A group of civil society organisations (CSO) has sought Delhi government's urgent intervention against alleged flouting of 'maximum per day charge limit' fixed by the state government for COVID-19 treatment at private hospitals.

Citing at least half a dozen breach of ceiling charges by private hospitals, the groups said that in some cases patients are not being informed about the government rates and are misled to sign false consent papers. They also complained about the lack of transparency in the availability of hospital beds exclusively meant for COVID-19 treatment under government fixed rates.

"Hospitals are not providing information about the exact availability and occupancy of rate capped beds in each category. Therefore, patients are often being admitted to the non-capped beds even when government fixed rate beds are available. Even in hospitals where all of COVID-19 beds are supposed to be provided as per government rates, patients have been charged at the hospital's own rates," the CSO letter to CM Arvind Kejriwal, Lieutenant Governor Anil Baijal and Chairperson of Delhi Disaster Management Authority stated.

The groups said the government rates are not being offered to patients with private health insurance coverage. "Several hospitals have unilaterally instituted a policy of billing insured patients as per the agreements with TPAs. Insurance companies on the other hand are unwilling to clear claims beyond the rates fixed by the government, particularly those related to non-medical expenses and consumables such as PPE where hospitals are levying exorbitant charges. Thus insured patients are unable to avail the government rates and are being forced to incur high out of pocket expenditure, even though there is no such exclusion for insured patients in the Delhi Government policy," they point out.

Charging high rates for twin-sharing or single rooms, charging separately for medicines, investigations, PPE etc. were found to be other practices that go against the government order. They also accused hospitals of administering experimental drug therapies without taking informed consent of patients.

False billing of patients for care that was never provided, differential care to patients paying hospital rates versus the government fixed rates, detaining patients until the bill amount is settled by the family, even when the billing is in violation of Delhi government orders, absence of doctors or medical staff in hotel rooms attached to private hospitals and inadequate support and redressal for patients who have contacted individual officials of the Delhi government or filed formal complaints are some of the other complaints raised by the groups.

The civil society groups have sought immediate action on patient complaints and grievances including individual cases cited by them. "The government must conduct an enquiry and ensure that formal action is taken against hospitals in the form of a show cause notice, penalty etc. Since the evidence indicates that the complaints by patients are only a symptom of broader violations in the hospital, the Delhi government must conduct detailed investigations into the practices of each of the hospitals named in the complaints regarding implementation of the government order. The government must also ensure that hospitals return the excess money they have charged from patients, in violation of the order," they said.

The letter called for a formal grievance mechanism, with adequate civil society representation for timely redressal of formal complaints against private hospitals. They also wanted the government to maintain a live database that is publicly available on its website and provides details of complaints filed, including date, name of hospital against whom complaint has been filed, status of the complaint and details of action taken. The formation of an audit committee, to conduct monthly audits of the treatment and bills of all private hospitals providing COVID-19 treatment have also been suggested.

The groups wanted the government to ask private hospitals to prominently display the fixed package rates for COVID-19. Hospitals claiming to have NABH accreditation should display accurate information regarding the accreditation status along with the duration of validity in the same area as where the rates are displayed, they said.

Mandatory public reporting requirements for private hospitals, transparency of total hospital bed capacity and government fixed rate beds, regulation of charges for hotel beds attached to hospitals and ensuring quality of care, real time information on number of fixed rate beds, ensuring government fixed rates apply to all ICU beds are the other demands.

The group wanted COVID-19 suspected patients to be eligible for government treatment rates. The government has also been asked to take steps towards controlling the irrational use of experimental therapies for COVID-19 and protect patients from unnecessary, high expenses.

The signatories of the petition include All India Drug Action Network (AIDAN), Jan Swasthya Abhiyan (JSA) - Delhi and National Alliance for Maternal Health and Human Rights (NAMHHR).

The Delhi government prescribed maximum per day rates for COVID-related treatment in private hospitals on June 20. As per the order, the prescribed maximum rates were to be applicable for various categories of beds - isolation bed, ICU bed without ventilator, ICU bed with ventilator - subject to an upper limit of 60 per cent of the total hospital bed capacity.