Private hospitals and medical establishments across Maharashtra are now required to display their charges for services and facilities in areas visible to patients, under a rule that state authorities put in place on Friday — arriving four days after the Union health ministry had circulated its own directive on the matter.
Under the government resolution, price lists are required to appear in a visible location, rendered in both Marathi and English. The ministry's directive noted that displaying treatment costs in locations patients can easily access would help individuals and their families understand what care is likely to cost, and place them on steadier footing when weighing their options.
Those pushing for reform in healthcare pricing have long backed such steps, contending they would reduce instances of inflated charges and disputes over billing.
District civil surgeons, along with district and municipal health officers, have been directed by the public health department — the government resolution's issuing body — to pass on the relevant details to every private medical establishment under their purview. Directives were also issued requiring those in charge of such premises to pursue administrative measures against any venue found to be operating outside the prescribed regulations.
Under Schedule III of the Maharashtra Nursing Homes Registration Rules, 2021, fee structures for medical procedures and the facilities on offer are to be posted where patients and visitors can readily see them, as laid out in the government resolution. The regulation further requires that the pricing chart be updated whenever rates undergo any change. Under rules in place for medical facilities, any hospital that accepts overseas patients is required to make publicly visible the bundled pricing structures set aside for that group.
Dr Abhay Shukla, a representative from the Jan Swasthya Abhiyan, described the move as welcome, while noting it had taken longer to arrive than it should have. Provisions covering rate display and billing transparency had already been written into the Maharashtra Nursing Homes Registration Act rules adopted in 2021, yet Dr Shukla noted that enforcement of those measures arrived later than it should have, given that advocacy for hospital-rate openness had been ongoing for roughly four years.
When reached on Friday evening, a number of hospital administrators indicated the notification had not yet come through to them. One hospital administrator noted that conversations with the state about itemised billing displays had taken place some years back, adding that a typical inpatient invoice can carry hundreds of individual line-item charges. The hospital's chief executive noted that listing every detail on a display board was not feasible, and said earlier talks had established that the general-category beds section would carry only a handful of top-level subheadings.
Health advocates have raised concerns about the practice of itemising hospital invoices, noting that patients routinely receive separate line charges for accommodation, medical fees, pharmaceuticals, disposable supplies, facility maintenance, and various other services — a breakdown that can push the total amount owed well beyond what was initially anticipated.
Dr Shukla called for the introduction of a regulatory framework to keep profit margins from growing beyond reasonable bounds, and argued that enforcing both current regulations and the provisions set to be introduced under the forthcoming Act would help reduce what patients pay at hospitals and strengthen their protections.
The regulation leaves unanswered a question about what recourse is available to patients or their families when a hospital falls short of its obligations — a gap Dr Shukla described as the absence of any formal complaints pathway. Advocates have also drawn attention to questions about whether the patients' rights charter already on the books is being applied as intended.
One physician described the policy change as a move in a positive direction, adding that conversations about tightening the regulations further remained an option worth pursuing.
