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Thursday, June 17, 2021

Maharashtra caps treatment cost of mucormycosis at private hospitals

Prices capped vary for cities and rural areas, which have been categorised into A, B and C class cities

Written by Tabassum Barnagarwala | Mumbai |
June 5, 2021 1:03:27 am
Nagpur and Pune account for almost 33% of Maharashtra's mucormycosis casesA suspected mucormycosis patient been checked for signs of the rare fungal disease at the Navi Mumbai Municipal Corporation special OPD ward. (Express Photo by Amit Chakravarty)

Maharashtra became the first state to cap the treatment cost of mucormycosis patients at private hospitals on Friday. This move is likely to benefit over 2,000 patients without insurance, who are undergoing treatment at present.

Prices capped vary for cities and rural areas, which have been categorised into A, B and C class cities. Hospitals can charge maximum of Rs 4,000 for normal ward, per patient per day, for A-class cities such as Mumbai Metropolitan Region, Pune and Nagpur; Rs 3,000 for B-class cities like Nashik, Aurangabad, Bhiwandi, Amravati, Vasai-Virar, Malegaon, Nanded, Kolhapur, Sangli and Solapur; and Rs 2,400 for C-class areas that include all district headquarters and other areas not listed in categories A and B. For intensive care unit, maximum cap is Rs 7,500 per day and for ventilator Rs 9,000 for A category. These prices are Rs 4,500 and Rs 5,400, respectively, for C category. ENT (ear-nose-throat) surgery cost has been capped at a range of Rs 38,000 to Rs 65,000 for A-class cities; Rs 28,500 to Rs 48,750 for B category, and Rs 22,800 to Rs 39,000 for C category areas. Skull base neurosurgery is capped at Rs 1 lakh and eye surgery at maximum of Rs 55,000.

“Our earlier notification of price capping in 80 per cent private beds allocated for Covid-19 patients was not applicable here, since 86 per cent mucormycosis patients have recovered from Covid and are considered Covid-negative,” said Dr Sudhakar Shinde, who chaired the committee for price capping.

He said the state had to come up with a separate notification for mucormycosis as cases were rising. The state government received complaints from patients, who have received bills as high as Rs 39 lakh for facial and brain surgery to remove the fungus. State officials said private hospitals were charging a lot for surgeries to remove the fungus. “ENT procedure cost escalated four times due to the high demand,” an official said. Maharashtra has recorded 5,000 cases of this fungal infection, which develops as a secondary infection after Covid. The fungus is commonly seen spreading in the face and brain.

At least 4,000 patients continue to undergo treatment. Officials said 50 per cent either had insurance or were admitted to government hospitals or under MPJAY. Remaining 50 per cent were admitted to private hospitals without insurance, they added. Price capping will be applicable for those who do not have insurance or for hospitals not part of General Insurance Public Sector Associations (GIPSA). For hospitals that have GIPSA agreement, lowest bed rate will be applicable.

“Any hospital found violating any provision of this notification shall be deemed to have committed an offence and shall be liable for cancellation of registration,” the notification stated.

Price capping is not applicable for doctor’s consultation fee, MRI and CT scan, and drugs. Antifungal amphotericin B comprises the largest component in hospital bills with a month-long treatment costing Rs 8 lakh and above worth of antifungals. While the overall hospital charges will reduce, patients will have to continue paying drug cost in the private sector. In government hospitals, amphotericin is administered for free.

Private hospitals said the notification might affect the number of mucormycosis patients they admitted, forcing some to turn away such cases. In Lilavati hospital, 10 mucormycosis patients are admitted, four of them slated for a surgery on Saturday. “We are already following all rules of the government. We have not received any overcharging complaint,” said Dr V Ravishankar, COO in Lilavati.

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