KUALA LUMPUR — A detailed study is needed to further investigate the reason for differences in private hospital treatment charges between patients using guarantee letters from insurers and those who pay first and claim later, said Deputy Finance Minister Lim Hui Ying.
She said an analysis of private hospital billing claims submitted to insurance companies and takaful operators (ITO) had shown that this was happening in certain cases, where the total treatment cost is higher for patients using guarantee letters.
“Since the treatment charges imposed are less transparent, a more detailed study is required to understand this issue better and determine appropriate follow-up measures,” she said during a question-and-answer session in the Dewan Rakyat today, Bernama reports.
Lim was responding to Sim Tze Tzin (Bayan Baru-PH), who asked the Finance Ministry to clarify the differences in private hospital charges between the upfront payment and reimbursement method, versus the guarantee letter method.
The deputy minister said the government is aware of this issue, including other policyholders’ concerns raised during the recent public hearing sessions held by the Public Accounts Committee (PAC).
The issue of different private hospital charges for those who pay upfront and claim reimbursement from their insurers later, and those who use guarantee letters, was previously dismissed by the Association of Private Hospitals Malaysia (APHM).
APHM president Datuk Dr Kuljit Singh said it was a “common misconception…which has to be proven”, claiming that private hospitals follow standardised charges regardless of a patient’s payment method.
Lim today said the government is working to find a long-term solution to address the issue of rising medical costs and private hospital charges. For this, the Health Ministry is collaborating with various stakeholders, including the Finance Ministry, private hospitals, and ITOs.
“This includes enhancing the transparency of medication costs and facilitating comparisons of common medical expenses. This integrated action plan was presented to the PAC yesterday,” she said.
PAC yesterday began the first of a series of closed-door sessions on insurance and private hospital matters following two public hearings held to gather complaints and experiences of policyholders in dealing with premium hikes and excessively high private hospital charges.
Sim today had also asked for the top ten illnesses which recorded the highest insurance claim rates for hospital treatment in 2023.
To this, Lim said based on data from ITOs, they are pneumonia, spinal issues, digestive system disorders, heart diseases, dislocated and sprained joints, acute appendicitis, virus and influenza-related infections, other respiratory issues, ear, nose and throat-related issues, and fevers. – February 26, 2025