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regular-article-logo Tuesday, 07 May 2024

Bengal govt asks hospitals to follow rates and refund

The state clinical establishment regulatory commission asked Nightingale Hospital to return to a patient the portion of a surgery’s cost that will not be reimbursed under the scheme

Subhajoy Roy Calcutta Published 22.12.20, 03:09 AM
The bill for the surgery was Rs 1.33 lakh

The bill for the surgery was Rs 1.33 lakh Shutterstock

The state clinical establishment regulatory commission on Monday asked Nightingale Hospital to accept the rates of the Bengal government’s health scheme and return to a government employee the portion of a surgery’s cost that will not be reimbursed under the scheme.

The employee, 40, alleged that the hospital had forced her husband to sign a declaration that they would not claim reimbursement under the health scheme. The woman underwent an orthopaedic surgery at the hospital in September 2019.

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She also complained that the doctor who performed the surgery told her that the implant she needed would cost much more than the rate offered by the health scheme and she had to pay the price fixed by the hospital, said retired judge Ashim Banerjee, the chairperson of the commission.

“The declaration made by the woman’s husband will become null and void. We have asked the woman to file reimbursement claims under the West Bengal Health Scheme. The hospital has to pay back the woman the amount that will not be reimbursed under the scheme,” said Banerjee.

“The woman complained that she had been charged Rs 71,000 extra for the implant. The health scheme rate says the implant would cost Rs 5,500, but the hospital charged her Rs 76,789,” Banerjee said.

The bill for the surgery was Rs 1.33 lakh. “The woman said the doctor told her that the surgery could not be done at the rate mentioned in the health scheme. She also said her husband had written the declaration under duress,” said Banerjee.

An official of a private hospital said the implant rates mentioned in the health scheme were for indigenous implants, whereas most doctors were trained in handling imported ones. That is why many doctors do not want to perform implants on patients admitted under the health scheme, he said.

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