New Delhi:

The Centre in an affidavit in the Supreme Court on Wednesday has proposed that state governments may consider Ayushman Bharat-PMJAY or Central Government Health Scheme (CGHS) rates as the benchmark basic rates for the treatment of coronavirus patients in private hospitals.

In an affidavit filed before a bench led by Chief Justice S.A. Bobde, the Ministry of Health disclosed guidelines for states to regulate the treatment costs of Covid-19 in private hospitals.

The bench was hearing a PIL filed by advocate Sachin Jain for free or subsidised medical treatment to Covid-19 patients, particularly in hospitals that had received government land at concessional prices. On 14 July, the Supreme Court had asked the central government to frame guidelines regulating costs of Covid-related treatments.

The health ministry,in the affidavit filed in response to the PIL, noted that these guidelines could be followed if a state was considering utilising private healthcare facilities to augment public health infrastructure in its fight against the Covid-19 pandemic.

Solicitor General Tushar Mehta said the cost of treatment in these hospitals should be earmarked and the “issue of caps on pricing or Covid treatment should be left to the individual state government”.

However, private hospitals opposed the suggestion of price caps, especially in cases where patients have insurance cover.

The price caps should also not be made applicable to cases of comorbidity, their lawyers told the court.

CJI Bobde asked the government to urge insurance companies to release dues promptly.

“When there is a pandemic, insurance companies cannot keep their hands off,” he said.

The court adjourned the matter for two weeks after private hospitals asked for some time to respond to the government’s affidavit.

The Union Ministry of Health and Family Welfare (MoHFW) in the report in the Supreme Court gave suggestions for cost-effective treatment of Covid-19 patients after convening a stakeholders meeting following the court’s direction on July 14.

“States arrive at fair rates on priority basis to ensure there is no over-charging of COVID-19 patients or indiscriminate hike for patients. States may consider Ayushman Bharat-PMJAY and/or CGHS rates as the benchmark basic rates. Certain states have already fixed rates for Covid-19 treatment in private hospitals,” said the report. The cost ideally should be all-inclusive PPE, drugs (generic to the extent possible), consumables; investigations, procedures, treatment of co-morbidities, diagnostics, patient transportation and referral, added the report.

In the report, the health ministry said that health is a state subject and the primary responsibility in terms of management of Covid-19 rests with the states. “States may consider exploring utilizing health facilities available in the private sector to augment the available public health infrastructure for Covid-19. Many states have fixed rates and communicated the same to private hospitals”, said the health ministry.

A bench headed by Chief Justice Bobde on July 14 had said that “We, therefore, consider it iniquitous to impose a ceiling on the charges for treatment of Covid-19”, and permitted the petitioners to make a representation to the Centre.

“The decision of the said meeting shall be placed before this court for further consideration of the matter before issuing directions/guidelines under the Disaster Management Act, to the various State Governments/Union Territories”, said the top court while hearing a PIL filed by Sachin Jain raising the issue that private hospitals, given land free of cost, should not charge heavily from Covid-19 patients.

The health ministry, proposing guiding principles for the states, said while the decision for utilizing the services of the private sector rests with the states, normative guidance may be provided to the states to facilitate them for arriving at reasonable rates for the private hospitals to undertake Covid-19 treatment.

“The costing may consider any/all of the below parameters: a. Categorization of hospitals (NABH/ non-NABH) b, Categorization of illness (Mild, Moderate, Severe) c. Category of beds (Isolation Bed without oxygen; Oxygen supplementation bed; ICU bed with non-invasive Ventilation, ICU bed with Ventilator, etc.) d. Tier wise categorization of cities (A, B, C) e. Categorization of hospitals (Tertiary care, Secondary care) or on basis of bed strength (250-50)”, said the report.

The health ministry emphasized that the states should set up a mechanism where such fair rates are given wide publicity and where grievances regarding overcharging can be redressed and timelines fixed for their redressal.