Following their massive protests that reportedly killed over 40 patients, the Karnataka government came down and amended the Karnataka Private Medical Establishments (Amendments) Bill.
The Karnataka Private Medical Establishments (Amendments) Bill 2017
Salient differences
Original
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Modified
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The Karnataka Private Medical Establishments (Amendments) Bill 2017
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The Karnataka Private Medical Establishments (Amendments) Bill 2017
( L A Bill No 44 of 2017)
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1.Short title and commencement.-
(2)It shall come into force at once.
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1.Short title and commencement.-
2.It shall come into force on such date as the State Government may, by notification, appoint and different dates may be appointed for different provisions of this Act.
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2.Amendment of section 2
(i) after clause (e) the following shall be inserted, namely:-"(e-1) "District or Metropolitan Grievance Redressal Committee" means the District or Metropolitan Grievance Redressal Committee constituted under section 8;"
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2.Amendment of section 2.-
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(i)after clause (f), the following shall be inserted, namely:-“(f-1) “Grievance” means any complaint in respect of non-compliance to the Patient’s Charter or Private Medical Establishment's Charter;- deleted
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(m2) “prescribed" means prescribed by rules made by the State Government under this Act;
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3.Substitution of expressions.- For the expressions “Registration Authority" or “Registration Authorities” wherever they occur in the Principal Act, the expressions “Registration and Grievance Redrcssal Authority" or “Registration and Grievance Redrcssal Authorities” shall be substituted respectively.
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3.Amendment of section 3.- In section 3 of the Principal Act, in the provisio after the words "till the disposal of the application" the words "and shall comply with the provisions" shall be inserted.
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4.Amendment of section 3.- In section 3 of the Principal Act, in the proviso after the words "till the disposal of the application" the words "and shall comply with the provisions of this Act" shall be inserted
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"4. Registration Authority.-There shall be a Registration Authority in each district consisting of the following members, namely:-
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“4. Registration and Grievance Redressal Authority.- There shall be a Registration and Grievance Redressal Authority in each district consisting of the following members nominated in such manner with such qualification as may be prescribed, namely: -
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5.Amendment of section 5.- In section 5 of the Principal Act, after the words "shall make an application" the words "through on-line" shall be inserted.
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Deleted
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6.Amendment of section 6.- In section 6 of the Principal Act, after clause (iv) the following shall be inserted, namely: -
"(iv-a) that Private Medical Diagnostic Laboratory is located outside 200 meters radius of Government Hospital;"
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6.Amendment of section 6.- After section 6 of the Principal Act, the following proviso shall be inserted, namely:-
"Provided that no new Private Clinical Laboratory shall be permitted within a radius of 200 meters from the Government Hospital or from the Hospital promoted or managed by a society or trust or autonomous organization owned or controlled by the State Government or Central Government or Local Bodies with effect from the date of commencement of the Karnataka Private Medical Establishments (Amendment) Act, 2017.
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7. Amendment of section 7.- In section 7 of the Principal Act,-
(i) for sub-section (1) the following shall be substituted, namely:-
"(1) On receipt of an application through on-line under section 5 the Registration Authority may having regard to the provisions of section 6 and after such enquiry as may be necessary, by the Inspection Committee, either grant registration subject to that conditions as may be prescribed or reject the application within thirty daysfrom the date of receipt of the complete application in all respects; in case of any delay beyond thirty days the registration shall be deemed to have been granted. The Registration Authority may constitute the Inspection Committee consisting of such members as may be prescribed."; and
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7.Amendment of section 7.- In section 7 of the Principal Act,-
(i) for sub-section (1) the following shall be substituted, namely:-
(1) On receipt of an application under section 5 the Registration and Grievance Redressal Authority may having regard to the provisions of section 6 and after such enquiry as may be necessary, by an Inspection Committee, either grant registration subject to the conditions as may be prescribed or reject the application within ninety days from the date of receipt of the complete application in all respects:
Provided further that in case of any delay beyond ninety days the registration shall be deemed to have been granted.”
(ii) after sub-section (3), the following shall be inserted, namely:-
(4) For purpose of sub-section (1), the Registration and Grievance Redressal Authority may constitute the Inspection Committee consisting of such members as may be prescribed.
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(5) On receipt of application for renewal of registration, the Registration and Grievance Redressal Authority may having regard to the provisions of section 6 and after such enquiry as may be necessary by the Inspection Committee constituted under sub-section (4) either grant renewal subject to the condition as may be prescribed or reject the application within ninety days from the date of receipt of the complete application in all respect; in case of any delay beyond ninety days the renewal shall be deemed to have been granted.
(6) The Registration and Grievance Redressal Authority shall not reject the application for registration or renewal without giving an opportunity of being heard to the applicant and without recording the reasons for such rejection.
(7) The Registration and Grievance Redressal Authority, on its own or based on any written complaint, may cause inspection or direct the Inspection Committee constituted under sub-section (4) to inspect, at a reasonable time, any private medical establishment, to satisfy itself that the conditions of registration are being duly observed and complied with.
{8) In case the Registration and Grievance Redressal Authority finds that the private medical establishment is not being run in accordance with the conditions of registration, the Authority shall direct the establishment to remedy the same within the reasonable time as may be specified in the order.”
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(ii) in sub-section (3) for the words " five years" occurring in two places the words " three years" shall be substituted.
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Deleted
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8. District or Metropolitan Grievance Redressal
(1) The District or Metropolitan Grievance Redressal Committee shall be headed by the Chief Executive Officer of the Zilla Panchayat of the District and consists of Superintendent of Police of the District, one representative among Private Medical Establishments in the District,District Surgeon, Public Prosecutor and Woman representatives to be nominated by the State Government.-
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Deleted
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"8. Functions of the Registration and Grievance Redressal Authority.- (1) The Registration and Grievance Redressal Authority on receiving a complaint regarding non-compliance to the Patient’s Charter or Private Medical Establishment's Charter shall enquire into the complaint:
Provided that the complaints pertaining to negligence, non-adherence to standard protocols for treatments, procedures and prescription audit shall be referred to the Karnataka Medical Council for enquiry and report within sixty days to the Authority.”
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(3)The Registration and Grievance Redressal Authority shall, to remedy the Grievance, hear the aggrieved person and the other party and shall dispose of the complaint by a summaiy trial v/ithin ninety days from the date of complaint.
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'9A. Functions of the Experts Committees and other Committees.-
( c)make recommendation to the State Government regarding fixation of cost of each health service or treatment and different rates may be proposed for different class of private medical establishments; and
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'9A. Functions of the Experts Committees and other Committees.-
( c)recommend standard protocols for treatments and procedures, and prescription audit;
( d)make recommendations for fixation of uniform package rates for each procedure and treatment covered under any of the health care assurance scheme of the Government for private medical establishments; and
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( 2) The State Government on the recommendation of the Expert Committee fix the rates of each class of treatment and different rates may be fixed for different class of private medical establishment.
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(2) The State Government, on the recommendation of the Expert Committee, and after previous publication, calling for objections from the persons likely to be affected and considering the same shall fix and notify the following, namely:-
(a) classification of Private Medical Establishments;
(b) minimum standards of infrastructure, staffing pattern and qualification of staff;
(c) standard protocols for treatments, procedures and prescription audit; and
(d) uniform package rates for each procedure and treatment covered under any of the health care assurance scheme of the Government for private medical establishments.
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11. Amendment of section 10.- In section 10 of the Principal Act,-
(i) in sub-section (1),-
(a) after the words "schedule of charges'1 occurring in two places the words "or the rates fixed by the State Government" shall be inserted; and
(b) after the words "on the notice board" the words "in a prominent place or reception" shall be inserted.
(ii) in sub-section (2) after the word "charges" the words "fixed by the State Government" shall be inserted.
(iii) after sub-section (2) the following shall be inserted, namely:-
"(3) Every Private Medical Establishment shall follow the rates as fixed by the Government and including the package rates for investigation, bed charges, operation theatre procedure, intensive care, ventilation, implants, consultation and similar tests and procedures and any additional treatments or procedure shall not attract additional charges over and above such rates fixed by the State Government including the package rates unless explained to and consented to by the patient.
(2) Every Private Medical. Establishment shall provide proper estimates for treatments not covered in fixed rates and charges to the patient or attendant of the patient during initiation or due course of treatment and final bill shall not exceed estimates."
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1. Substitution of section 10.- For section 10 of the Principal Act, the following shall be substituted, namely:-
“10. Schedule of charges and establishment details to be notified.- (1) Every Private Medical Establishment for the information of patients and general public shall notify and make available the schedule of charges for consultation fee, investigations, medical treatments, procedures, hospital charges and other services, and establishment details, as may be prescribed, in each of the manners specified below:-
(i) display schedule of charges and establishment details in the prescribed manner on a public website to be provided by the Government;
(ii) display schedule of charges and establishment details in the prescribed manner on its own website, if any;
(iii) display consultation fee, rates of major and largely used investigations, procedures, treatments and other services, and hospital charges on the notice board of the establishment at a conspicuous place at the reception; and
(iv) schedule of charges in form of booklets or brochures, which is readily available to patients and public at the establishment at all times:
Provided that in the event of any discrepancy in the schedule of charges notified as per the above detailed manners, the least amount shall be considered to be effective.
(2) For the services provided, the Private Medical Establishment shall collect from the patient or his relative or attendant an amount not more
than the charges notified as per sub-section (1), after providing an itemized bill.
3)For the services provided to a patient belonging to eligible household under the National Food Security Act, 2013 ( en^ra c of 2013 and referred under any of the health assurance schemes of the Government, no charges shall be collected from the patient.
(4)For the services provided to a patient not belonging to eligible household under the National Food Security Act, 2013 (Central Act 20 of 2013) but referred under any of the health assurance schemes of the Government, the charges over and above the amount reimbursable from the Government as per the scheme norms shall be collected subject to the rates notified under sub-section (1), after providing an itemized bill.
(5)In case of any investigation or treatment or procedure being necessary over and above the standard protocol prescribed under clause (c) of sub-section (2) of section 9A for any patient covered under sub-section (2) or (3) or (4), the concerned private medical establishment can undertake the same after explaining the need to the patient or his representative and obtaining his consent, and charge additional amount, subject to the rates notified as under sub-section (1) after providing an itemized bill.
(6)Every Private Medical Establishment shall provide proper estimates for treatments and charges to the patient or attendant of the patient during initiation or due course of treatment and final bill shall not exceed the estimates."
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12. Amendment of section 11.- In section 11 of the Principal Act,-
. in clause (i) after the words, "it at the establishment" the words "in the event of such emergencies, the Private Medical Establishment shall provide necessary healthcare to save the life of the patient without insisting on advance payment" shall be inserted; and
(i) . after clause (iv) the following shall be inserted, namely:-
" (v). Every Private Medical Establishment shall display the Patient’s Charter and Private Medical Establishment's Charter in such place easily visible to the public; and
(ii) Every Private Medical Establishment shall handover in the event of the death, the body of the deceased immediately, without insisting on the payment of the dues. The same may be recovered from representatives of the diseased in due course."
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12.Amendment of section 11.- In section 11 of the Principal Act,-
(i) in clause (i) after the words, "it at the establishment" the words "in the event of such emergencies, without insisting on advance payment" shall be inserted; and
(ii) after clause (iv) the following shall be inserted, namely: -
"(v) display the Patient’s Charter and Private Medical Establishment's Charter in such place easily visible to the public;
(i) handover in the event of the death of a patient, the body of the deceased immediately, without insisting on prior payment of the dues:
Provided that in case the patient was admitted under any of the health care assurance schemes the private medical establishment shall claim the amount as per the scheme norms from the Government in accordance with clause (d) of sub-section (2) of section 9A.
Provided further that the due amount in accordance with sub-section (2) of section 10 or balance due amount in accordance with sub-section (4) or (5) of section 10 may be recovered from representatives of the deceased in due course as per law.
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13. Insertion of new section 11 A:-
”11A. Patients’ Charter and Private Medical Establishment's Charter.- Every patient or authorised family member and Private Medical Establishment shall have the rights and duties specified in the Patient’s and Private Medical Establishment's Charter. Any violations of the Patient's and Private Medical Establishment's Charter shall be referred to the Grivenance Redressal Committee constituted under section 8.
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13.Insertion of new section 11 A:-
11 A. Patients’ Charter und Private Medical Establishment's Charter.- Every patient or authorized family member and Private Medical Establishment shall have the rights and duties specified in the Patient's and Private Medical Establishment's Charter as contained in the Schedule Lo the Act.
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15.Amendment of section 15.- In section 15 of the Principal Act, in sub-section (1) in the provisio after the words "Private Medical Establishment" the words "and also arrangements are made within reasonable time ensuring uninterrupted health care to the inpatients" shall be inserted
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15.Amendment of section 15.- In section 15 of the Principal Act,-
(1) in the heading for the word “Suspension” the words “Penalty or suspension” shall be substituted; «
(ii) the sub-sections(l), (2) and (3) shall be renumbered as subsections (5), (6) and (7) thereof and before sub-section (5) as so renumbered the following sub-sections shall be inserted, namely:-
"(1) In case of any private medical establishment failing to comply with any of the directions given by the Registration and Grievance Redressal Authority under sub-section (8) of scction 7, the Authority may impose a penalty not exceeding fifty thousand rupees and extend the time for compliance or procccd to cancel the registration of the establishment, after giving the establishment an opportunity of being heard.
(2) In case of a complaint from a patient regarding over-charging the Registration and Grievance Redressal Authority after holding enquiry under sub-section (3) of section 8 finds that the Private Medical Establishment has violated the provisions of sub-section (2), (4) or (5) of section 10 the Registration and Grievance Redressal Authority shall impose a penalty equivalent to one and half times of the overcharged amount, after giving the establishment an opportunity of being heard. Out of the penalty amount an amount equal to the over-charged amount shall be paid to the patient and the balance shall be deposited with the Arogya Raksha Samithi of the district for taking up public health activities:
Provided that in case of such over-charging by a particular private establishment the Registration and Grievance Redressal Authority after holding such enquiry under sub-section (3) of section 8 finds that the Private Medical Establishments has violated the provisions of section 10 for the third time within a calendar year, the Registration and Grievance Redressal Authority shall make n written complaint to the concerned Court
for taking up cognizance of the offence and subsequent prosecution. On conviction, the concerned private medical establishment shall be liable for a penalty which may be extend to three-times of the amount over charged or rupees one lakh, whichever is higher.
(3) In case of a complaint from a patient regarding any matter in the Patient’s Charter or Private Establishments Charter, other than the overcharging the Registration and Grievance Redressal Authority having found that the Private Medical Establishments has violated the provisions of section 11A shall impose a penalty of rupees ten thousand for the first non-compliance and rupees twenty five thousand for the second noncompliance during a calendar year on the concerned private medical establishment, after giving the establishment an opportunity of being heard. Fifty percent of the penalty amount shall be paid to the patient and the balance fifty percent shall be deposited with the Arogya Rakshana Samithi of the district for taking up public health activities:
Provided that in case of such complaint against a particular private establishment for the third time within a calendar year, the Registration and Grievance Redressal Authority shall make a written complaint to the concerned Court for taking up cognizance of the offence and subsequent prosecution. On conviction, the concerned private medical establishment be liable for a penalty which may be extend to fifty thousand rupees.”
(iii) in sub-section (5) as renumbered in the proviso after the words "Private Medical Establishment" the words "and also ensure that arrangements are made within reasonable time for uninterrupted health care to the inpatients." shall be inserted.
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16.Amendment of section 16.- In section 16 of the Principal Act,
(i) for the words "There shall be an Appellate Authority" the words "There shall be an Appellate Authority over Registration Authority" shall be substituted; and
(ii)
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