Govt holds Rs 10 crore dues to private hospitals, Health News, ET HealthWorld

Govt holds Rs 10 crore dues to private hospitalsBENGALURU: A whopping Rs 10.2 crore, claimed by private hospitals for treatment of Covid patients, has been withheld by the government’s Suvarna Arogya Suraksha Trust (SAST) while it ascertains veracity of claims.

The government is probing complaints related to overcharging and wrong billing by private hospitals with regard to Covid patients referred by government to private hospitals for free treatment.

SAST data shows there are 2,228 cases of overcharging, mostly in Bengaluru. In some cases, patients reached out to SAST on their own but in most, the SAST grievance cell wing noticed overcharging. “We made over 1.6 lakh calls,” said SAST authorities.

In cases referred by government to private hospitals, ideally there should have been cashless treatment and hospitals raised the claim. “Sometimes, patients were asked to buy medicines themselves. In some cases, for treatment of comorbidities, patients were made to pay. In all instances, hospitals should have raised the matter with SAST and taken approval instead of making patients pay,” SAST officers told TOI.

In 1460 cases, SAST has slapped notices on hospitals. In the rest, patients had no proof to back their complaint.

“Hearing of all cases will begin from December 9. Even those who didn’t have medical records to prove charges have been asked to come,” said Manoj Kumar Kolla, chief vigilance officer, SAST.

Besides, Rs 73.2 lakh has been refunded by hospitals in 50 cases. Dr HM Prasanna, president, Private Hospitals and Nursing Homes Association (PHANA), said holding back Rs 10 crore is not a major concern, as a few crores from the first wave and more than Rs 100 crore is pending from the second wave. “There could be cases of overcharging by some member hospitals, but not all,” he said.

NT Abroo, executive director, SAST, said “In all, Rs 688.5 crore has been paid for treatment of 2.2 lakh patients in government and private hospitals so far. We have paid 88% of claims. In 5% of claims we have denied payment and in 1%, private hospitals haven’t submitted required documents. The rest are being processed,” she said. However, SAST has no powers over complaints of overcharging filed by private patients who sought treatment on their own.

SAST helpline

Those with issues of overcharging in a private hospital can call 18004258330 or 18004252646. If patients are covered under the government scheme, SAST will take it up or refer it to district health authorities.