24, Apr 2021 | CJP Team

In a bid to ensure that people who are not covered by medical insurance, especially those hailing from economically weak backgrounds, are not deprived of critical medical care in case of Coronavirus infection, the Government of Maharashtra has issued a notification that lists a series of regulations for private and charitable hospitals and nursing homes.

The order has been issued in continuation of previous Covid-19 related public health notifications and under relevant provisions of the following Acts:

•       Indian Penal Code, 1860
•       Epidemic Diseases Act, 1897
•       Bombay Public Trusts Act, 1950
•       Disaster Management Act, 2005
•       Maharashtra Nursing Home (Amendment) Act, 2006
•       Maharashtra Essential Services Maintenance (Amendment) Act, 2011

As per this notification, medical facilities run by charitable trusts are required to discharge duties in accordance with Section 41 AA of the BPT Act, 1950 that deals with “Power of Charity Commissioner and State Government to issue directions in respect of hospitals, etc. to earmark certain beds etc. for poorer patients to be treated free of charge or at concessional rates.”

This notification effectively regulates prices that can be charged by healthcare providers. For healthcare providers in the area of the Municipal Corporation of Greater Mumbai (MCGM) 80 percent of isolation beds (Covid beds) and 50 percent of non-isolation beds (non-Covid beds) have been brought under prices that will be regulated by the MCGM Commissioner/District Collector Mumbai.

For healthcare centers across Maharashtra (excluding area under MCGM) 80 percent of total operational bed capacity including, both isolation and non-isolation beds, but excluding beds for PICU, NICU, day care and maintenance hemodialysis, will be available at regulated prices.

Facilities can charge rack rates for non-regulated beds while PICU, NICU, daycare and maintenance hemodialysis patients belonging to both categories (regulated and unregulated) will be charged at respective applicable rates on first come, first serve basis. The notification also prohibits discrimination in quality of care provided to patients availing treatment at either regulated or unregulated rates. All hospitals are also required to give patients pre-audited bills.

There are also several regulations for rates to be charged for insured patients by hospitals and heathcare facilities having different affiliations such as with General Insurance Public Sector Association (GIPSA) as a member of Preferred Private Network (PPN) or various Third Party Administrators (TPA).

This notification issued on August 31, 2020 was initially valid till November 30, 2020. It was subsequently extended to December 15, 2020, then to February 28, 2021 and finally to May 31, 2021.

The various notifications in chronological order and annexures may be viewed here: