Hospitals Must Reveal Prices: Kerala HC Upholds Clinical Establishments Act

The Kerala High Court has upheld the Kerala Clinical Establishments (Registration and Regulation) Act, 2018, dismissing appeals filed by the Indian Medical Association and the Kerala Private Hospitals Association. The ruling, delivered on November 26, 2025 by a Division Bench of Justices Sushrut Arvind Dharmadhikari and Syam Kumar V.M., mandates a comprehensive transparency framework across all clinical establishments in the state.

Under the court’s directions, hospitals must prominently display their services along with baseline and package rates at reception areas and on their websites, in both Malayalam and English. Every establishment is further required to operate a dedicated grievance desk, issue reference numbers for complaints, resolve issues within seven days, escalate serious grievances to the District Medical Officer, and maintain a monthly complaint register. Emergency care must be provided without any payment-related barriers.

The Bench also laid down strict obligations for patient care: hospitals must screen and stabilise emergency cases within their capacity, ensure safe and documented transfers where necessary, and provide all discharge reports to patients without delay. Each establishment must submit a compliance undertaking within 30 days, to be audited within 60 days. Violations may lead to suspension, penalties, or cancellation of registration.

Criticising private institutions for failing to implement the Act for seven years, the judges stated that the decision reaffirms the right to dignified, ethical, and equitable healthcare. The Registrar has been directed to notify the Chief Secretary and the State Police Chief to ensure enforcement, accompanied by one month of statewide public announcements.

The Act, implemented in phases since 2019, was designed to reduce billing opacity, address negligence, and bring uniform standards across Kerala’s healthcare sector. Though medical associations argued the regulations were vague and burdensome -- particularly for small establishments -- the court ruled that the state’s mandate falls squarely within its public health responsibilities and aligns with constitutional protections under Articles 21 and 47.

By reinforcing transparency, accountability, and emergency care norms, the framework strengthens patient rights without imposing undue burdens on compliant healthcare providers. Non-adherence invites civil and criminal consequences in addition to regulatory action.

The Kerala Clinical Establishments Act covers all public and private healthcare facilities across recognised systems of medicine, requiring clear pricing displays, defined service standards, and accessible grievance mechanisms. With the High Court’s ruling, these requirements now carry firm judicial backing, ensuring more equitable and trustworthy healthcare delivery across the state.

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