In a significant development, the Supreme Court has instructed the central government to establish uniform treatment charges at hospitals, payable by patients, within the next six weeks. The directive aims to streamline the healthcare system and potentially accelerate the widespread adoption of ‘cashless’ health insurance across India. Currently, varying treatment rates among different hospitals pose a challenge to the implementation of a cashless health insurance system nationwide.
A recent report by the Indian Express indicates that the move is expected to bring about a positive transformation in the general insurance industry, contributing approximately Rs 1 lakh crore in premiums to the health portfolio.
The two-judge division bench of the Supreme Court, while hearing a public interest litigation (PIL) initiated by an NGO, directed the Secretary of the Department of Health, Union of India, to collaborate with his counterparts in the State Governments/Union Territories. The objective is to formulate a concrete proposal within the stipulated six weeks. The PIL, filed by the Veterans Forum for Transparency in Public Life, urged the Supreme Court to determine the rate of fees chargeable by hospitals across the country, citing Rule 9 of the Clinical Establishment (Central Government) Rules, 2012.
In the event that the central government fails to present a concrete proposal by the next hearing, the Supreme Court bench, comprised of Justices B.R. Gavai and Sandeep Mehta, warned of considering appropriate directives on the matter.
The central issue revolves around the lack of standardized rates for similar treatments across hospitals, hindering the ‘Cashless Everywhere’ initiative recently launched by the general insurance industry. This scheme allows policyholders to receive treatments from any hospital in the country, not limited to those empanelled by their insurer. The Supreme Court emphasized the need for the central government to take responsibility and resolve the issue promptly.
Tapan Singhel, Chairman of the General Insurance (GI) Council, expressed optimism about the court’s stance, highlighting the importance of charging appropriate costs for customers during policy issuance and claims. Singhel believes that the Apex court’s encouragement for the central government to decide on standard hospital rates, combined with the ‘Cashless Everywhere’ initiative, will ultimately benefit citizens, emphasizing their fundamental right to quality healthcare.
However, the Indian Medical Association (IMA) and the Hospital Board of India have cautioned hospitals against accepting the ‘Cashless Everywhere’ initiative in its current format, citing potential risks. With over 40,000 registered hospitals in the country capable of offering cashless facilities to more than 30 crore health insurance policyholders, the outcome of this directive holds substantial implications for the healthcare and insurance sectors, as reported by the Indian Express.
