Hospitals and healthcare institutions across Karnataka will be required, from 1 November 2026, to itemise both the base landing price and the MRP of medicines, medical devices, and consumables on patient bills, under a directive issued by the state's Food Safety and Drugs Administration. Food safety and drug administration authorities based in Bengaluru's Palace Road district put out a formal notice through their office. Three legislative instruments form the circular's regulatory backbone: the Drugs (Prices Control) Order of 2013; the Clinical Establishments (Registration and Regulation) Act of 2010, together with rules Karnataka has put in place under that statute; and the Karnataka Private Medical Establishment Act of 2007, alongside its subsequently revised rules. A discrepancy between what hospitals and hospital pharmacies actually pay to procure medicines, medical devices, and consumables — the landing or base price — and the MRP printed on those products was flagged in a statement from the department. Invoices presented to patients in a number of instances reflected prices at or close to the maximum retail rate, with no disclosure of what the provider had originally paid to procure the items. Hospitals, healthcare facilities, and supply-chain participants — spanning C&F operators, distributors, wholesalers, and retailers operating within the state — have been directed by the department to itemise both landing or base prices and MRPs on every bill raised, including those issued under a patient's name, as part of broader measures aimed at keeping pricing visible, safeguarding patient interests, and curbing unfair trade conduct. Under the Clinical Establishments (Registration and Regulation) Act, 2010 — a piece of legislation that Karnataka has adopted — every clinical establishment operating in the state must hold a valid registration and meet the conditions attached to both obtaining and maintaining that status, according to the circular. Under Rule 9 of the Clinical Establishments (Central Government) Rules, 2012, the provision in question draws its authority. Venues covered by Rule 9(i) are required to post, in a visible location, a breakdown of fees tied to each service category alongside details of available amenities — with all information rendered in both English and the local language so that those seeking care can readily access it. Pricing for procedures and services at registered establishments must fall within the band of rates that the Central Government, working alongside state governments, periodically sets and publishes under Rule 9(ii). The circular further notes that both the Supreme Court and various High Courts have addressed these provisions, finding them directed at limiting unreasonable pricing and promoting fee transparency in hospital settings, while placing the duty of enforcement on state governments. Under the Act's subordinate regulations, service providers must display their fees and tariffs in a visible manner — including on any accessible online platforms — furnish customers with itemised billing and transparent charge breakdowns, and act in accordance with directions handed down by the Registering Authority and its authorised officers. Penalties, suspension, or cancellation of registration each fall within the scope of liability addressed by the rules. Covered under these directives are government-run facilities, privately operated ones, and trust-managed establishments — spanning hospitals, nursing homes, clinics, day-care centres, and diagnostic centres alike. Both inpatient and outpatient settings fall under this scope, covering situations where medicines, devices, implants, stents, consumables, and disposables are provided to patients and included in their billing. Licence-holders across the supply chain — from C&F operators and stockists through to distributors, wholesalers, and retailers operating under permits granted by the Food Safety and Drugs Administration Department — fall within the purview of these provisions as well. Taking effect on 1 November 2026, every hospital and healthcare institution will be required to provide patients with a fully itemised bill listing each medicine, device, implant, and consumable as a separate line entry; each such entry must state the product's generic and brand names alongside batch number, manufacturing date, and expiry date, together with the actual procurement cost to the facility exclusive of taxes, the MRP as printed on the packaging or notified by NPPA where applicable, the amount charged to the patient which may not exceed that MRP, and any taxes that apply; additionally, notices informing patients of their entitlement to view both the landing price and MRP on their bill must be posted at billing counters, pharmacy counters, and admission desks, and published on the institution's website. Hospitals are required to post this information along with a policy summary on their websites where one exists; purchase invoices, landing prices, and billing records must be kept on file for a minimum of three years and made available to authorised officers upon request; no hospital or institution may bill a patient above the MRP printed on the packaging or beyond any ceiling price set by the National Pharmaceutical Pricing Authority; and the District Health Officer, Chief Medical Officer, or Drug Control Authority in each district serves as the designated nodal officer responsible for overseeing implementation and monitoring compliance. Hospital billing records and procurement documentation are subject to spot inspections and unannounced audits at any time. Non-compliance with this circular may draw enforcement action under several statutes — among them the KPME Act and its associated rules, the Drugs and Cosmetics Act 1940, the Drugs (Price Control) Order 2013 made under the Essential Commodities Act 1955, and the Consumer Protection Act 2019, alongside any other legislation that applies — with all hospitals and healthcare institutions required to meet these obligations from 1 November 2026 onward. Billing software updates, staff training, and the posting of required notices are all actions healthcare facilities are expected to carry out without delay. The appended specimen bill — labelled Annexure-I — lays out a structured table covering columns for serial number, product details such as batch number, manufacturing date, and expiry date, along with quantity, landing or base price, MRP, the price actually charged, applicable tax, and the total amount payable. Among the items listed, a tablet carried a procurement cost of ₹18.00 against a printed ceiling price of ₹50.00, while an IV Infusion Set was sourced at ₹11.05 despite bearing a ceiling price of ₹325.00, and a Cardiac Stent came in at a procurement figure of ₹22,000 relative to its printed ceiling of ₹28,000. Housed within Annexure-II, a model patient-facing notice drafted for private corporate hospitals sets out a three-column billing structure under the heading "Transparent Billing for Medicines and Medical Devices," requiring that each invoice display the hospital's landing or base cost, the manufacturer-printed MRP, and the amount levied on the patient — with that final figure capped at MRP. Under the same framework, patients hold the entitlement to ask for landing-price and MRP breakdowns on any given item, cross-check the MRP printed on the original packaging, and raise a grievance via QR code whenever a charge exceeds the MRP or an itemised bill goes unprovided.
