BMC brings down COVID treatment cost by Rs 20.81 crore

In the past 15 months, the Brihanmumbai Municipal Corporation (BMC) has audited 31,065 private hospitals bills of Covid-19 patients amounting to ₹522 crore. After auditing, the civic body has managed to reduce an amount of ₹20.81 crore, of which ₹2.73 crore were reduced after inspecting 405 complaints of overcharging in 35 private hospitals.

Since the outbreak of the pandemic in March 2020, several private hospitals have been accused of overcharging Covid-19 patients. HT in a series of articles has highlighted the plight of patients who were charged ₹1 lakh per day for their treatment in the first wave. After receiving several such complaints, the BMC appointed 70 auditors in June 2020 to audit medical bills.

Suresh Kakani, additional municipal commissioner (health), said between June 2020 and August, almost 4% of the audited amount has been reduced from bills or refunded to patients.

“We are auditing bills from 35 private hospitals with each having two auditors. Once the officers review the bills, they instruct the hospitals either to reduce the amount from the current bill amount or refund it to the patients,” said Kakani.

In May 2020, the state capped Covid-19 treatment charges. According to a state government order, charges for a Covid-19 patient in the general isolation ward shouldn’t exceed ₹4,000 a day, the maximum charge for an Intensive Care Unit (ICU) is capped at ₹7,500 a day, and for ventilators, it is ₹9,000 a day.

Despite this, the patients have been complaining of inflated bills. On April 14, Sudhir Mishra, 51, a businessman was admitted to a private hospital in Andheri, after he was detected with Covid-19. When he was discharged on April 26, the hospital handed over a bill of ₹15 lakh. On May 12, he had to get admitted again when he developed mucormycosis also known as black fungus. “The fungus had spread in his mouth so the doctors had to remove his palate to stop it from spreading to his brain which would have killed him. Even after the surgery, he had to stay in the hospital for another 15 days as a precautionary measure. When he was discharged, we were given a bill of ₹22.5 lakh,” said Manisha Sudhir Mishra, 47, his wife. “Cumulatively, we had to pay over ₹37 lakh by selling our ancestral properties in our native town in Uttar Pradesh,” she said. They still have a debt of ₹12 lakh which they had to take from their family members.

The auditors revealed they find several types of discrepancies in bills which add to the financial constraints of patients. For instance, when patients are admitted, tablets like aspirin, B-Complex, and paracetamol are included in the package. Despite this, they are again charged separately for the same medicines. Again, for a patient’s treatment, a hospital requires five personal protective equipment (PPE), including N-95 masks. But while billing, hospitals charge the patients extra for the masks.

“If a hospital has given one drug to a patient, they are charged for the whole strip. While discharging, they do not even provide the remaining medicines to the patients. Also, a medical staff examines multiple patients wearing the same PPE, but patients are charged individually for the same PPE. Private hospitals use different creative ways to add up to the bills,” said an auditor who is responsible for a hospital in western suburbs.

Also, the BMC has received 405 complaints of overcharging in the past 15 months worth ₹19crore. All complaints of patients have been found to be correct, as per the data of the civic body.

“People can file a complaint before paying the bills or after it. There are no restrictions on it. Whenever we get any complaint of overcharging, our auditor inspects the bill within 48 hours,” said a senior health officer from BMC.

Nearly 75% of Covid-19 patients who were treated at private hospitals in the state were overcharged, despite a price cap by the Maharashtra government, revealed a study conducted by Jan Arogya Abhiyan along with Maharashtra Corona Ekal Mahila Punarvasan Samiti.

Talking to HT, Shakuntala Bhalerao of Jan Arogya Abhiyan said last week, “Introducing a price cap was a good step, but it was not implemented. We are calling upon the state to conduct a detailed audit and get the hospitals to return the overcharged amount to patients in one month.” Hindustan Times