KUALA LUMPUR: Some private hospitals charge patients using Guarantee Letters (GLs) higher rates than cash-paying patients and those using a pay-and-claim basis, according to findings by the Public Accounts Committee (PAC).
The committee also uncovered the practice of "unbundling", whereby hospitals impose separate charges for basic items that would ordinarily be included in room fees.
PAC member Dr Halimah Ali said the findings emerged from 19 proceedings conducted between February and August last year.
“The PAC found instances of unbundled charges for basic items such as clinical waste disposal, pillowcases and alcohol swabs, which should ordinarily be included in room charges,” she said when delivering the PAC chairman's statement on issues relating to medical insurance in the Dewan Rakyat on Thursday (June 25).
She added that the committee had also identified a lack of transparency in cross-subsidisation, with private hospital billing structures failing to accurately reflect actual costs.
“Charges for medicines and medical supplies are often subject to significant mark-ups, sometimes reaching 300%, to subsidise mandatory operational costs that are either not billed directly or are subsidised, such as ward charges, ICU services and the provision of 24-hour emergency departments,” she said.
Among its recommendations, the committee said Bank Negara Malaysia (BNM) should impose firm punitive action against any insurer found to have manipulated the interpretation of, or failed to comply with, interim measures in a manner that undermines the welfare and interests of policyholders.
“BNM should also ensure that the insurance and takaful industry transitions towards smaller and more stable annual premium adjustments to avoid significant financial shocks to policyholders.
“It should also review cohort-based premium pricing and consider a suitably calibrated approach to strengthen fairness in risk-sharing while preserving affordability and long-term sustainability.
“The Malaysia Competition Commission (MyCC) should provide guidance to stakeholders on discount negotiations between hospitals and insurers to ensure the process remains fair and does not adversely affect patient access,” Dr Halimah said.
She added that the Health Ministry should ensure amendments to the Private Healthcare Facilities and Services Act 1998 are implemented to empower the ministry to regulate private hospital service charges beyond doctors’ fees.
“The ministry and BNM should strengthen complaint resolution channels and mechanisms relating to insurance and medical costs to ensure issues are resolved efficiently and effectively.
“In collaboration with the Domestic Trade and Cost of Living Ministry, the government should also establish price control mechanisms for medicines and medical devices to ensure prices remain reasonable and to prevent excessive profiteering,” she said.
