Transparent medical billing plan needs more time


KUALA LUMPUR: The delay in ­implementing the long-anticipated Diagnosis-Related Group (DRG) payment system for private healthcare services is due to the need for stronger institutional capacity and comprehensive data collection, says Health Minister Datuk Seri Dr Dzulkefly Ahmad.

He said the government must ensure all key components are in place before rolling out the system, which aims to standardise billing practices and improve transparency across the healthcare sector.

“There’s no need for assumptions or­ ­negative perceptions. What matters is implementing a good initiative effectively, one that requires careful preparation and sound execution so it achieves its intended purpose.

“We need capacity-building and adequate data sharing from private medical practitioners. It’s not about pressure from anyone,” he told the Dewan Rakyat yesterday.

Dzulkefly was responding to a supplementary question from Tan Kok Wai (PH–Cheras), who asked whether the delay of the DRG was due to lobbying by private hospital groups concerned about its impact on profit margins.

Initially scheduled for phased implementation beginning in late 2025, the Health Ministry announced in August that the DRG system is now expected to be ­formally launched in 2027.

The DRG framework will provide a standardised and transparent mechanism for healthcare payments, in which billing is based on defined categories such as ­diagnosis, procedure and complications rather than itemised charges to prevent overcharging.

In response to Tan’s initial query on the main challenges in implementation, Dzulkefly cited tight timelines, rising public demand for affordable healthcare and medical cost inflation as ­pressure points.

“We need comprehensive data because patient care standardisation relies on actual treatment data from private practitioners.

“Data sharing is essential in determining treatment rates, not just averages, but also consistency,” he added.

He said this information would be ­critical to building the national framework ­tailored to Malaysia’s healthcare landscape – to be known as the Malaysian DRG System.

Dzulkefly also emphasised the need for skilled personnel and proper medical coding, adding that implementation success depends on a trained workforce with the capacity to manage and execute the system effectively.

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