HC upholds hosp’s removal from Ayushman panel for charging blood: The wider industry impact

He apprised the court that he had submitted a complaint to the Varanasi police commissioner

The hospital had allegedly charged Rs 9,000 for two units of blood provided to a two-month-old child suffering from blood cancer, instead of providing them free of cost under the government health scheme. Prayagraj : The Allahabad high court has upheld the removal of a private hospital from the panel of hospitals empanelled under the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), citing prima facie shortcomings in the implementation of the scheme and failure to observe necessary treatment protocols.

A division bench of Justice JJ Munir and Justice Indrajeet Shukla dismissed the hospital’s writ petition challenging the State Empanelment Committee’s order dated Aug 19, which struck off its empanelment under the State Health Agency for Comprehensive and Integrated Services (SACHIS). The petitioner-hospital received a show-cause notice on June 18.

This procedure was mandatory for a patient admitted to the ICU, according to the order. Examining the order passed against the hospital, the court said that although it was not sufficiently elaborate, this did not detract from the substance of the facts emerging from the record. The court added that although the state must confer empanelment in a non-discriminatory manner, the material on record prima facie disclosed serious shortcomings on the hospital’s part in implementing the scheme and observing the necessary protocols while providing treatment under it. The order stated that the transfusion units had not been recorded in the bed head ticket by the doctor attending to the child. Hence, the adverse order was passed.

Because of a loss of confidence, drawing an analogy, the HC observed in its judgment dated Sept 28 that the position was akin to a patient choosing to opt out of the services of a particular consultant or doctor.

“Prima facie material has surfaced against the petitioner-hospital showing serious shortcomings in the implementation of the scheme on their part and in observing necessary protocols while offering treatment under the scheme,” the court observed. Considering the prima facie facts of the case, the court took exception to the alleged conduct of the doctors and the hospital management. The HC also noted that empanelment under SACHIS or the Ayushman Bharat scheme did not affect the hospital’s right to practise its profession. It clarified that removal from the scheme’s panel did not prevent the hospital or its doctors from carrying on their profession or treating patients who approached them for their services.

The court also noted that the doctor who appeared before the State Empanelment Committee on behalf of the hospital had admitted to the lapses.

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