MOH looking into third-party administrator fee in healthcare

A view of KK Hospital. Minister of State for Health Chee Hong Tat said the focus of MediShield Life should still be on large hospital bills.
A view of KK Hospital. Minister of State for Health Chee Hong Tat said the focus of MediShield Life should still be on large hospital bills.ST PHOTO: KUA CHEE SIONG

The Ministry of Health (MOH) is considering rules that will make third-party administrator (TPA) fee arrangements more transparent, Minister of State for Health Chee Hong Tat said yesterday.

If implemented, these regulations will be on top of the revised ethical guidelines for doctors, which state that doctors should let patients know if these fees are passed on to them.

"MOH is assessing if these disclosure requirements should be further reinforced through our regulations," Mr Chee said. "We are also working with the Life Insurance Association and the Integrated Shield Plan insurers to ensure that their appointed TPAs do not have any conflicts of interest."

He added that insurers should let policyholders know if they have any financial arrangements with the doctors.

Mr Chee was responding to Mr Desmond Choo (Tampines GRC), who asked whether the ministry would consider regulating managed care and TPA companies as healthcare entities.

These companies do not directly provide healthcare services to patients. However, they provide intermediary services such as managing employer medical benefits.

Mr Chee said that such companies must not charge in a way that compromises patient well-being or leads to escalating healthcare costs, and that the ministry is monitoring the situation and will step in if necessary.

He also fielded questions from Mr Ong Teng Koon (Marsiling-Yew Tee GRC), who asked if there are more ways to help people who have problems paying for outpatient treatment even after subsidies, and if outpatient insurance can be included under MediShield Life.

Mr Chee said that people can use their Medisave for outpatient scans and claim for expensive outpatient treatments such as chemotherapy under MediShield Life.

Those who still cannot afford treatment after these can apply for help from Medifund, he said.

However, Mr Chee stressed that the focus of MediShield Life should still be on large hospital bills.

"It is important to bear in mind that expansions in MediShield Life coverage will lead to higher premiums for all policyholders," he said.

"With an ageing population, we need to carefully consider the trade-offs to ensure the scheme remains affordable and sustainable."

A version of this article appeared in the print edition of The Straits Times on November 08, 2016, with the headline 'MOH looking into third-party administrator fee in healthcare'. Print Edition | Subscribe