The West Bengal Clinical Establishment Regulatory Commission on Tuesday asked Ohio Hospital in New Town to return Rs 45,000 to a patient who was asked to pay in cash despite the hospital using the patient’s Swasthya Sathi card and claiming reimbursement, the panel’s head said on Tuesday.
The hospital was also imposed a fine of Rs 25,000 because it had claimed reimbursement under Swasthya Sathi and also made the patient pay.
Retired judge Ashim Banerjee, chairperson of the West Bengal Clinical Establishment Regulatory Commission, said it was “fraud”.
The patient, a 74-year-old male, was admitted to the hospital in September.
“The patient was admitted under the Swasthya Sathi scheme, yet the hospital made his family pay out of their pocket. The hospital also took the Swasthya Sathi card from the patient,” Banerjee said.
“The hospital said they did not use the Swasthya Sathi card. They said they admitted the patient as a cash patient (where the patient’s family pays for the treatment),” said Banerjee.
“But we enquired with the Swasthya Sathi cell, and learnt that the hospital had been reimbursed Rs 19,800 (under the scheme). Besides, they also gave a declaration that the patient was admitted under the cashless facility. This is fraud,” Banerjee said.
He said the hospital was asked to return Rs 45,000 it took from the patient.
There was also a dispute about the money the patient’s family paid. Banerjee said the family claimed they had paid Rs 95,000, but the hospital only acknowledged having received Rs 45,000. The hospital denied having taken the extra money, Banerjee said.
“We have asked the hospital to return Rs 45,000 to the patient party. We have also imposed a penalty of Rs 25,000 on the hospital,” he said.
He said the police would probe the matter.
Rahul De, of Ohio Hospital, said the family had given consent to treat the patient as ‘cash patient’. “The patient was critical. We did not wait for money and started the treatment…. Later, the family told us they were very poor and requested us to claim whatever reimbursement we could under Swasthya Sathi and deduct the amount from the bill. We did that to help them,” said De.
