Rajasthan High Court - Jodhpur
Satyam Multispeciality Hospital vs State Of Rajasthan on 13 November, 2018
Author: Sandeep Mehta
Bench: Sandeep Mehta
HIGH COURT OF JUDICATURE FOR RAJASTHAN AT
JODHPUR
S.B. Civil Writ No. 13957/2018
Satyam Multispeciality Hospital, 5-A-5, Jawahar Meera Marg, Sri
Ganganagar Through Its Partner Dr. Kiran Marg S/o Surendra
Garg Aged About 51 Years. R/o 5-A-4 , Jawahar Meera Marg, Sri
Ganganagar.
----Petitioner
Versus
1. State Of Rajasthan, Through Secretary , Medical And
Health Department , Jaipur (Raj)
2. The Chief Executive Officer, Rajasthan State Health
Assurance Agency, Swasthya Bhawan, Tilak Marg, Jaipur
(Raj.)
----Respondents
Connected With
S.B. Civil Writ No. 13740/2018
Sri Ganganagar E. E. G Centre, (Tantia General Hospital), 2-A-
33, 34, Sukaria Nagar, Sri Ganganagar (Rajasthan) Through Its
Manager Jasveer Singh S/o Sh. Gurdat Singh, Aged About 45
Years, R/o 10 Llp, Sri Ganganagar (Rajasthan)
----Petitioner
Versus
1.State Of Rajasthan, Through Secretary, Medical And Health
Department, Jaipur (Raj.)
2.The Chief Executive Officer, Rajasthan State Health Assurance
Agency, Swasthya Bhawan, Tilak Marg, Jaipur (Raj.)
----Respondents
S.B. Civil Writ No. 13960/2018
Angel Hospital, Opp. Ima House, Suratgarh Road, Sri
Ganganagar, Through Its Proprietor Dr. Desh Bandhu Gupta S/o
Sh. M.p. Gupta Aged About 42 Yrs, R/o 3-J-3 Jawahar Nagar, Sri
Ganganagar.
----Petitioner
Versus
1.State Of Rajasthan, Through Secretary , Medical And Health
Department , Jaipur (Raj).
2.The Chief Executive Officer, Rajasthan State Health Assurance
(2 of 12)
Agency, Swasthya Bhawan, Tilak Marg, Jaipur (Raj.)
----Respondent
For Petitioner(s) : Mr.Sanjeet Purohit
For Respondent(s) : Ms. Shweta Bora
Mr.Harbans Singh, Joint Director,
Medical &Health Department Bikaner.
HON'BLE MR. JUSTICE SANDEEP MEHTA
Judgment / Order DATE OF PRONOUNCEMENT : 13/11/2018 These three writ petitions involve common question of law and facts and thus are being decided by a single order.
The petitioners herein are multi-speciality and super-speciality hospitals of Sriganganagar. Looking to the paucity of facilities and manpower in the State run hospitals and with an idea to provide high quality cashless medical facilities to the IPD patients of identified families covered under National Food Security Act (NFSA), the State Government introduced a Medical Insurance Scheme known as Bhamashah Swasthya Bima Yojana (hereinafter referred to as 'the BSBY Scheme', for brevity) covering nearly 1400 kinds of illnesses. The beneficiaries under the scheme were to receive insurance cover for a sum between Rs. 30,000/- to Rs.3,00,000/-per year. 46 packages were strictly reserved for the government hospitals whereas 14 packages were reserved only for private hospitals. The beneficiary family was required to be registered under the BSBY Scheme.
(3 of 12) Being compliant with the requirements of the Scheme, all the three petitioner hospitals applied & were registered thereunder. The service MOU for reimbursement of the cost of the treatment of the patients was entered into between the petitioner Hospitals and the New India Assurance Company Ltd. The petitioners' registration under the BSBY Scheme is valid till December, 2018. The petitioner Hospitals were provided user ID and password for registering and treating the patients. Under the scheme, once patient was treated and discharged, the hospital concerned was required to submit the claim form to the insurer who would directly reimburse the expenses of treatment to the concerned hospital after approval of the insurance claim as per the Clause 20 of the agreement. Clause 25, 26 & 27 of the agreement prescribe the procedure of Inspection in relation to deficiencies in services of the empaneled hospitals and consequences thereof, which are produced hereinbelow for the sake of ready reference.
^^25- fujh{k.k] iSuYVh ,oa vLirkyksa dh vfu;ferrk ik;s tkus ij dkj.k crkvks uksfVl tkjh djus dh izfØ;k %& chek daiuh }kjk vLirkyksa dk fu;fer fujh{k.k fd;k tk ldsxkA jktLFkku LVsV gSYFk ,';ksjUs l ,tsalh ds vf/kdkfj;ksa] deZpkfj;ksa] vf/kd`r O;fDr;ksa }kjk rFkk fpfdRlk ,oa LokLF; foHkkx ds vf/kdkfj;ksa }kjk Hkh ;kstuk ds vUrxZr fujh{k.k fd;k tk ldrk gSA lkekU;r% chek daiuh }kjk fujh{k.k nyksa dk xBu fd;k tk;sxk] ysfdu vko';drk gksus ij eq[; dk;Zdkjh vf/kdkjh] jktLFkku gSYFk ,';ksjsUl ,tsalh ds }kjk vf/kd`r O;fDr ,oa chek daiuh ds vf/kd`r O;fDr;ska ds lkFk la;qDr Vhe dk xBu Hkh fd;k tk ldrk gSA chek daiuh }kjk fujh{k.k ny ds lHkh lnL;ksa ds fy, igpku i= cuk;k tkuk vko';d gS rFkk vLirky ds fujh{k.k ds le; igpku i= fn[kk;k tkuk okaNuh; gSA vLirky ds fujh{k.k ds i'pkr fujh{k.k ny }kjk vLirky ds iz'kkld@M~;wVh MkWDVj@izca/kd@v/kh{kd@izeq[k fpfdRlk vf/kdkjh ds lkFk ,d tkap fjiksVZ rS;kj dh tk;sxhA ftl ij vLirky ds izkf/kd`r O;fDr ,oa fujh{k.k ny ds izR;sd lnL; ds gLrk{kj gksuk vfuok;Z gSA gLrk{kj ds lkFk fujh{k.k ny ds izR;sd lnL; dk uke] in ,oa 'kS{kf.kd ;ksX;rk fy[kuk vko';d gSA ;fn vLirky fujh{k.k ny dh fjiksVZ ds fdlh fcUnq ls lger ugha gS rks og viuk er rnkuqlkj fjiksVZ ds vafdr dj ldrs gSA (4 of 12) ;fn dksbZ vLirky la;qDr fjiksVZ ij gLrk{kj djus ls euk djrk gS rks fujh{k.k ny dks ftys ds eq[; fpfdRlk ,oa LokLF; vf/kdkjh ls laidZ fd;k tkuk pkfg,A eq[; fpfdRlk ,oa LokLF; vf/kdkjh] ftys ds fdlh vf/kdkfj;ksa esa ls ,d vf/kdkjh dks vf/kd`r djsxsa tks ;g fuf'pr djsxk dh vLirky us tkap fjiksVZ ij gLrk{kj djus ls euk dj fn;k gSA 26- vLirkyksa dks dkj.k crkvks uksfVl tkjh djuk%& ;fn chek daiuh @ jktLFkku LVsV gSYFk ,';ksjsUl ,tsalh dks fujh{k.k ny ls vFkok vU; fdlh ek/;e ls vLirky dh vfu;ferrkvksa ds ckjsa esa irk pyrk gS rks chek daiuh@jktLFkku LVsV gSYFk ,';ksjsUl ,tsalh }kjk vLirky dks dkj.k crkvks uksfVl fn;k tk;sxkA dkj.k crkvks uksfVl esa ikbZ xbZ vfu;ferrkvksa dks fcUnqokj mYysf[kr fd;k tk;sxk rFkk izR;sd vkjksi ds lanHkZ esa ftl vk/kkj ij vkjksi yxk;k gS mls layXu djsxsaA fcuk fdlh mfpr vk/kkj ij dkj.k crkvks uksfVl esa yxk;s x;s vkjksi izHkkoh ugha ekus tk;sxsa rFkk bl vk/kkj ij vLirky ds fo:) dksbZ dk;Zokgh ugha dh tk ldsxhA vLirky dks tokc nsus ds fy, uksfVl tkjh djus dh fnukad ls de ls de lkr dk;Z fnol dks le; nsuk gksxk rFkk vLirky vius tokc esa Hkh dkj.k crkvks uksfVl esa fn;s x;s izR;sd fcUnq dk vyx&vyx mRrj nsxkA ;fn vLirky dk tokc larks"ktud ik;k x;k rks chek daiuh@jktLFkku LVsV gSYFk ,';ksjsUl ,tsalh }kjk dk;Zokgh lekIr dj nh tk;sxhA ;fn vLirky dk tokc larks"ktud ugha ik;k tkrk gS rks chek daiuh@jktLFkku LVsV gSYFk ,';ksjsUl ,tsalh dks vLirky dks Li"V :i ls lwfpr djuk gksxk fd mlds }kjk fn;s x;s tokc ds fdlh fcUnq ls D;ksa ugha lger gSA dsoy ;g fy[kuk i;kZIr ugha gksxk fd ^^vkids } kjk fn;k x;k tokc vi;kZIr ,oa larks"ktud ugha gS**A 27- ;fn dksbZ vLirky vfu;ferrk,sa djrk gqvk ik;k tk;sxk rks chek daiuh }kjk mldks fuEukuqlkj nafMr fd;k tk ldrk gS%& 1- ;fn dksbZ vLirky foLr`r fujh{k.k ds i'pkr nks"kh ik;k tkrk gS rks izFke ckj %& dkj.k crkvks uksfVl fn;k tk;sxk ijUrq dkj.k crkvks uksfVl ds lkFk izFke ckj fuyacu ugha fd;k tk;sxkA vLirky ds tokc ,oa mldksa O;fDrxr lquokbZ dk ekSdk nsus ds i'pkr Hkh ;fn vLirky nks"kh ik;k tkrk gS rks ,sls Dyse~l dks fujLr dj fn;k tk;sxk rFkk iSdst vekamV dh jkf'k ds 5 xquk jkf'k ds cjkcj 'kkLrh Hkh yxk;h tk ldsxhA nwljh ckj %& ;fn vLirky ij iwoZ esa dksbZ vkjksi fl) gks x;k gS ,oa vc nwljh ckj iqu% xaHkhj vfu;ferrk,a ik;h tkrh gS rks dkj.k crkvks uksfVl ds lkFk vLirky dk vLFkkbZ fuyacu Hkh fd;k tk;sxkA vLirky dks O;fDrxr :i ls lquus dk ekSdk nsus ds mijkar Hkh nks"kh ik;k tkrk gS rks ,sls Dyse~l dks fujLr dj fn;k tk;sxk rFkk iSdst vekmaV dh jkf'k ds 10 xquk jkf'k ds cjkcj 'kkLrh Hkh yxk;h tk ldsxh rFkk iSusYVh tek djkrs gh rqjar izHkko ls mldk fuyacu lekIr dj fn;k tk;sxkA ¼uksV%& ;fn izFke dkj.k crkvks uksfVl ds vkjksi fl) ugha gksrs gS vFkok l{ke Lrj vFkkZr ftyk Lrjh; ifjosnuk fuLrkj.k desVh@jkT; Lrjh; ifjosnuk fuLrkj.k desVh }kjk vLirky dks funksZ"k ?kksf"kr fd;k tkrk gS rks bls izFke uksfVl gh le>k tk;sx ,oa ,sls izdj.kksa esa vLirky dk dkj.k crkvks uksfVl ds lkFk fuyacu ugha fd;k tk;sxkA½ rhljh ckj ,oa mlds ckn %&;fn vLirky ij iwoZ esa nks ckj vkjksi fl) gks x;k gS ,ao vc rhljh ckj iqu% xaHkhj vfu;ferrk,a ik;h tkrh gS rks dkj.k crkvks uksfVl ds lkFk vLirky dk vLFkkbZ fuaycu Hkh fd;k tk;sxkA vLirky dks O;fDrxr :i ls lquus dk ekSdk nsus ds mijkar Hkh nks"kh ik;k tkrk gS rks ,sls Dyse~l dks fujLr dj fn;k tk;sxk rFkk iSdt s vekmaV dh jkf'k ds 20 xquk jkf'k ds cjkcj 'kkLrh Hkh yxk;h tk ldsxh rFkk iSusYVh tek djkrs gh rqjra izHkko ls mldk fuyacu lekIr dj fn;k tk;sxkA ¼uksV%& ;fn izFke nksuksa dkj.k crkvks uksfVl ds vkjksi fl) ugha gksrs gS vFkok l{ke Lrj vFkkZr ftyk Lrjh; ifjosnuk fuLrkj.k desVh@jkT; Lrjh; ifjosnuk fuLrkj.k desVh }kjk vLirky dks funksZ"k ?kksf"kr fd;k tkrk gS rks bls izFke uksfVl gh le>k tk;sxkA½ 2- ;fn vLirky dk tokc larks"ktud ugha ik;k tkrk gS rks chek daiuh@jktLFkku LVsV gSYFk ,';ksjUs l ,tsl a h dks vLirky dks Li"V :i ls lwfpr djuk gksxk fd mlds }kjk fn;s x;s tokc ds fdlh fcUnq ls D;ksa ugha lger gSA dsoy ;g fy[kuk i;kZIr ugha gksxk fd ^^vkids }kjk fn;k x;k tokc vi;kZIr ,oa larks"ktud ugha gSA** (5 of 12) 3- ljdkjh vLirkyksa ds fy;s%& izFke ckj %& dkj.k crkvks uksfVl fn;k tk;sxk ijUrq dkj.k crkvks uksfVl ds lkFk izFke ckj fuyacu ugha fd;k tk;sxkA vLirky ds tokc ,oa mldks O;fDrxr lquokbZ dk ekSdk nsus ds i'pkr Hkh ;fn vLirky nks"kh ik;k tkrk gS rks ,sls Dyse~l dks fujLr dj fn;k tk;sxk rFkk iSdts vekmaaV dh jkf'k ds 5 xquk jkf'k ds cjkcj iSuYVh Hkh yxk;h tk ldsxhA nwljh ckj %& ;fn vLirky ij iwoZ esa dksbZ vkjksi fl) gks x;k gS ,oa vc nwljh ckj iqu% xaHkhj vfu;ferrk,as ik;h tkrh gS rks dkj.k crkvks uksfVl ds lkFk vLirky dk vLFkkbZ fuyacu Hkh fd;k tk;sxkA vLirky dks O;fDrxr :i ls lquus dk ekSdk nsus ds mijkar Hkh nks"kh ik;k tkrk gS rks ,sls Dyse~l dks fujLr dj fn;k tk;sxk rFkk iSdt s vekmaV dh jkf'k ds 10 xquk jkf'k ds cjkcj 'kkLrh Hkh yxk;h tk ldsxh rFkk iSusYVh tek djkrs gh rqjra izHkko ls mldk fuyacu lekIr dj fn;k tk;sxkA ¼uksV%& ;fn izFke dkj.k crkvks uksfVl ds vkjksi fl) ugha gksrs gS vFkok l{ke Lrj vFkkZr ftyk Lrjh; ifjosnuk fuLrkj.k desVh@jkT; Lrjh; ifjosnuk fuLrkj.k desVh }kjk vLirky dks funksZ"k ?kksf"kr fd;k tkrk gS rks bls izFke uksfVl gh le>k tk;sxkA½ ljdkjh vLirky dks ;kstuk ls fdlh Hkh voLFkk esa vlaca/k ugha fd;k tk ldsxkA 28- futh vLirkyksa dks ;kstuk ls vlaca) fd;k tkuk %& fuEufyf[kr izdj.kksa esa vLirky dks ;kstuk ls vlaca a) fd;k tk ldrk gS %& 1- ;fn vLirky viuh ethZ ls ;kstuk varxZr viuh lsok,a yxkrkj ugha j[kuk pkgk jgk gSA 2- ;fn vLirky }kjk ckj&ckj /kks[kk/kM+h ,ao Hkz"Vkpkj es fa yIr ik;k tkrk gSA 3- ;fn vLirky ftyk Lrjh; ifjosnuk fuLrkj.k desVh ,oa jkT; Lrjh; ifjosnuk fuLrkj.k desVh@vihyh; izkf/kdj.k }kjk fn;s x;s fu.kZ;ksa dh ikyuk ugha djrk gS ;k mudh vogsyuk djrk gSA 4- ;fn ;g ik;k tkrk gS fd vLirky vkj ,Q ih esa ,EiSuyesaV ds fy;s fn;s x;s izko/kku la[;k 1-24-2 ds izko/kkuksa dks iw.kZ ugha djrk gS ;k bu fn'kk&funsZ'kksa ds vuqlkj dfe;ka ik;h tkrh gS rFkk psrkouh nsus ds ckn Hkh fu/kkZfjr le; lhek esa mudks iw.kZ ugha djrk gS rks vLirky dks ;kstuk ls vlac) fd; tk ldsxk 5 chek daiuh dks fdlh Hkh vLirky dks ;kstuk ls vlac) djus ls iwoZ eq[; dk;Zdkjh vf/kdkjh dh Lohd`fr fy;k tkuk vko';d gSA** Clause 28 of the agreement prescribes the conditions in which an empanelled hospital could be dis-empanelled. In this clause, it is clearly stipulated that in case any empanelled hospital is found violating any of these conditions, then, it would be given a warning and on failing to fulfill the deficiencies/shortcomings, the action of dis-empanelment could be undertaken against such hospital.
The petitioner hospitals claim that they were adhering to all the terms and conditions of the agreement and MOU. However, (6 of 12) without any rhyme or reason or without any prior intimation, their user ID and password were blocked/suspended by the respondent authorities and they were deprived of admitting patients under the BSBY Scheme whereupon the petitioners have approached this Court through these writ petitions for assailing the impugned action.
Show Cause Notice of the writ petitions were issued to the respondents. Replies have been filed stating inter alia that various complaints were received against the petitioner Hospitals with the allegation that they were found indulged in corrupt practices in conspiracy with the staff of the Government Hospital. They were managing absondance of the patients under the BSBY Scheme from the Government Hospitals and then would force them to get treatment from their hospitals so as to draw the insurance claim. The Joint Director, Medical & Health Services Bikaner constituted a Committee for inquiring into the matter on 01.08.2018. The Committee submitted its report on 14.08.2018 which allegedly verified these allegations and some of the medical staff of the Government Hospitals were found indulged in these activities. Thereupon, in order to prevent continuation of such illegal and corrupt practices, the petitioner hospitals' user ID and password were suspended in accordance with BSBY Scheme. A copy of the order dated 06.09.2018 has been placed on record as per which the Joint CEO, State Health Assurance Agency allegedly heard the representatives of the petitioner hospitals and thereafter disempenalled the petitioner hospitals from the BSBY Scheme.
(7 of 12) Shri Sanjeet Purohit, learned Counsel representing the petitioners vehemently and fervently urged that there is no material whatsoever on record to show that the petitioners were ever indulged in any of the illegal or corrupt practices as set out in the reply or in the order dated 06.09.2018 whereby the petitioners were held responsible for violating the terms and conditions of the BSBY Scheme while disempanelling them from the BSBY Scheme. He urged that the inquiry report contrarily indicates that the patients were voluntarily taking treatment in the private hospitals on account of paucity of facilities in Shriganganagar District Government Hospital. He pointed that the petitioners had simply approached the State Health & Medical authorities at Jaipur for finding out the reasons of blocking of their user ID and password. The authority concerned acted in a totally highhanded manner and fictionally portrayed the meeting to be the personal hearing as contemplated under the MOU and passed the order dated 06.09.2018 behind the back of the petitioners. The order was conveyed to the petitioners by e-mail dated 26.09.2018 and thus, as per Shri Sanjeet Purohit, the order is fabricated and was passed in a back date. He strongly contended that the petitioner hospitals are providing specialized and super-specialized medical facilities to the poor people at a negligible cost which is unconceivable in the government hospitals at Sirganganagar. As per Shri Purohit, by the impugned action of the respondent authorities, the state authorities have rather put the beneficiaries of the Scheme in a disadvantageous position because they would (8 of 12) now unable to get treated in the petitioner hospitals by availing the benefits of the Scheme. On these grounds, Shri Purohit implored the Court to accept these writ petitions and quash the impugned order as being grossly illegal, perverse, arbitrary and having been passed in gross violation of the principles of natural justice and to direct restoration of the user ID and password of the petitioners under the BSBY Scheme.
Per contra, Ms. Shweta Bora, Associate to Mr.Anil Bissa, AGC learned Counsel representing the respondents vehemently and fervently opposed the submissions advanced by the petitioners' Counsel. She contended that upon receiving complaints, a detailed inquiry was conducted and it was found that the management staff of these empanelled hospitals were indulged in managing abscondance of the patients from the Government Hospitals and then these patients were lured to approach the private hospitals where they were subjected to unwarranted costly medical procedures so as to take undue advantage of the BSBY Scheme and get the reimbursement from the Insurance Company. She contended that in case these patients had been treated at the Government Hospitals, the amount of reimbursement would have been received directly by the Government rather than being paid to the private hospitals and thus, as per Ms. Bora, it is a clear case wherein the petitioners have indirectly prevented huge sums of money in form of insurance reimbursements from going to the public exchequer and thus they do not deserve any relief in exercise of the extraordinary writ jurisdiction of this Court.
(9 of 12) I have given my thoughtful consideration to the argument advanced by learned Counsel for the parties and have gone through the material available on record.
Firstly this Court is of the firm opinion that the contention advanced by Shri Purohit that the order dated 06.09.2018 was passed in a back date cannot be ruled out. Had there been an iota of truth in the respondent's case that the order dated 06.09.2018 was actually passed on that very day after providing opportunity of hearing to the petitioners, they should have filed or referred to the preceding events of show cause notice etc. issued to the petitioners before holding any such hearing etc. Manifestly no such proof of prior show cause notice etc. has been placed on record nor is there any pleading in the reply that prior notice was issued to the petitioners before issuance of order dated 06.09.2018. It is an admitted position that the order dated 06.09.2018 was conveyed to the petitioners by email on 26.09.2018. If the order had been passed on 06.09.2018, then there was no occasion for the respondents to have withheld the same for almost twenty days. Thus, the order is definitely ante-dated and appears to have been fabricated for somehow or the other defending the impugned action which is grossly perverse and arbitrary. Clause 28 of the MOU, referred to supra clearly postulates that no hospital empanelled under the Scheme could be removed from the list without issuance of a show cause notice and without giving it an opportunity of removing deficiencies/eliminating the cause of (10 of 12) complaint. Admittedly, no such opportunity to remove deficiencies was ever provided to any of the petitioners and instead, an ex- parte inquiry was conducted and the petitioners' user ID and password were suspended and they were dis-empenlled by the ante dated order dated 06.09.2018. Furthermore, the inquiry reports dated 13.08.2018 and 14.08.2018 which form the foundation of the impugned action also indicate that the allegations set out in the impugned communication dated 06.09.2018 cancelling/suspending the hospital IDs of the petitioners under the Scheme are totally nonexistent.
The crux of the enquiry reports dated 13.08.2018 & 14.08.2018 are reproduced hereinbelow for the sake of ready reference.
1- izeq[k fpfdRlk vf/kdkjh] Jhxaxkuxj }kjk i=kad 4521 fnukad 13-8-18 ¼izfr layXu½ ls izLrqr rF;kRed izfrosnu es crk;k x;k gS fd Jhxaxkuxj ftyk iatkc dh lhek ij fLFkr gksus ds dkj.k fpfdRlky; esa ejhtksa dh vksihMh yxHkx 1800 ls 2000 rd jgrh gS o HkrhZ ejhtksa dh la[;k cSM ds vuqikr esa vf/kd jgrh gSA cSM dh la[;k de gksus ds dkj.k ejht vU;= LFkkuksa ij pys tkrs gSA lkFk gh fpfdRldksa ds ikl fpfdRldh; dk;Z dh vf/kdrk gksus ,oa vU; dk;Z ;Fkk fpfdRlky; esa ,oa fpfdRlky; ds vfrfjDr ftys ds vU; fpfdRlk laLFkkuksa esa ifjokj dY;k.k f'kfojksa esa M~;Vw h] fpfdRldksa dh dksVZis'kh] esfMdy cksMZ] oh-vkbZ-ih- esfMdy Vhe esa mifLFkfr ,ao vU; vkikrdkyhu lsokvksa ds dkj.k Hkh Hkkek'kkg LokLF; chek ;kstuk o xSj Hkkek'kkg ;kstuk ds ejht Hkh vU;= LFkku ij viuh lqfo/kkuqlkj bZykt ysrs gSA 2- MkW0 nsosUnz dqekj xzkos j] izHkkjh fp0v0 ltZjh us vius c;ku esa vafdr fd;k gS fd fpfdRlky; esa ejhtksa dh la[;k miyC/k csM ,oa fpfdRldksa dh vis{kkd`r vf/kd gksuk crk;k gS lkFk gh fpfdRldksa ds ikl dk;Z dh vf/kdrk gksus ds dkj.k Hkkek'kkg LokLF; chek ;kstuk o xSj Hkkek'kkg ;kstuk ds ejht Hkh vU;= LFkku ij viuh lqfo/kkuqlkj bZykt ysrs gSA ¼izfr layXu½ 3- Mk0 vukfedk vxzoky] foHkkxk/;{k L=hjksx us vius c;ku esa vafdr fd;k gS fd fpfdRlky; esa ejhtks dh la[;k vf/kd gksus ds ckotwn Hkh vfrfjDr le; nsdj Hkh vPNs bZykt dh Hkjiwj dksf'k'k dh tkrh gS lkFk gh foHkkx esa ,e-,l-] ts-,l- o ,l-,l- ugha gksus ds dkj.k o fMyhojh cSM MkDVj ds vuqikr esa vf/kd gksus ds dkj.k fgLVdVkWeh dslst ugha fd;s tk jgs gSaA ¼izfr layXu½ 4- Mk0 jfodqekj Hkxr] foHkkxk/;{k vfLFkjksx us vius c;ku esa vafdr fd;k gS fd fpfdRlky; esa odZyksM T;knk gSA Vªkes k dslt s vf/kd gS o vkFkksZisfMDl ds vks-Vh- fnol de gSA ftlds dkj.k ejht bZykt gsrq vU;= LFkku dks pys tkrs gSA ¼izfr layXu½ 5- Mk0 Vsdpan] uksMy vf/kdkjh] Hkkek'kkg LokLF; chek ;kstuk ftyk fpfdRlky; Jhxaxkuxj us vius c;ku esa vafdr fd;k gS fd Hkkek'kkg LokLF; chek ;kstuk ds varxZr ykHkkfUor ejhtksa ds ,Cldks.M gksus ds ckn muds VhvkbZMh fMfyV djus ds funsZ'kks@ a fu;eksa ds ckjs es eq>s dksbZ tkudkjh ugha FkhA fpfdRlky; esa dk;Zjr Jh v'kksd us chdkusj esa fnukad 5-2-18 dks vk;ksftr izf'k{k.k esa Hkkx fy;k (11 of 12) us eq>s ekSf[kd :i ls crk;k fd izf'k{k.k esa ejht ds ,Cldks.M gksus dh fLFkfr esa VhvkbZMh fMfyV djus ds ckjs esa crk;k x;kA lkFk gh ;g Hkh crk;k fd ejhtksa dh tkap gsrq tks tkaps bl fpfdRlky; esa ugh gksrh mudk ,e-vks-;w- dj futh laLFkkuksa ls djok tkrh gSA ckgj tkap djokus okys ejht vf/kdrj ,Cldks.M gks tkrs gSaA ¼izfr layXu½ 6- desVh lnL; Mk0 eqd's k esgrk] vfr0 eq[; fpfdRlk ,oa Lok0 vf/k0 ¼i0d0½ Jhxaxkuxj ,oa Jh udqy 'ks[kkor] ftyk dk;ZØe izca/kd] ,u;w,p,e] Jhxaxkuxj }kjk izLrqr fjiksVZ esa vafdr fd;k gS fd ftyk vLirky Jhxaxkuxj ls fofHkUu Lis'kfyLV okMksZ ls ekg vizsy] ebZ o twu esa ,Cldks.M ejhtksa dh QkbZyksa esa ls Qksu uEcj fudkydj ejhtksa ls iwNrkN ,ao dsl fjdksMZ ds voyksdu esa lkeus vk;k gS fd jktdh; fpfdRlky; es dk;Zjr Mk0 uhjt xksLokeh] Mk0 vk'kh"k NkcM+k] Mk0 jk?ko VkafV;k rFkk Mk0 gjh'k xqIrk }kjk futh fpfdRlky;ksa esa ,Cldks.M ejhtksa dk vkijs'ku@bZykt fd;k x;k A ¼izfr layXu½ fu"d"kZ %& mDr rF;ksa ds voyksdu ls ,slk izrhr gksrk gS fd ejhtksa dk ,Cldks.M gksus dk eq[; dkj.k jktdh; fpfdRlky;] Jhxaxkuxj esa cSM dh rqyuk esa ejhtksa dh la[;k vf/kd feyus okyk ykHk jktdh; fpfdRlky; ds lkFk&2 fpfUgr futh fpfdRlky;ksa feyus dh tkudkjh feyus ij ejht csgrj lqfo/kk dks e/;utj j[krs gq, fcuk crk;s@crkdj futh fpfdRlky; esa bZykt gsrq pys tkrs gSAa Neither of these reports referred to in the order dated 06.09.2018 set out the name or detail of any patient covered under the BSBY Scheme who allegedly was made to abscond from the Government Hospital for luring him/her to the petitioners hospitals. Rather the conclusion of report dated 14.08.2018 prepared by the Dy. Director Medical and Health Services Bikaner shows that the patients voluntarily left the Government Hospital, Sriganganagar because of paucity of beds and also because they were confident of getting better treatment at the identified private hospitals empanelled under the BSBY Scheme.
In this background, this Court is of the firm opinion that the impugned action of dis-empanelment of the petitioner hospitals from the BSBY Scheme by effect of the manifestly antedated and baseless order 06.09.2018 the Joint CEO, Rajasthan State Health Assurance Agency is illegal, arbitrary, perverse and violative of principle of natural justice besides being in contravention of mandatory provision of Clause 28 of the MOU and cannot be (12 of 12) sustained in the eye of law. Thus, the writ petitions deserve acceptance and are hereby allowed. The order dated 06.09.2018 whereby the petitioner hospitals were dis-empanelled is quashed and set aside. The respondent authorities are directed to issue/restore user ID and password to the petitioner hospitals within three days.
A cost of Rs.5000/- is imposed upon the CEO, Rajasthan State Health Assurance Agency for passing a totally frivolous and antedated order leading to unnecessary litigation in this Court. Cost upon being paid shall be appropriated in the funds of Rajasthan State Legal Services Authority.
(SANDEEP MEHTA),J Sudhir Asopa/ Powered by TCPDF (www.tcpdf.org)