PHCFS ACT / REGULATION : FEES SCHEDULE

The Private Healthcare Facilities and services Act was passed in 1998 and gazetted, and the Regulations to the Act was launched in 2006. On the day of the launch, the Federation of Private Medical Practitioners of Malaysia presented a memorandum to the Minister, YB Dato Dr Chua Soi Lek, declaring that the Regulations had many discrepancies and needed to be amended. There were many of the regulations that were unfair and not practical in our Malaysian context. He agreed. Then began the long journey of meetings after meetings, trying the iron out the details of the amendments to the Regulations. Till this day ( 4 years later ) we are still working out the amendments and the discrepancies and unfairness continues, and some doctors have been harressed by " little Napoleons " when they do their inspection rounds that things in the clinic are not conforming to the regulations, although the amendments were accepted by the MOH, many moons ago.
Of particular relevance was the fees schedule. For some reason ( known best to the politicians and the MOH ), doctors fees in private hospitals ( which form approx. 15-20% of the overall private hospital bill ) should be regulated and capped, but the private hospital charges ( which form 80-85% of the private hospital bill ) need not be capped. Such wisdom and discrimination, perplexes all of us. So we have been negotiating with the MOH, to revised the fees schedule. The last meeting was on the 3rd Sept 2010. The MOH is very keen to revise the fees schedule as there were allegedly, many cases of overcharging, using multiple coding for one procedure ( we call salami, they call unbundling ) and other abuses. We are keen to revise and amend because the fees schedule was base on MMA fees 4th schedule ( drawn up in 2002 ) and is now 8 years old. In fact, YB Chua agreed that the fees should be revised every 2 years. Well, it is now 4 years pass 2006 and 8 years pass 2002. So it is time for review. We have also made a point, repeatedly, that there should be no doctors fees schedule ( abolish the doctors fees schedule ), if there is no hospital's fees schedule. The point was simple, how can you justify controlling the 20% of the bills when you make no attempt to control the 80% of the bill, that rises at will? Well at last Friday's meeting, they again mention that they will look into a private hospital's fees schedule.
Anyway, this blog is to inform one and all, that the MOH has set up a mechanism to review the fees schedule. Basically, all specialist in all their different specialties will their own fees schedule working group. They will then submit their fees schedule to a Task Force Committee for vetting and coordinating. This Task force committee will then submit their recommendations on the fees schedule to the Main Committee on the fees schedule. This main committee is headed by the DG of Health with all the deputy DGs. This is the final authority.
Being of small little faith and knowing how long this will all take ( in the meantime, abuses go on allround ), I have proposed for a 20% across the board increment on the fees of the present fees schedule. ( the MMA was in support and in fact recommended a 30% increase across the board ). All procedures not in the present fees schedule, to be submitted to the present Task force, as soon as possible, so that the present fees schedule be updated and be more comprehensive. To this they agreed. Lets see how long it will take to come about.
The whole mechanism sounds very good. Almost as good as the concept of 1Malaysia. But let us see the working out. Somehow, when I set through the 3 hour meeting, I did not have a sense that they were serious, or keen to revise quickly. We were discussing over and over, what we had agreed many moons ago, and coming back to the same point. I hope that it will all come through, for the sake of the patients and the doctors, but I will not hold my breathe, waiting for it to come.
Dealing with civil servants and politicians, require a different set of skills, which many of us physicians are not so attuned to, and comfortable with.
Fees schedule for private hospitals, lets see what happens. We will keep bringing it up, whenever there is an opportunity.