Maharashtra Draft Bill - Cut Practice in Health Care Services

Why in news?

Maharashtra has recently drafted the “Prevention of Cut Practice in Health Care Services Act, 2017.

What is it about?

• The bill is to address the rampant "Cut" Practice which refers to the commissions paid for making medical referrals.
• The practice involves those in the medical network such as the doctors, pharmaceutical companies, diagnostic laboratories and hospitals.
• Several MBBS graduates see this as a means of recovering their investment in medical education.
• Also, with rising competitors, medical practitioners resort to commissions practice as a means of survival.
• The bill will be the first of its kind in India to make a formal recognition of the commissions practise for referral of patients.
• The ultimate objective is to reduce the cost to the patient who pays fees that include the commission to the referring doctor.

What does the draft Bill propose?

• The bill provides for investigating allegations of money exchange, ‘cuts’, commissions or material gifts offered in exchange for referral of patients.
• It prohibits all healthcare service providers from demanding or accepting gratification through these means.
• This applies to hospitals, doctors, pharma companies, diagnostic labs, maternity homes, dispensaries and clinics.
• It authorises the Maharashtra Anti-Corruption Bureau (ACB) as the investigating agency.
• Punishment ranges from a fine of Rs 50,000 to imprisonment up to five years.

What are the shortfalls?

• The ACB, whose primary competence is in the investigation of corruption, may find it difficult to pursue technical or scientific inquiries.
• E.g. Establishing the need and validity of a test or consultation recommended by a doctor.
• Officials from the implementing body said malpractice in the cash form may be difficult to trace.
• It is also difficult to establish if a particular drug, manufactured by a certain company was prescribed actually for pecuniary gains.
• Also, since anyone can file a complaint, there is a concern among doctors that this could be misused against honest doctors.
• There are systems wherein a doctor or clinic ties up with a diagnostic lab to share profits.
• But going by the definition of ‘cut’ practice in the draft Bill, even this can be investigated on technical grounds, even if no ‘cut’ has been paid.
• Besides, the draft Bill has not made any mention of the medical tourism.
• Notably this commonly works through an agent routing international medical patients to specific corporate hospitals for a commission.

Source: Indian Express