Private hospitals will have to display treatment costs

October 8, 2012
tp-doctor-apollo-hospital-delhi

New Delhi, October 8: In a major move aimed at checking unnecessary medical tests and procedures, the health ministry on Sunday said it was working on a plan to make it mandatory for all private hospitals to declare and display the treatment costs of different diseases.

Jagdish Prasad, director general of health services (DGHS), told TOI that the ministry's plan would check overbilling and bring in transparency in the healthcare sector.

"Our aim is to notify standard costs for various medical procedures such as angioplasty, coronary bypass surgery etc. We also plan to categorize hospitals based on quality of services offered and develop standard treatment costs for each category," DGHS Prasad said.

He said suggestions are being sought from all stakeholders, including the corporate-run hospitals, on how the new system can be rolled out.

"We will initially ask each hospital to give their treatment charges, which would help us slot these hospitals into categories," Prasad said. A standard guideline for treating conditions like heart attack, stroke, diabetes, osteoporosis and cancer, is also on the anvil, the senior ministry official said.

Unwarranted procedures add to cost

Prasad said the guidelines will be introduced under the Clinical Establishment (Registration and Regulation) Act 2010, which was notified recently.

The planned guidelines would also give a boost to evidence-based approach to treatment, said Dr Kameshwar Prasad, head of the clinical epidemiology unit of AIIMS. "Unwarranted procedures and diagnostic tests put extra financial burden on the healthcare system and cause increased morbidity and mortality. For example, a person suffering from muscular chest pain does not require angiography. Still, many hospitals routinely put such patients through this procedure," the doctor said.

Experts cite studies showing rampant use of unnecessary procedures in India. For instance, hormone replacement therapy is carried out in post-menopausal women despite there being no evidence that it reduces cardiac events. Similarly, antioxidant vitamins are commonly prescribed for reducing cardiovascular disease though there's no evidence of its efficacy. The Elisa test has till recently been widely used for diagnosis of tuberculosis. It has since been banned due to its unreliability.

The DGHS also said patient treatment cannot be taken as a clinical trial. "Stem cell therapy is being offered for spine injuries by many hospitals and patients are charged for that. This despite the fact that there's no proven effect of the therapy. This can only be stopped through patient awareness and strict monitoring by government agencies," Prasad said.

AIIMS is leading a first-of-its kind global initiative to promote evidence-based healthcare. Said institute director, Dr R C Deka, "Awareness of the latest evidence-based treatments is necessary. However, treatment costs should also be borne in mind by doctors while suggesting procedures for patients."Deka also said overprescription was also leading to immunity against many antibiotics, a problem that was likely to become serious in the future. Standardized procedures should help in curbing this trend, he added.


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News Network
February 14,2020

London, Feb 14: Liquor tycoon Vijay Mallya once again asked the Indian banks to take back 100 per cent of the principal amount owed to them at the end of his three-day British High Court appeal on Thursday against an extradition order to India.

The 64-year-old former Kingfisher Airlines boss, wanted in India on charges of fraud and money laundering amounting to an alleged Rs 9,000 crores in unpaid bank loans, said the Enforcement Directorate (ED) and the Central Bureau of Investigation (CBI) are fighting over the same assets and not treating him reasonably in the process.

“I request the banks with folded hands, take 100 per cent of your principal back, immediately,” he said outside the Royal Courts of Justice in London.

“The Enforcement Directorate attached the assets on the complaint by the banks that I was not paying them. I have not committed any offenses under the PMLA (Prevention of Money Laundering Act) that the Enforcement Directorate should suo moto attach my assets," he said.

"I am saying, please banks take your money. The ED is saying no, we have a claim over these assets. So, the ED on the one side and the banks on the other are fighting over the same assets,” he added.

Asked about heading back to India, he noted: “I should be where my family is, where my interests are.

"If the CBI and the ED are going to be reasonable, it’s a different story. What all they are doing to me for the last four years is totally unreasonable.”

Lord Justice Stephen Irwin and Justice Elisabeth Laing, the two-member bench presiding over the appeal, concluded hearing the arguments in the case and said they will be handing down their verdict at a later date after considering the oral as well as written submissions in the “very dense” case over the next few weeks.

On a day of heated arguments between Mallya’s barrister, Clare Montgomery, and Crown Prosecution Service (CPS) counsel Mark Summers, arguing on behalf of the Indian government, both sides clashed over the prima facie case of fraud and deception against Mallya.

“We submit that he lied to get the loans, then did something with the money he wasn’t supposed to and then refused to give back the money. All this could be perceived by a jury as patently dishonest conduct,” said Summers.

“What they [Kingfisher Airlines] were saying [to the banks] about profitability going forward was knowingly wrong,” he said, as he took the High Court through evidence to counter Mallya’s lawyers’ claims that Westminster Magistrates Court Judge Emma Arbuthnot had fallen into error when she found a case to answer in the Indian courts against Mallya.

Mallya, who remains on bail on an extradition warrant, is not required to attend the hearings but has been in court to observe the proceedings since the three-day appeal opened on Tuesday. A key defence to disprove a prima facie case of fraud and misrepresentation on his part has revolved around the fact that Kingfisher Airlines was the victim of economic misfortune alongside other Indian airlines.

However, the CPS has argued that “there is enough in the 32,000 pages of overall evidence to fulfil the [extradition] treaty obligations that there is a case to answer”. “There is not just a prima facie case but overwhelming evidence of dishonesty… and given the volume and depth of evidence the District Judge [Arbuthnot] had before her, the judgment is comprehensive and detailed with the odd error but nothing that impacts the prima facie case,” said Summers.

At the start of the appeal, Mallya’s counsel claimed Arbuthnot did not look at all of the evidence because if she had, she would not have fallen into the multiple errors that permeate her judgment. The High Court must establish if the magistrates’ court had in fact fallen short on a point of law in its verdict in favour of extradition.

Representatives from the Enforcement Directorate (ED) and Central Bureau of Investigation (CBI), as well as the Indian High Commission in London, have been present in court to take notes during the course of the appeal hearing.

Mallya had received permission to appeal against his extradition order signed off by former UK home secretary Sajid Javid last February only on one ground, which challenges the Indian government's prima facie case against him of fraudulent intentions in acquiring bank loans.

At the end of a year-long extradition trial at Westminster Magistrates’ Court in London in December 2018, Judge Arbuthnot had found “clear evidence of dispersal and misapplication of the loan funds” and accepted a prima facie case of fraud and a conspiracy to launder money against Mallya, as presented by the CPS on behalf of the Indian government.

Mallya remains on bail since his arrest on an extradition warrant in April 2017 involving a bond worth 650,000 pounds and other restrictions on his travel while he contests that ruling.

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News Network
March 27,2020

Mumbai, Mar 27: Reserve Bank of India (RBI) Governor Shaktikanta Das on Friday said that Monetary Policy Committee (MPC) has taken note of the global economic activity coming to a near standstill due to the coronavirus pandemic and added that large parts of the world could slip into recession in the coming days to the coronavirus crisis.
"The MPC noted that global economic activity has come to a near stand-still as COVID-19 related lockdowns and social distancing are imposed across a widening swath of affected countries. Expectations of a shallow recovery in 2020, from 2019's decade low in global growth, have been dashed," Das said.
"The outlook is now heavily contingent upon the intensity, spread and duration of the pandemic. There is a rising probability that large parts of the world will slip into recession," he added.
The RBI Governor further added that "the implied GDP growth of 4.7 per cent in Quarter 4 of 2019-20, in the second advance estimates of the National Statistics Office which was released in February 2020, within the annual estimate of 5 per cent for the year as a whole is now at risk."
As per the outlook for the year 2020-21, Das said, "Apart from continuing resilience of agriculture and allied activities most other sectors of the economy will be adversely impacted by the pandemic depending upon, its intensity, spread and duration."
Das also announced a reduction in the repo and reverse repo rates for banks.
"The repo rate has been reduced by 75 basis points to 4.4 per cent. The reserve repo rate has been reduced by 90 basis points to 4 per cent," Das said addressing the media.
The decision for "a sizeable reduction" in the policy repo rate, according to the RBI Governor was taken to "revive growth and mitigate the impact of COVID-19 and ensure financial stability." 

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News Network
February 19,2020

New Delhi, Feb 19: The UIDAI on Tuesday said its Hyderabad office has sent notices to 127 people for allegedly obtaining Aadhaar numbers on "false pretences" but asserted these have nothing to do with citizenship.

The notices were issued after reports from the police, the Unique Identification Authority of India (UIDAI) said.

"Aadhaar is not a document of citizenship and UIDAI has been mandated under the Aadhaar Act to ascertain residency of a person in India for 182 days prior to applying for Aadhaar," the nodal body, which issues the 12-digit biometric ID, said in a statement.

The Supreme Court, in its landmark decision, has directed the UIDAI not to issue Aadhaar to illegal immigrants, it said.

"It may be noted that the regional office Hyderabad received reports from the state police that 127 people have obtained Aadhaar on false pretences, as in their preliminary enquiry they were found illegal immigrants who were not qualified to obtain an Aadhaar number," the UIDAI said.

As per the Aadhaar Act, such Aadhaar numbers are liable to be cancelled.

"Therefore, the regional office Hyderabad has sent notices to them to appear in person and to substantiate their claims for getting an Aadhaar number," it said.

The UIDAI emphasised that these notices have "nothing to do with citizenship and cancellation of Aadhaar number is in no way related to the nationality of any resident".

In case it is found and proved that any of them obtained Aadhaar by submitting false documents or through false pretences, their Aadhaar is liable to be cancelled or suspended depending on the severity of the transgression, UIDAI said.

"Severe errors like forged documents, etc., will lead to appropriate actions, including suspending /cancelling the Aadhaar," it cautioned.

"Sometimes it becomes necessary to cancel the Aadhaar number when it is found that a resident has obtained it by submitting false biometrics or documents. It is a routine quality improvement process that the UIDAI takes up regularly," the authority said.

The 127 people have been asked to appear before the UIDAI deputy director in Hyderabad for a personal hearing on February 20.

Additional time has been given to allow them to collect the requisite documents, "Since it may take them some more time to collect the original documents that they had submitted for obtaining Aadhaar, as informed by the state police, the UIDAI has postponed the personal hearing to May 2020," it added.

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