A previous Malaysia deputy health minister has endorsed the creation of a regulatory entity tasked with overseeing and managing reimbursements offered by health insurance providers.
Dr Lee Boon Chye has advocated for the establishment of the body, emphasising its potential to effectively handle arbitration disputes and ensure appropriate conduct by these companies.
“There should ideally be a regulatory authority to oversee the conduct of managed care organisations (MCO) so that if there are any grievances, that authority can act as an arbitrator to mediate payment disputes,” he said in a report from Free Malaysia Today.
This endorsement follows a similar call by Dr Kuljit Singh, the president of the Association of Private Hospitals Malaysia (APHM), for the formation of such an overseeing authority concerning health insurance reimbursements.
Currently, insurance companies fall under the oversight of Bank Negara Malaysia (BNM).
Lee proposed that having a specialised authority would be more advantageous due to its in-depth knowledge of the medical field. He envisioned the body consisting of two distinct authorities, each contributing expertise in their respective domains. BNM would supervise financial aspects, while the health ministry would monitor medical aspects.
“Under BNM, it is a bit difficult because they are not conversant in the medical field. I don’t think they are able to do the vetting as to whether claims are legitimate or whether the rejection of guarantee letters is legitimate,” Lee said.
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