At least 25 of the 30 private hospitals designated for treatment of Covid-19 patients in Ahmedabad are not ready to sign the MoU with the Ahmedabad Municipal Corporation (AMC) despite health department assuring them of increasing the reimbursement amount fixed by the state government.
Some super-speciality hospitals this paper spoke to claimed they were not taken into confidence and had no clue how they could contribute to Covid-19 care.
Citing “non-parity in services and specialisation” across these private hospitals, they have rejected the uniform rate card formula notified by the state government and demanded fixing of charges for individual hospitals based on its running costs than a common slab for everyone.
“The actual cost of treatment is higher that the rates fixed by the state government. Not only that they also have to understand that private hospitals do not work in this way. The basic cost each hospital bears is different and based on that they have their schedule of charges. It cannot be same for everyone. For instance, the ICU rates cannot be same for all hospitals depending upon the infrastructure and the medical and paramedical staff. There is a huge difference between two hospitals even with similar bed capacity,” said Dr Bharat Gadhavi, president of Ahmedabad Hospitals and Nursing Homes Association (AHNA), reacting to the assurances of increasing the reimbursement amount fixed by the state government.
Sources in the state health department said the department was considering increasing the charges fixed for reimbursing hospitals through a Government Resolution of April 16, 2020 for OPD and IPD services to Covid-19 patients treated free of cost. Thus, even if raised, the slab will remain uniform for all the requisitioned hospitals.
As per the GR, while the patients do not have to pay anything, the costs will be reimbursed by the state government. For this, while Rs 200 is fixed for OPD, different slabs have been fixed for IPD patients depending upon the facilities provided.
“The charges were fixed by the state government keeping the district hospitals in mind and not the big cities like Ahmedabad. So there is already a consensus on the fact that the charges are not at par with the expenses to be incurred by these private hospitals. There is a deliberation to hike these charges fixed by the state government across all slabs,” a senior official said.
However, AHNA members claimed that on an average a private hospital incurs between Rs 20,000-22,000 for the general ward per day, while for ICU the running cost is between Rs 30,000-40,000 per patient per day.
Also, some of hospitals requisitioned by AMC are super-specialty hospitals that have challenged the criteria followed for selecting them. “We are running spine super specialty hospitals for years now. With all the equipment and machines inside the hospital it is not fit to be converted into a Covid hospital. There was no communication or discussion before we came to know through news reports that our hospital has been requisitioned,” said Dr Bharat Dave of Stavya Spine Hospital and Research Institute in Mithakali.
Similarly, Parekh Hospital in Satellite, a joint replacement super-specialty hospital, is another in the list of 30 hospitals. “AMC has taken all hospitals without any discussion with any of us. It seems there is no thought of feasibility put in before putting these hospitals under designated hospitals list,” said Dr Ketu Parekh running the hospital.
The first list of seven private hospitals requisitioned as designated Covid-19 hospitals by the Ahmedabad Municipal Corporation (AMC) was issued on May 6. This week, AHNA and the Indian Medical Association’s Gujarat branch wrote to the state government as well as the civic authorities citing requisitioning of private hospitals by using “coercive methods” terming it to be dictatorship.
The AMC has approved six private and corporate hospitals for Covid-19 treatment where patients are being treated at their existing rates, which is one of the issues the private hospitals have. There are over 150 patients lodged in these hospitals — HCG Mithakali, Sterling Bodakdev, Narayani Rakhiyal, Shalby Naroda, Tapan Hospital Prahladnagar and SMS Hospital Chandkheda.
The MoU conditions
Based on the GR issued on April 16, 2020, the beneficiaries will include all Covid-19 patients who will be treated free of cost. The fixed cost that will be reimbursed by the state government is Rs 200 per patient for OPD. The medicines are to be given free of cost to the patients by the respective hospital and for X-RAY, blood test or any other test, an amount of Rs 200 is to be paid.
The charges being paid to the hospital include charges for doctor’s visit, nursing charges, medicines, laboratory and radiology charges, follow-up charges, refreshments for patients, food (twice a day) and consultation up to five days from the date of discharge.
Suspected Covid-19 patients to be tested only at the laboratories specified by the government. The responsibility of sending the samples to such laboratories is with the designated hospital. The charges for the same will be paid by the government as per the prevailing norms.
For treatment of the patients at the designated hospitals, supply of PPE kits, N95 masks, triple layer masks, Hydroxychloroquine tablets are to be made available by the Chief District Medical Officer.
Expenses like staff salary, electricity bill etc. are not to be paid to the designated hospitals.
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