Pune: Pune has the highest number of COVID-19 cases, and many patients are opting for treatment at private hospitals. The district administration has appointed audit teams to rein in hospitals from overcharging patients. But that might not provide much-needed relief to patients as the committee will check the bills of only 1.86% of the total number of patients who have been treated at private hospitals until now.
The audit teams would only check bills of the patients who have been charged more than Rs 1.5 lakh, leaving the majority of them out of its purview.
Therefore, bills pertaining to only 2,578 persons as against more than 1.38 lakh patients who have been treated at private facilities would come under this scanner. Patients, moreover, are not aware of this measure.
Pune district has been worst affected by COVID-19 with 57,926 active cases, 3,08,434 total cases and 6,073 deaths, according to Pune divisional commissionerate. It has the highest number of COVID-19 cases in any city across India as of October 7.
Maharashtra had recorded 2,44,527 active cases, 14,80,489 total cases and 39,072 as on that day, as per the public health department (PHD) of the state.
Price capping
In order to control private hospitals from overcharging COVID-19 patients, the Maharashtra government has capped prices for treatment, through a government resolution and a notification.
For example, charges for routine care and isolation wards per patient have been fixed at Rs 4,000, charges for intensive care unit (ICU) without ventilator, at Rs 7,500, and ICU with a ventilator at Rs 9,000. Besides, charges for consumables like personal protective equipment (PPE), should be divided among all patients in the ward concerned.
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But hospitals continue to overcharge patients. Thus, separate audit teams have been assigned for all major hospitals, while one audit team works for all small hospitals. The total number of functioning audit teams, however, has not been disclosed by authorities.
COVID-19 facilities
Pune district has 223 COVID-19 facilities, which include dedicated COVID-19 hospitals (DCH), dedicated COVID-19 health centres (DCHC) and COVID-19 care centres (CCC). While 45 facilities are of the government’s, 182 are run by private players according to the Divisional Commissionerate. Although the dashboard shows 253 facilities, 20 facilities do not have beds.
According to the official data, 60% patients in Pune are hospitalised, while 40% patients, who are asymptomatic, are under home isolation. Thus, 1,85,060 patients have been treated at hospitals. Of them, 75% patients have opted for treatment at private facilities, says the divisional commissioner of Pune, Saurabh Rao. This comes to a total of 1.38 lakh patients, who have taken treatment at private hospitals.
| Area | Number of audited bills | Inflated amount charged by hospitals | |
| 1 | Pune Municipal Corporation | 695 | Rs 1.97 crore |
| 2 | Pimpri Chinchwad Municipal Corporation | 1,172 | Rs 1.7 crore |
| 3 | Pune Rural | 711 | Rs 64 lakh |
| Total | 2,578 | Rs 4.31 crore |
Source: Pune district administration
But audit teams have checked bills of only 2,578 patients and have saved them Rs 4.31 crores, as per the data provided by the administration to The Wire. However, the admin refused to provide data of the hospital names and more details on hospital-wise inflated bills.
“Approximately 15% patients require oxygen, 4.5% require ICU without a ventilator and 4.5% require ventilator support,” says Dr. Pradip Awate of the public health department.
About 24% patients require critical care and their bills are higher. At least 33,120 patients have received hefty bills, though this figure could this be less than what the situation is. But, the administration has checked only 7.7% bills of patients who needed critical care, leaving the majority to fend for themselves.
Little respite for affected families
Amruta Kharabi (67), a farmer from Chakan, has been undergoing treatment at Jahangir Hospital, one of the reputed hospitals in the city, from September 11. His family has already paid Rs 7 lakh.
“My father was in ICU for 15 days till September 26, and now he is in the general ward. ICU charges are Rs 9,000 per day as per government orders, including consultation, nursing charges, and investigations, like CBC among others. I do not understand how they handed over this much bill of 25 days. He is still in the hospital,” Kharabi’s son Rahul says.
Pune district has been worst affected by COVID-19 with 57,926 active cases, 3,08,434 total cases and 6,073 deaths. Photo: REUTERS/Adnan Abidi
Kriti Care Centre in Chakan, Pune, has handed over a bill of Rs 3.6 lakh to Ajay Pande (54), who runs a salon in Chakan. Jyoti Dhamale, his sister says, “He was on a ventilator for 11 days and on oxygen for seven days in the general ward along with four more patients. The hospital has charged Rs 10,000 for the room per day for 18 days, Rs 10,000 as ventilator charges for 11 days and oxygen charges pf Rs 3,000 for seven days. No break down of nursing charges, PPEs, consultation charges have been mentioned. We have got all tests done and bought medicines ourselves.”
Dhamale has complained to various agencies, including audit teams, since the day when her brother was discharged from the hospital on October 6.
Lackadaisical approach
Asked about why authorities have not been able to check every bill, additional commissioner of Pune Municipal Corporation (PMC), Rubal Agarwal, tells The Wire, “Pune has many patients and to check each bill is not practical. Audit teams check all bills above Rs 1.5 lakh. If patients with bills less than Rs 1.5 lakh complain, audit teams check that too.”
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When asked to disclose the names of hospitals which have overcharged patients, she refused to disclose the information saying that it might damage the reputation of hospitals.
Dr Manisha Naik, who heads the audit team at PMC says, “Government has decided Rs 1.5 lakh based on capped rates. And we follow the same rule.”
Overcharging by private hospitals continue
Activists, who have been helping patients ensure that audit is carried out for their bills, say the government’s efforts have not been of much use.
Social activist Vasant More says, “PMC had appointed audit teams only at 25 hospitals that are big. And, one health official looks into the bills of remaining 50 hospitals in the PMC’s jurisdiction from the end of August. We have to help patients get their bills to the audit team. They themselves cannot do it.”
A woman sits with her child inside a quarantine centre for the coronavirus disease (COVID-19) patients amidst the spread of the disease at an indoor sports complex in New Delhi, India, September 22, 2020. Photo: Reuters/Anushree Fadnavis
Many patients are not aware of audit teams and many are not in a position to get in touch with audit teams. “Members of the audit teams are transferred to other jobs, and they are not working with full capacity since the first week of this month,” More adds.
Mayuri Gawade (30) had to deposit Rs 40,000 to admit both her parents at Jeevandhara Hospital, Katraj, Pune. She says, “I have visited PMC to bring down the deposit amount, but no use. The hospital has charged Rs 90,000, including deposit, for just three days. Where do I get the money from? My father drives an auto, and my mother is a homemaker. I have to run my house and take care of my family.”
Navnath Kamate (45), a businessman from Katraj, had admitted his father-in-law Ramchandra Sanas (70) at Bharati Hospital, Pune. Sanas died on the fourth day. Kamate says, “I had to pay a Rs 1.40-lakh deposit, and Rs 66,000 as bills for four days. Besides, I have also paid for expensive medication separately.”
Kamate had approached the PMC audit team, but he had lost one bill and could not get the benefit of the scheme.
On the other hand, officials have not responded as to what action would they take against hospitals which are overcharging patients in violation of government norms.
Varsha Torgalkar is an independent journalist.
