Doctors: Ministry, medical council must address concerns about third-party admins

The Malaysian Medical Association urged the Health Ministry and the Malaysian Medical Council (MMC) to address ethical issues raised about the involvement of third-party administrators (TPA) in the healthcare industry. — Reuters file pic
The Malaysian Medical Association urged the Health Ministry and the Malaysian Medical Council (MMC) to address ethical issues raised about the involvement of third-party administrators (TPA) in the healthcare industry. — Reuters file pic

KUALA LUMPUR, June 22 — The Health Ministry and the Malaysian Medical Council (MMC) must address ethical issues raised about the involvement of third-party administrators (TPA) in the healthcare industry, said the Malaysian Medical Association (MMA)

MMA president Dr Ravindran R. Naidu noted that patient confidentiality was already an issue that has plagued the industry for the past 22 years, and could worsen with the growth of TPAs.

TPAs are organisations appointed to handle payments of medical bills by corporate entities.

“Huge amount of patient data is captured by TPAs on a daily basis. Does this comply with the Personal Data Protection Act?” he said in a statement..

Dr Ravindran pointed out that the market share of TPAs have increased from 1.5 per cent in 1997 to 10 per cent in 2014, adding that some government-linked companies (GLCs) have also invested in TPAs.

He said that certain TPAs are owned by pharmaceutical distribution companies, and warned that such integration could lead to monopolistic conditions if unchecked.

“The Harvard group engaged by the Health Ministry mooted the idea of Voluntary Health Insurance to the Health Ministry, and if it takes off, it may become the ‘Mother of all TPAs’,” he added.

“The MMC and the Health Ministry cannot dismiss these grievances as a private contract or trade issue between GPs and TPAs as it involves ethical issues for the registered medical practitioners while providing the services to the patients,” he said.

Among the other issues with TPAs highlighted by the MMA were delayed payments to clinics, denial of patients’ right to choose their clinics and medication, minimal consultation fees paid to medical professionals, charging various fees to general practitioners and even taking a certain percentage from invoices issued by doctors.

“There are 7,000 GP clinics in the country and the time has come for the Health Ministry and the MMC not only to listen to their grouses but to take action.

“If the issues raised by GPs in the past 22 years is not addressed promptly, the end losers will be the patient,” he said in a press statement.

In April, the Health Ministry launched the Malaysian Health Data Warehouse (MyHDW), which aims to connect public and private hospitals as well as clinics in order to share a variety of information and knowledge including a patient’s medical records in a secured system.

According to the ministry, MyHDW will synchronise patient data from public and private clinics and hospitals, including university hospitals and Armed Forces hospitals, as well as data from the National Registration Department (NRD), the Department of Statistics, and other “health-related agencies.”

The use of MyHDW has raised concerns as to whether there are privacy issues and who has access to confidential patient data.

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