TaxTMI 
TaxTMI 
2006 (8) TMI 703
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....of the B. P.T. Act which are running charitable hospitals including nursing home or maternity home, dispensaries or any other center for medical relief and whose annual expenditure exceeds of 5 lacs rupees are "state aided public trust" within the meaning of clause 4 of section 41AA of B.P.T. Act. 2. The public Charitable Trust under the provision of B. P.T. Act which are running charitable hospitals and covered under the definition of "state aided public trusts" are under legal obligation to reserve and earmark 10% of the total number of operational beds for indigent patients and to provide medical treatment to the indigent patients free of cost and to reserve and earmark 10% of the total number of operational beds at concessional rate to the weaker section patients as per the provisions of Section 41AA of Bombay Public Trusts Act, 1950. 3. In emergency, the charitable Hospitals must admit the patient immediately and provide to the patient "Essential Medical Facilities" for all life saving emergency treatment and procedure till stabilization. Further transportation to the public hospital would also be arranged by the charitable hospitals, if necessary. Charitable....
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....0 In case of weaker section patients, Charitable hospitals shall provide medical examination and treatment in its each department at concessional rates. The weaker section patient's bill of billable services shall be prepared at the rates applicable to the lowest class of the respective hospital. The medicines, consumables and implants are to be charged at the purchase price to the hospital, however the weaker section patients shall pay atleast 50% of the bills of medicines, consumables and implants. If Doctors forego their charges, then the same shall not be included in the final bill of the weaker section patients. The bill so prepared after deducting the payment made by the weaker section patients shall be debited to PPF Account. 11. Charitable hospitals shall physically transfer 2% of the total patients billing (excluding the bill of indigent and weaker section patients) in each month to PPF Account. The amount available in the PPF Account shall be spent in the subsequent month in such manner to provide medical treatment to maximum number of patients. If in minor cases of surplus, the same shall get adjusted in the following months. 12. Charitable hospital....
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....y Commissioner. 18. Monitoring committee shall hold its meeting once in a month and monitor implementation of the Scheme by each charitable hospitals. Monitoring committee shall consider grievances of the patients, if any, made and submit its report to the Charity Commissioner. 19. Committee further recommends that in case of breach of terms and conditions of Section 41AA by any charitable hospitals besides penal action provided under Section 66 of the Bombay Public Trusts Act, 1950, Charity Commissioner shall make report to the Government of Maharashtra requesting to withdraw exemption granted to the concerned hospitals during the next preceding year in payment of contribution towards P. T.A. Fund and amount of contribution towards P. T.A. Fund be recovered from the said hospital. Besides that Charity Commissioner shall request the Government to withdraw any other concessions/benefits given to the said hospital." 4. Mr. C. U. Singh, Senior Counsel for the Association of Hospitals, placed before us the following points for consideration : - "1. 2% of total patient's billing (other than billing of indigent patients and weaker section patients) to be....
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....ed in various clauses and particularly clauses 4, 11, 12, 13, 14, 15, 16 and 17 and a few new clauses need to be added. 8. Clauses 4, 11, 12, 13, 14 and 15 are reframed by us thus : 4. That each public Charitable Hospital shall create separate fund which may be called Indigent Patients Fund (for the sake of brevity, hereinafter referred to as "IPF") and shall credit two per cent of gross billing of all patients (other than indigent and weaker section patients) without any deduction. 11. The Charitable Hospitals shall physically transfer 2% of the total patients' billing (excluding the bill of indigent and weaker section patients) in each month to IPF Account. The amount available in the IPF Account shall be spent to provide medical treatment to maximum number of indigent and weaker section patients. In case of surplus or shortfall in the IPF Account of the month, the same shall get adjusted in the subsequent months. In case there is imbalance in the credit of the IPF Account and the expenditure incurred in the treatment of indigent and weaker section patients for more than six months, such Charitable Hospital may bring this aspect to the notice of the Monit....
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....(Chairman). (ii) Civil Surgeon (Member-Secretary). (iii) Health Officer of Zilla Parishad (Member). (iv) Representative of Charitable Hospitals in Districts (Member). 10. Clauses 18 and 19 shall be renumbered 17 and 18. 11. The following new clauses 19, 20 and 21 shall be as under: 19. The Charitable hospitals which face individual difficulties in meeting objectives/ obligations shall be at liberty to apply to the Charity Commissioner with all supporting documents who may consider suitable modifications if a case for relief is made out. 20. The Charity Commissioner shall notify the list of the Charitable Hospitals in Greater Mumbai Region on the Notice Board of his office and two newspapers widely circulated in Greater Mumbai, one in Marathi and the other in English and the list of Charitable Hospitals in each District on the Notice Board of the office of the Joint Charity Commissioner and the two widely circulated newspapers of the District. 21. Each of the Charitable Hospitals governed by this Scheme shall publish the Scheme on its Notice Board displayed at a conspicuous place of the Hospital. 12. The Scheme for treat....
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....g medical treatment to the indigent and weaker section patients as provided herein after. 8. The Charitable Hospitals shall provide following non billable services free to the indigent patients as well as weaker section patients -- (a) Bed (b) RMO Services (c) Nursing Care (d) Food (if provided by the hospital) (e) Linen (f) Water (g) Electricity and (h) Routine Diagnostics as required for treatment of general specialties. (i) House Keeping services. 9. In case of indigent patients, the Charitable Hospitals shall provide medical examination and treatment in its each department totally free of cost. The indigent patient's bill of billable services shall be prepared at the rates applicable to the lowest class of the respective hospital. The medicines, consumables and implants are to be charged at the purchase price to the hospital. If Doctors forego their charges, then the same shall not be included in the final bill of the indigent patients. The bill so prepared shall be debited to IPF Account. The Charitable Hospitals shall not ask for any deposit in case of admission of indigent ....
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....The procedure for admission of patients shall be as provided in subsequent clauses. 15. The Charitable Hospitals shall admit indigent patients to the extent of 10% of their operational beds/average occupancy for medical examination and treatment. So also, the Charitable Hospitals shall admit weaker section patients to the extent of 10% of their operational beds/average occupancy for medical examination and treatment coming to their hospitals from the sources referred to in clause 14. The Charitable Hospitals shall verify the economic status of the patients from their Medical Social Worker on the basis of scrutiny of any one of the following documents produced by the concerned patients: (i) Certificate from Tahsildar; (ii) Ration Card/Below Poverty Line Card. 16. The Members of the Monitoring Committee in Greater Mumbai Region shall be as follows : - (i) Joint Charity Commissioner, Maharashtra State, Mumbai (Chairman). (ii) Joint Director of Health Services (Medical), Mumbai (Member-Secretary. (iii) Secretary/Nominee of Association of Hospitals in Mumbai (Member). (iv) Health Officer, Municipal Corporation of Greater Mumbai, Mumb....