Billing often becomes a contentious issue between hospital and patients. This case is an example of this fact; it’s learning could prove to be useful for hospital management and administrators.
Irrefutable Facts
The patient was admitted in hospital’s ICCU six times within an eight-month period and was put on oxygen support during each admission.
At the end of the treatment, the hospital issued a separate bill of INR 10,860 for oxygen charges.
The patient sued the hospital, alleging that it charged separately for the supply of oxygen, which was an illegal and unfair trade practice according to the NABH guidelines.
The patient further alleged that while she was in the ICCU, the hospital ceased providing all medications, and the attendant had to obtain them from outside at her own expense.
Hospital’s Plea
The hospital stated in defence that the ICCU charges could not be adjudicated under provision of the Consumer Protection Act. Additionally, the NABH guideline should be considered just as a draft copy or suggestion, as the Central Government has not adopted it.
Court’s Observations
The court observed that “regarding billing dispute, the Consumer Forum / Commission has no authority to entertain the matter,” but “the Consumer Forum / Commission has ample power to entertain the matter when unfair trade practice is involved.”
The court concluded that demanding separate payment for oxygen supplied in ICCU constituted a clear case of unfair trade practice.
The court rejected hospital’s defence after observing that it had failed to provide any valid documentation / guidelines “to show that they are entitled to charge the equipment for oxygen separately in ICCU.”
Making these observations, the court held that the hospital had committed unfair trade practice.
Prevention Is Better Than Cure
Hospitals should have clear billing protocols. Patients should be clearly and transparently informed about the services chargeable upon admission or when new treatments / interventions are proposed. The discretion to determine fees / charges lies with the doctor / hospital, but this discretion must be exercised reasonably. The court’s decision in this case is clearly erroneous. Furthermore, it is rather unfortunate that neither the regulators nor the professional bodies in India are interested in formulating guidelines / protocols on important issues, causing significant hardship to patients, doctors and even courts.
Source : AMRI Hospital v/s M. Madhumita Saha
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