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Health Ministry Explores Regulation of Third-party Administrators in Malaysia

Kuala lumpur: The Health Ministry (MOH) is currently evaluating a proposal to regulate third-party administrators (TPAs) involved in managing health insurance claims, in response to concerns raised by the Malaysian Medical Association (MMA) regarding TPAs interfering with doctors’ professional responsibilities in patient care. Health Minister Datuk Seri Dr Dzulkefly Ahmad confirmed that the issue had been discussed in Cabinet and requires the collaboration of several ministries, including the Domestic Trade and Cost of Living Ministry (KPDN).

According to BERNAMA News Agency, Dr Dzulkefly emphasized that the regulation of TPAs is a significant agenda for the MOH, noting that the matter had been presented to the Cabinet. He highlighted that the jurisdiction extends beyond the MOH, necessitating cooperation with other ministries to arrive at a viable solution. Dr Dzulkefly made these remarks during a full enforcement operation of the Control of Smoking Products for Public Health Act 2024 (Act 852).

The MMA recently urged the government to regulate TPAs following a new directive from a TPA associated with a major financial institution. This directive required that long-term prescriptions be written using only the active ingredient name. Dr Dzulkefly reiterated that the MOH supports the use of generic medicines, provided they have undergone studies to ensure their safety and efficacy and are comparable to original drugs.

Addressing another issue, Dr Dzulkefly commented on reports of visitors allegedly being barred from hospitals due to dress code violations. He stressed the importance of discretion in such cases, clarifying that while guidelines exist, effective communication and respect for visitors should remain a priority. An incident was reported where a woman claimed she was denied entry to Cyberjaya Hospital for wearing a sleeveless top, but Dr Dzulkefly assured that discretion should guide the enforcement of dress codes to ensure patients receive necessary support from family members.

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