DISCLAIMER: As per the rules of the Bar Council of India, law firms are not permitted to solicit work or advertise. This article is solely for the purpose of providing information and creating legal awareness about recent High Court judgments affecting healthcare administration. The content herein should not be interpreted as legal advice or a solicitation of legal work.

Mandatory Fee Display: Decoding the Kerala High Court’s November 2025 Judgment

Healthcare Compliance Update | By M S Sulthan Legal Associates | February 2026

Transparency in healthcare pricing has long been a contentious issue in Kerala. However, the legal debate has now been decisively settled. In a landmark judgment delivered in November 2025, a Division Bench of the Kerala High Court dismissed multiple writ petitions filed by private hospital associations challenging the constitutional validity of Section 39 of the Kerala Clinical Establishments (Registration and Regulation) Act, 2018.

This ruling is not just a judicial opinion; it is an immediate mandate. It reinforces the statutory obligation for every clinical establishment—from small clinics to multi-specialty hospitals—to transparently display their rates. Failure to comply is now an open invitation for penalties during District Medical Officer (DMO) inspections.

1. The Core Mandate: Section 39 Analyzed

Section 39 of the Act mandates that every clinical establishment must display the rates charged for each service provided. The petitioners argued that this infringed upon their fundamental right to carry on trade and business (Article 19(1)(g)), claiming that pricing strategies are "trade secrets."

The High Court's Rationale

The Court rejected the "Trade Secret" argument, stating that the Patient's Right to Informed Consent includes "Financial Consent." A patient cannot make a choice without knowing the cost. The Court observed that "Healthcare is not a standard commercial trade; the asymmetry of information between doctor and patient necessitates a higher burden of transparency."

2. What Must Be Displayed? (The Compliance Checklist)

Based on the judgment and the subsequent circulars from the State Council, hospitals must ensure the following are visible to patients before they avail services:

Mandatory Display Requirements

Baseline Rates: Consultation fees (General/Specialist), Nursing charges, Room rent categories (General Ward to Suite).
Diagnostics: Rates for all lab investigations and imaging (X-Ray, MRI, CT).
Package Rates: Fixed costs for standard procedures (e.g., Cataract surgery, Normal Delivery, C-Section).
Language: The display must be in both Malayalam AND English.
Location: Prominently displayed at the Reception/Cash Counter and on the establishment's Official Website.

3. The Consequences of Non-Compliance

With the legal challenge dismissed, the stay on enforcement actions is lifted. District Medical Officers (DMOs) are now empowered to:

Conduct surprise inspections specifically checking for fee display boards.
Issue "Show Cause" notices for violation of license conditions.
Levy penalties ranging from fines to the suspension of the Clinical Establishment registration for repeat offenders.

Conclusion

The era of "hidden charges" or revealing bills only at discharge is legally over in Kerala. We strongly advise all our healthcare clients to immediately audit their reception areas and websites. Updating your fee board is far cheaper than fighting a license suspension notice.

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