Punjab & Haryana High Court Cracks Down On Empanelled Hospitals For 'Artificially' Lowering Package Rates To Attract Patients

The Punjab & Haryana High Court has ordered the Director General, Health Services, Haryana to verify the package rates of all empanelled hospitals and take strict action, including cancellation of licences, in cases of policy violations. The Court also cautioned against the practice of hospitals offering artificially low package rates to attract patients and later charging separately for essential procedures, holding that such conduct cannot be permitted.Justice Harpreet Singh Brar said, "the Director General, Health Services, Haryana is directed to verify the package rates of all empanelled hospitals, either himself or through the concerned authorised Civil Surgeon. In case any of the empanelled hospitals are found to be violating the policy, appropriate corrective measures shall be taken, including cancellation of their license. The Director General shall further ensure that the cost of treatment is explained to the patient or their next of kin in a language they are familiar with, instead of merely obtaining signatures on cyclostyled proformas." The Court further said that, practice of artificially lowering package rates to attract patients initially, only to later charge separately for essential procedures, shall not be permitted.The directions came while allowing a plea filed by an 85-year-old retiree seeking reimbursement of ₹7.42 lakh incurred during treatment at Paras Hospital, Panchkula for critical coronary artery disease.The petitioner had undergone angioplasty between April 19 and April 22, 2023. While the State contended that reimbursement had been made as per the Haryana Government's policy dated July 14, 2020, the petitioner argued that the hospital had charged excessive amounts—particularly over ₹6 lakh towards medicines and consumables—despite the treatment being covered under a package rate.The State maintained that certain procedures, particularly Intravascular Lithotripsy (IVL), were not part of the notified package and thus fell under “non-package” procedures, with reimbursement restricted to ₹1,750 per day for consumables.Justice Harpreet Singh Brar found that the petitioner was suffering from a life-threatening condition involving heavily calcified coronary blockages, for which conventional angioplasty would have been ineffective. Consequently, advanced procedures such as Rotablation and IVL were medically necessary and duly administered.Rejecting the State's stand, the Court held that denial of reimbursement on the ground that IVL was not part of the package amounted to a hyper-technical approach. It emphasized that once the necessity of treatment is undisputed, reimbursement cannot be denied merely because the procedure does not find explicit mention in the policy.The Court further clarified that IVL is not a distinct or unrelated procedure but a specialised form of angioplasty used in complex cases. It also rejected the classification of a high-cost IVL catheter (₹3.5 lakh) as a routine “consumable,” terming such an interpretation irrational and contrary to the purpose of a welfare policy.Observing that “a policy meant to preserve life cannot be allowed to become an instrument of denial,” the Court held that the right to health cannot be reduced to a hollow promise through rigid and literal interpretation of policy provisions.Allowing the petition, the Court directed the State to reimburse the entire medical expenses incurred by the petitioner along with interest at 6% per annum from the date the amount became due..The Court issued a slew of directions including that:The State was directed to consider inclusion of IVL within package rates for coronary artery disease.The Director General, Health Services, Haryana was directed to audit package rates of all empanelled hospitals.Hospitals found violating policy norms may face corrective action, including de-empanelment or cancellation of licences.Authorities must ensure that patients are clearly informed about treatment costs in a language they understand, rather than relying on standardised consent forms.The practice of lowering package rates initially and later imposing separate charges for essential procedures was expressly disapproved.The Court also directed the State to file a compliance report within three months.Mr. Madan Lal, Advocate for the petitioner.Mr. Saurabh Girdhar, AAG, Haryana.Ms. Ayushi, Advocate for Mr. Padamkant Dwivedi, Advocate for respondent No.4. Mr. Harsh Aggarwal, Advocate for respondent No.5.Title: Hukam Singh v. State of Haryana and othersClick here to read order

Punjab & Haryana High Court Cracks Down On Empanelled Hospitals For 'Artificially' Lowering Package Rates To Attract Patients

Aiman J. Chishti

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Aiman J. Chishti

Punjab & Haryana High Court Cracks Down On Empanelled Hospitals For 'Artificially' Lowering Package Rates To Attract Patients

Aiman J. Chishti

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Aiman J. Chishti

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