MMA working with ministry to regulate healthcare middlemen

MMA president Dr Ravindran R Naidu says unregulated third-party administrators are among reasons clinics operated by general practitioners have closed down. (Bernama pic)

PETALING JAYA: The Malaysian Medical Association (MMA) wants the health ministry to regulate the activities of third-party administrators (TPAs) appointed by companies to manage their employees’ medical care.

Its president, Dr Ravindran R Naidu, said the unregulated TPAs were among the reasons that clinics operated by general practitioners (GPs) had closed down over the last few years.

“Some of them use their dominant position (through appointment by companies) to reduce doctors’ consultation fees, and others take a fixed percentage of the doctor’s fee as ‘administrative fees’,” he said.

In a statement today, he said MMA had stated that the latter was considered “fee-splitting” and was unethical.

He added that the association was now working with the ministry to regulate the TPAs so that unethical practices were eliminated.

He said this in the wake of Health Minister Dzulkefly Ahmad’s recent assertion that GPs should rely less on insurance companies in their professional practices.

Ravindran said the TPAs were appointing clinics and signing service agreements with them while administering employee healthcare on behalf of employers that hired them.

“As the proportion of patients enjoying employer-paid or subsidised healthcare goes up, the (number of) self-paid patients goes down,” he said.

“We believe this trend will not reverse, and it is very difficult for a clinic to survive on cash patients alone, especially in urban areas.”

He also said the ministry’s move to cap doctors’ fees also distorted the market, especially as revisions were frequently made on the fee schedule set by the government.

Ravindran added that competition from private hospitals and diagnostic centres funded by businesses, as well as increases in regulatory compliance costs and the cost of practice, had also contributed to private clinics closing down.

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