovidIndia

Bench has assembled.

#CovidIndia

Bench: Mr Sohan, has the govt done something?

Adv Sohan for State govt: Yes, It has issued a GO. I am at home, I have forwarded it in the WhatsApp of your Lorships.

Bench: What is the tenure of the order...can you run us through the order?

Sohan: We have fixed the rates.

Adv Anand submits that none of the suggestions placed earlier have been included in the new GO.

Bench: Mr Sohan, run us through the order....the salient features

Sohan begins reading GO

#CovidIndia

GO has regulated prices of pvt hospitals and private nursing homes for COVID-19 walk-in patients as well as others.

General wards - Rs 2645, includes reg, bed, nursing anf boarding, blood transfusion, oxygen, Xray, consultation, diagnosis etc.

This is an all inclusive rate?

Sohan: Costly medicines like Remdesivir is excluded from

Rate of RTPCR to remain as fixed by Govt.

PPE Kits- 2 per general ward and 5 per ICU, those will be governed by MRP.

Bench: Very good!

#CovidIndia

Sohan: Under Sec 14 of Clinical establishment Act, DMO is the grivance Redressal Officer for any grievances in respective District regarding overcharging in Hospitals

Bench: Complaint can be given by email and physically also? What about time frame?

Sohan: Yes. Time frame, I am not sure.

Bench: We need to think about a time frame for filing complaints...

Sohan: Penalty for overcharging will be 10x the fee.
All shops, retailers selling PPE kits etc cannot charge over MRP, if so penalty will be levied.

#CovidIndia

Adv KV Anand: We are on the issue of fixing the rates for exclusion.

Anand: Let me point out what is happening....This is what happens when a patient comes to a pvt hospitals.

Blood tests will be Rs 1,500 and lab tests will be approx 3,500 for patients. Remsidivir also will be needed....

Anand: Charges in ward vary from 190 to 300. Exp in Radilogy for Rs 4000 to 50000. Charges for oxygen will also be levied.

No point in increasing beds without ICU beds.....The general notion is that only 2-3 PPE kits are rqd when a patient is admitted.

In this pandemic situation, we also don't want to charge extreme prices : Anand (appearing for pvt hospitals).

#CovidIndia

Bench: Last year, this time there were hardly any patients in hospitals. Many were not able to pay staff.

Because of the pandemic, you are having 100% occupancy. Normally it is on 50-60%.

Learn to average your costs

We could have expected private hospitals - We will do it.

Bench: Imagine the plight of a citizen who earns 1000 and sees a bill of 2-3 lakhs. We are seeing infections rising rapidly. This is not an isolated case.....anyone can catch the infection now.

You are looting people. Think about it, we have to intervene now.

#COVID19

Bench: We found unconscionable billings, Rs 22,000 for PPE kits.

Look at the bills....we have masked every name

We saw our humble "Kanji" is charged at Rs 1300. Our Humble Kanji.

Dolo is charged Rs 30-40.

#CovidIndia

Bench: We are happy that govt has come with our order. We will let the GO operate. There is no challenge to it now.

Let us see how it goes

#CovidIndia
#BedsAvailability

Bench: AP, Madras and Rajasthan has come out with orders.

We are happy that the govt has come up with order as per our suggestions.

#COVID19

Anand: Govt is not giving subsidized rates for oxygen, electricity etc. We are paying in full.

Bench: We will see. Make a representation separately. We are sure that the govt will consider....

#COVID19

Bench: Not here to waive off all wrongs here in the society.

We are only here to have a generalized system in place.

#COVID19

Bench: We took that example of "that" (hospital which charged 22k for PPE kits) hospital just to show you.

We will not take up that issue at all. We will leave it to competent authorities....You can fight it out, we will not stop you.

#COVID19

Snr Adv Gopakumaran Nair for IMA: We have placed our proposal before Govt

Bench: That has been considered by Govt....We are not expecting IMA to act as an arbiter, as the spokesperson of private hospitals.

What do you say about new GO?

#COVID19

Nair for Indian Medical Association: Lorships, may differentiate between poor and well to do people, who can pay a reasonable price for COVID-19 treatment

Bench: In pandemic situation there is no rich and poor.
We don't approve cross-subsidization during pandemic.

#COVID19

Bench to State: How can DMO, who is very very busy, as he is charge of vaccination drive also, can he be effective as a grievance redressal officer?

Sohan: He can manage...

#COVID19

Bench: We are not saying that order will have a retrospective effect. All bills raised after order, henceforth, will be governed by GO.

Any admission and bills prior to this bill will be governed by the then rates.

But you have to check whether rates are just or exorbitant

Bench: You have to take a call on Toll free number.

What about unused hospitals? What about private FLTCs? Will come under this order?

#COVID19

Bench: Govt to come out with some clarification for FLTC also.

We will have diff order: State

#COVID19

Bench: These are the things for you to consider:

-Toll free number,

-Sectoral magistrates will issue orders who will be in charge of specified areas, who will work under DMO.

-FLTCc will be governed by this GO until you have a separate one for them.

#COVID19

We propose to pass a judgement today, we will place it for compliance later : Bench

#COVID19

One adv says: I lost my mother due to COVID-19. I paid over 10.2 lakhs for 30 days.

Ideally, the bill should have been 2.5 lakhs. 10.2 Lakhs for my mother is nothing, that's how I see it.

But look at the price hike.

#COVID19

Adv Jijo Paul for Catholic Hospital Association: We will implement the GO as such

Bench: we certainly appreciate that!

Paul: Pls direct Govt to release funds as we are treating funds under Karunya Scheme.

Bench: This cant be don't in WP. We will ask govt to help you

Bench dictating Judgement

Bench: Health for all without a financial burden in imperative. The pandemic is a wake-up call for govt that it carries the primary responsibility of citizens' health, esp for vulnerable sections

#keralahc
#COVID19

Bench: The second wave brings back importance to Right to Health under Article 21.

Bench refers to judgments and international covenants in this regard.

#COVID19

Bench: The soul of the afore is that

a) Right to citizen nondiscriminatory access to Health
b)Adequate treatment
c)Affordable Treatment

#COVID19

The petitioner seeks to direct to provide affordable, if not free treatment to all citizens 9amid COVID-19) without discrimination : Bench

Petitioner argues that the number of active cases in climbing up, every day and admission in hospitals are declining. This puts citizens to unimaginable financial burden: Bench

Response of Govt is that GO dated 10.5.2021 as been issued, where cost of COVID-19 patients has been rationalized.

50% of all hospitals ordered to be exclusively reserved for COVID-19 patients treatment: Bench

#CovidIndia

Bench: Order also notifies rates for regulating prices to be charged by Pvt hospitals and private nursing home - "walk-in" COVID-19 patients.

Exclusions in GO also mentioned.

Rates for RT PCR tests will be as regulated by previous GO.

#COVID19

Anand informs of many costs will have to be incurred by Private Hospitals like electricity, oxygen etc : Bench

#COVID19

Court mentions all submissions made by parties in the WP.

#COVID19
#CovidIndia

Bench: We are more than pleased with the GO, provides grievance redressal mechanism, the ambit of tariff that can be charged by the private sector.

We find these rates to be extremely reasonable because it includes all components of basic hospitalization.

#covid

We also have to record an appreciation as for the first time under Kerala Clinical Establishment Act, 2018, Private hospitals are directed to abide by Section 39 and related rules.

Hospitals will have to publish rates of beds, any violation will have penal consequences : Bench

Bench: The new GO covers all fields almost entirely. We are happy with GO.

However, some issues are: toll-free numbers, sectoral magistrates, etc.

We have suggested govt to take up unused hospitals.

Only concern that remains is on First-Line Treatment Centres (FLTCs).

What happens to a poor person, who is not under Karunya scheme who comes for treatment? Bench

#COVIDEmergency

Post facto clearance maybe required, Court is informed.

#CovidIndia

Directions :

GO dated 10.5.2021 shall be implemented by Govt and all stakeholders and any admissions after this order will be governed by the rates

All private hospitals, would be bound to offer treatment strictly as per GO and any violation will be strictly dealt with

Grievanvce Redressal mechanisms to be implemented forthwith and State level Authority is also to be in place immediately.

Incident commanders appointed by the Govt under DM Act, to check whether GO is being flouted by any hospital.

Every Private hospital will display rates of services (esp COVID-19 treatment) as per sec 39 of the 2018 Act and Rules.

Every Private hospital will display rates of services 9esp COVID-19 treatment) as per sec 39 of the 2019 Acta nd Rules f

State to consider having a toll-free number in place for citizens.

Govt to consider adding on hospital beds from time to time. To consider taking auditoriums, hotels, halls, hostels and such other for beds so that burden of a citizen to go to private hospital can be attenuated

No private hospital can charge for drugs, oximeter more than the cost price at which it is procured. Direct Incident Commanders and DMOs to monitor this.
Not one rupee of profit should be collected

Merely because GO permits 5 PPE kits for ICU, it shall not be charged, unless it is pro-rata depending on number of patients.

Bench: Is there a problem with oxygen?

Sohan: We requested for 400 MT from Centre. Centre maybe directed to consider State's request.

We have active cases 4.25 lakhs.

Centre is giving 1200 MT to Karnataka.

Bench: That is approved by the Supreme Court.

#CovidIndia

Centre: That is being monitored.

A complaint on Ambulances raised before Bench.

#keralahighcourt : We will not interfere. You are expanding too much. Bring it to the notice of the Govt.

Govt is doing well...It has come up with a fantastic order.

@vijayanpinarayi
#COVID19

Matter to be heard next in two weeks.

We leave liberty to approach Court on an earlier date for any party : Bench

#CovidIndia
#keralahc

Bench: Mr, State Attorney, we appreciate the stand taken by the State. You have made our burden much lesser.

We were not sure if you would come up with such an order

@vijayanpinarayi
@CMOKerala

#COVID19India

Private Hospitals, we pray that to join the citizens as a team. You can make your profits later, after 2-3 months. Please do not engage in profiteering now: Bench

Bench rises.

#keralahighcourt
#COVID19

[BREAKING] Kerala High Court approves State govt decision to cap Covid treatment price, reserve 50% beds in private hospitals for COVID patients

report by @Rintumariam

#keralahighcourt #COVID19

@CMOKerala @shailajateacher

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