Page 43 - The Insurance Times July 2020

1. The Proposed Cost per day as a ceiling for the various types of stay in hospitals are as follows –

Hospital Rates for per day of admission (in Rs.)
Moderate Sickness Severe Sickness Very Severe Sickness
Category of Hospitals ISOLATION BEDS including ICU without need for ICU with ventilator care
supportive care & oxygen ventilator care (invasive/noninvasive)
NABH Accredited Hospitals 10,000/- (including cost of 15,000/- (including cost 18,000/- (including cos
(including entry level) PPE Rs. 1200/-) of PPE Rs. 2000/-) of PPE Rs. 2000/-)
Non-NABH Accredited 8,000/- (including cost of 13,000/- (including cost 15,000/- (including cost
Hospitals PPE Rs. 1200/-) of PPE Rs. 2000/-) of PPE Rs. 2000/-)

Inclusions are – Type of City/District % of CELING RATE
€ Consultation PER DAY

€ Nursing Charges Metropolitan Cities 100%
€ Room Stay & Meals Othe State Capitals 90%
€ COVID testing Rest of the country 75%
€ Monitoring & Investigations –Biochem& Imaging; Phys-
3. As per the type of Hospital, based on the in-
iotherapy
frastructure & expertise available –
€ PPE

€ Drugs & Medical Consumables Type of Hospital # of beds # of % of
€ Biochemical Waste Management & other Protective Minimum ceiling
gear Specialities rate

€ Bed side procedures like Ryles tube insertion, urinary offered per day
tract Catheterization Tertiary Hospital >100 7 100%
Nursing Homes 50-100 4 80%
Exclusions Per Diem Bases are – Standalone Hospitals >50 2 65%
€ Interventional Procedures like, but not limited to, Cen-
tral Line insertion, Chemoport Insertion, bronchoscopic ** Each Hospital to have an Operational ICU & OT
procedures, biopsies, ascitic /pleural tapping, etc,
which may be charges at the rack rate as on 31st De- 4. Investigations are a part of the Per Diem cost,
cember 2019 however in exceptional cases, some of the diagnostics have
to be conducted more frequently than 90% of all cases.
€ High end drugs like Immunoglobulins, Meropenem,
Parentral Nutrition, Tocilizumab, etc - to be charged In order to bring about a cost optimization for the most
at MRP utilised Investigations, some of the capping proposed are –
a. Arterial Blood Gases (ABG) – INR 400/-
€ High end investigations like MRI, PET scan - to be
charges at rack rates of hospital as on 31st December b. Blood Sugar Level (BSL) – INR 100/-
2019
c. D- Dimer Levels – INR 800/-
€ Dead body storage & carriage @INR 5000/-
d. Haemograms– INR 150/-
€ Treatment of any co-morbid conditions, an additional
e. CT Chest – INR 3500/-
amount of up to INR 5000/- would be allowed
f. X Ray Chest – INR 500/-
2. Geographically, the proposed rates are for g. ECG – INR 300/-
hospitals as given below –

The Insurance Times, July 2020 43