MOH to formalise panel to look into issues related to Integrated Shield Plans

Insurers said expanding their panels is on the cards, but a "reckless" expansion could cause premiums to rise significantly.
Insurers said expanding their panels is on the cards, but a "reckless" expansion could cause premiums to rise significantly.PHOTO: KOH POH KOON/FACEBOOK

SINGAPORE - A pro-tem committee looking into issues related to Integrated Shield Plans (IP) will be formalised into a committee appointed by the Ministry of Health (MOH), Senior Minister of State for Health Koh Poh Koon said on Saturday (April 3).

Details on the committee and its proposed recommendations will be released when ready, Dr Koh said in a Facebook post.

Doctors and IP insurers have been locked in a battle over insurers having panel doctors in the past few weeks, noted Dr Koh.

Private sector doctors have expressed their unhappiness with IP insurers for excluding many specialists from their panel of doctors for policyholders and have called such panels "highly exclusive".

Insurers said expanding their panels is on the cards, but a "reckless" expansion could cause premiums to rise significantly. Doctors also cannot expect default fees at the upper end of fee benchmarks set by MOH, they added.

Dr Koh urged both sides to remember that they ultimately serve the best interests of a common customer: patients who are policyholders. His remarks were the first time that the Government has weighed in on this debate publicly.

"Both sides have made valid points on areas that needed to be improved but have also expressed views that are not correctly reflecting the trade-offs and balance needed to ensure sustainability of the premium of insurance plans and the provision of cost-effective quality healthcare in the longer term," he said.

Dr Koh said he met representatives of the Singapore Medical Association (SMA), Life Insurance Association (LIA) Singapore and the Academy of Medicine, Singapore on Wednesday (March 31) to discuss improvements to the way IP panels are set up and administered.

Frank discussions among stakeholders to identify the issues and work on the solutions needed to improve the system are the right way forward, he added.

Among the items discussed were expanding insurers' panel of doctors with clear and transparent criteria, and improving the pre-authorisation process for treatment claims by doctors who are not on the panels, he said.

Several ideas were also raised on improving transparency of doctors' fees and outcomes, insurers' performance, and better processes to deal with any unfair behaviour, said Dr Koh, who described the discussions as constructive.

The Straits Times reported on Saturday that two dialogues between doctors, IP insurers and the MOH have been held since last October, and that there has been some clarification and greater understanding between parties with the ministry helming talks.

Dr Koh said SMA's intent to set up a complaints committee and the LIA's plan to create an IT platform to streamline data-sharing and claims process are both positive and helpful steps in the right direction.

"The parties all agreed that we will formalise the existing pro-tem committee into a committee appointed by the Minister for Health," he said.

"The committee will take the work forward, and work in the public's and patients' interest to deliberate and implement changes for quality, safe, cost-effective and affordable care for all."