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HomeHealthCovid patients say Delhi private hospitals still overcharging, ignoring govt rate caps

Covid patients say Delhi private hospitals still overcharging, ignoring govt rate caps

More than a month after Delhi govt capped rates for Covid treatment, patients say hospitals don't disclose this information and insurance companies don't cover the excess amount.

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New Delhi: For brothers Rizwan and Imran Ali, their father testing positive for Covid-19 and getting admitted to a Delhi hospital is bad news on more than one front. After his first day at the privately-run Max Hospital in Saket, 57-year-old Ramzan Ali’s treatment cost had grossed close to Rs 2 lakh.

“The hospital has given me an estimate of Rs 1.73 lakh for just a day’s stay. How are we supposed to pay this kind of money? We have already paid Rs 50,000 at the time of admission,” said Rizwan Ali, a resident of Dwarka, on 28 July. Their father was admitted on 27 July.

When asked about why they hadn’t availed of the Delhi government’s capped rates for private hospitals, Rizwan said, “We didn’t know that the Delhi government has capped prices. The hospital hasn’t mentioned either. They simply said the rate is Rs 50,000-Rs 60,000 a night.”

The Alis weren’t the only ones to find that they were being charged the hospital’s rate and not the capped prices set by the Arvind Kejriwal government.

Patients at other hospitals also told ThePrint that not only they had been charged more than the capped prices, but were also not informed that the government has made such a rule. Some of them alleged that they were overcharged even after demanding that they be billed according to the rates set by the government.

To complicate matters, insurance providers were unwilling to cover the expenses that went above the prescribed Delhi government rates, they said.

Unlike other states such as Maharashtra where fines were imposed and action taken, activists alleged, the Delhi government has no grievance redressal mechanism or a government agency that monitors or enforces the order.

Also read: Why Delhi’s Covid hospitals are struggling to fill ‘lucrative’ senior resident doctor posts

What Delhi govt order says

Following reports of private health facilities overcharging for Covid treatment, the Delhi government on 20 June ordered the capping of rates for 60 per cent of the total beds.

For hospitals accredited to the National Accreditation Board for Hospitals and Healthcare providers (NABH), daily rates were Rs 10,000 (including PPE cost of Rs 1,200) for isolation beds, Rs 15,000 (including PPE cost of Rs 2,000) for ICU without ventilator beds and Rs 18,000 (including PPE cost of Rs 2,000) for ICU with ventilator beds.

For non-NABH accredited hospitals, the same category rates were capped at Rs 8,000 (including Rs 1,200 PPE cost), Rs 13,000 (including Rs 2,000 PPE cost), and Rs 15,000 (including Rs 2,000 PPE cost), respectively.

More than a month since the order was issued, there have been several instances of private hospitals flouting this.

Also read: CCTVs in wards, one attendant for patients — Delhi issues new guidelines for Covid hospitals

Over charging, lack of information

Back at Max Hospital, both Ali brothers have been trying to speak to the hospital authorities to have their father’s hospital bill corrected according to the government rates. They also complained that there wasn’t any notice or signage put up at the hospital informing patients about the government’s order.

“Not everyone knows about every government order. Why haven’t they put up the rates on a board so that the common man is informed?” Rizwan asked.

On a visit to Moolchand Hospital on 28 July, ThePrint found information about bed availability and a rate card at the entrance. But patients said the hospital has been inflating the prices.

Nitin Gulati’s 60-year-old mother Tarun Lata was admitted there from 20 June to 30 June. When she was discharged, the bill was Rs 2.59 lakh, which came to more than Rs 20,000 per day — double the rate set by the government.

Gulati also found that his mother was charged for oxygen for nine days even though she wasn’t administered it. The hospital also charged them Rs 4,477 per day for PPEs, four times the capped price.

“The hospital told me that since my mother was admitted on 20 June (the day the order was passed), she was not eligible for it,” said Gulati.

When asked about the case, Moolchand Hospital’s medical superintendent Madhu Handa refused to comment and referred ThePrint to the billing department. At the billing department, the person in-charge was on leave. When ThePrint reached out to Handa again, she said she was not aware of the details of the case and could not discuss the matter further due to patient confidentiality.

Like Gulati, Nitin Kumar and his mother Biney Rani also claimed that they paid inflated prices. Rani was admitted to Max Hospital in Saket on 29 June and was discharged on 2 July.

“Day after her admission, I received a message of an estimate charging Rs 27,000 per night instead of Rs 10,000. At the time of discharge too, the issue was not resolved and I had to pay over Rs 75,000 extra just to get my mother discharged,” said Kumar. He also said his relative, who was his mother’s attendant, did not consent to admitting her in the uncapped category.

Max Hospital, however, claimed that Rani and the relative had opted for an uncapped category room. “The same was explained and the attendant agreed and gave consent at the time of admission,” the hospital stated in its response emailed to ThePrint.

Also read: Covid patients in Delhi hospitals have gone down, people getting cured at home: Kejriwal

Insurance trouble

Insurance companies have allegedly refused to cover the full expenses borne by patients and are only releasing amounts that match the government rate card.

In Gulati’s case, his IFFCO Tokio corporate health insurance paid for only Rs 1.02 lakh of the total Rs 2.59 lakh bill they received. Gulati claimed his mother was kept in hospital for two extra days and not discharged until the full amount was paid.

After negotiation, IFFCO Tokio paid Rs 80,000 more, but Gulati said he had to cough up Rs 78,348 on account of the “illegal and unjust actions” of the hospital.

“For private hospitals in Delhi, we have to follow the Delhi government rates. Whether the excess can be covered or not needs to be evaluated on a case-to-case basis,” said an official at a private insurance company, requesting anonymity.

The Ali family said they have been unable to reach Max Bupa Health Insurance, the insurance provider for Ramzan, though the company claimed that Covid patients’ concerns were cleared on priority.

“Over 95 per cent cashless claims have been approved within 30 minutes for all Covid cases. We have proactively connected with customers to collect required information and process their claims faster,” Max Bupa stated in an email to ThePrint.

Also read: Delhi govt hospitals, private facilities asked to show number of vacant beds at entry gate

Activists trying to push govt to act

With more patients narrating similar stories, around 20 civil society groups sent a letter to Chief Minister Arvind Kejriwal and Lieutenant Governor Anil Baijal on 25 July against non-compliant private hospitals.

“We had sent another letter earlier on 23 June saying that the order allows private hospitals to profiteer and this is what is happening. Order doesn’t mention anything about private insurance holders. There’s no information in the public domain. How will people even verify?” Malini Aisola of the All India Drug Action Network said.

The letter also includes testimonies of five patients. None have received a response yet from the Delhi government, the activists said. ThePrint reached Delhi’s Director General, Health Services, Dr Nutan Mundeja and Health Minister Satyender Jain through calls and WhatsApp messages, but had not received a response till the time of publishing this report.

“These are all patients who have filed complaints, yet there is no grievance redressal mechanism by the Delhi government,” pointed out Aisola.

Also read: Hospitals refusing to treat Covid patients must face action: Amicus curiae to Delhi HC


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