Standardise hospital treatment charges or CGHS rates will be enforced, Supreme Court tells Centre

The Supreme Court of India on Tuesday took serious note of the considerable discrepancy in the prices of medical treatments across government and private medical facilities. The Court strongly criticised the Centre’s failure to enforce the 14-year-old Clinical Establishment (Central Government) Rules, which entail the notification of a standard rate for various medical treatments and procedures, in keeping with the living standards of different region.

This observation was made during the hearing of a public interest litigation (PIL) petition filed by the non-profit organisation Veterans Forum for Transparency in Public Life. The PIL urged the central government to establish a regulated fee structure for patients as per Rule 9 of the Clinical Establishment (Central Government) Rules, 2012. This regulation mandates all registered medical facilities to openly display their service charges for patients in local vernacular and English. The pricing of each service must be within the range outlined by the central government, as decided in consultation with the state governments.

However, the central government informed the Supreme Court that despite numerous correspondences with the state governments seeking their cooperation on the matter, it had received no responses. In response, the Supreme Court ruled that the central government cannot shrug off its responsibility on providing affordable healthcare for all, a fundamental right of citizens. The Union health secretary has been asked to convene a meeting with the health secretaries of all states to ensure that standard rates are notified within a month. "If Union govt fails to find a solution, then we will consider petitioner's plea for implementing CGHS-prescribed standardised rates," SC warned.

“The General Insurance Council and the insurance industry at large have always looked to minimise friction for customers, especially at the time of claims, while simultaneously offering best-in-class products at reasonable rates. We recently launched the ‘Cashless Everywhere’ initiative after discussions and deliberations with all players in the ecosystem. We have always maintained that we need to charge an appropriate cost for customers, whether it’s at the time of taking out a policy or bearing certain expenses at the time of a claim. It is very encouraging to see the Apex court urging the Centre to take a decision on standard hospital rates. We feel that this, along with ‘Cashless Everywhere’, will eventually benefit our citizens, for whom it’s a fundamental right to receive good healthcare,” said Tapan Singhel, Chairman of the GI-Council.

A member of the GIC, speaking on the condition of anonymity, said two provider meetings were held, where providers were invited and representatives of hospital associations had joined in these interactions as well. It was after these discussions and deliberations that “cashless everywhere” was announced by the Council. But some hospitals subsequently expressed apprehension about this initiative. The person explained that it is a win-win situation for hospitals that back this initiative as they could potentially see more patients.

A related issue here, the person said, was the lack of a regulator for hospitals who would serve as the voice of the customer, to ensure standardisation in treatment quality, service, provision of cashless facilities, and convenience for patients. The Department of Financial Services (DFS), too, has urged the NHA, insurers, and DFS to come together to explore the possibility of setting up a health regulator to provide affordable care to customers.

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