Lok Sabha Question No. 3133 (UNSTARRED), answered on 2019-12-06
Subject: Standardization of Rates for Common Surgical Procedures
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Raj Hans Hans

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE

## DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 3133 TO BE ANSWERED ON 6 TH DECEMBER, 2019

## STANDARDIZATION OF R ATES FOR COMMON SURGICAL PROCEDURES

## 3133. SHRI HANS RAJ HANS:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

- (a)  whether  the  Government  has initiated  coding  classification  of  diseases and  fixing  the standardize  rates  for  common surgical  procedures  such  as  cataract,  kidney transplant, angi oplasty etc. in bid to ensure parity and fair pricing on national level across the private and Government hospitals;
- (b) if so, the details thereof and if not, the reasons therefor; and
- (c) the other measures being taken to limit artificial medical inflation where patients end up paying more?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SHRI ASHWINI KUMAR CHOUBEY)

(a) to (c) : 'Public Health' being a  State subject,  it  is  within  the  domain  of  State/Union Territory Govern ment to frame guidelines/protocols under the appropriate provisions applicable in the respective State/UT.

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The  Government  of  India  has,  however,  enacted  the  Clinical  Establishment (Registration  and  Regulation)  Act,  2010  and  notified  Clinical  Es tablishments  (Central Government)  Rules,  2012  for  registration  and  regulation  of  clinical  establishments country.  In the States /UTs where the said Act is in force, the clinical establish required to meet the norms such as minimum standards of facilities and services, minimum requirement of personnel, maintenance of records and reports  and displaying of rate conspicuous  place.    The  clinical  establishments  are  also  required  to  follow  Sta Treatment  Guidelines  issued  by  the  Central/ State  Governments  and  charge  rates  for  each type of procedure and service within the range of rates determined from time to time National  Council  for  Clinical  Establishments  has  developed  a  standard  list  of  me procedures and a standard template for costing medical procedures and shared the same with the States and Union Territories.  The implementation and enforcement of the said A within the purview of the State/UT Governments.

Currently,  the  Act  has  been  adopted  by  11  States  namely,  Si kkim,  Mizoram, Arunachal  Pradesh,  Himachal  Pradesh,  U.P,  Bihar,  Jharkhand,  Rajasthan,  Uttarakhan Assam  and  Haryana  and  all  Union  Territories  except  Delhi.  The  implementation  an enforcement of the said Act falls within the ambit of the States/Union terri tories.

Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (AB - PMJAY) provides health cover up to Rs. 5 lakh per family per annum to around 10.74 crore families as per Economic  Caste  Census.  The  scheme  is  being  implemented  through  1392  health  ben efit packages at defined rates. In addition, there is one unspecified surgical package as w scheme does not differentiate between a public and private hospital for reimburseme empanelled hospitals.

AB - PMJAY  is  a  cashless  scheme  and  it does  not  require  any  payment  by  the beneficiary to the Healthcare Provider for availing the benefits. Further, anti - fraud units at National and State levels have been set up, which work pro - actively to curb any issues related to charging money from benefic iary.