MMA president Dr Azizan Abdul Aziz said one of the major issues caused by TPAs, also known as managed care organisations, was the practice of fee-splitting, whether by reducing consultation fees or claiming a portion of the fees from the final settlement of a medical bill.

With these third parties deducting between 10% and 15% from the total bill, Azizan said it could affect a private clinic’s sustainability and quality of care, as general practitioners (GPs) would be forced to cut costs or adjust prices to cover their losses.

“We wish to remind all private medical practitioners that under the guidelines set by the Malaysian Medical Council, fee-splitting is unethical.

“If left unchecked, these unethical practices in our healthcare system will lead to a further escalation in healthcare costs, in particular private primary care services.

“As the issue has an impact on healthcare delivery for the population, we call on MPs to address the matter in the upcoming parliamentary session,” she said in a statement.

Azizan also said that MMA had been engaging with the health ministry on the issue since 2015, with no regulatory action taken.

She said that TPAs charged GPs high fees to be registered as panel clinics, were not transparent about their operations, and had the habit of delaying claims payments.

The MMA president proposed the establishment of an authoritative body to regulate TPAs to ensure ethical practices, and a unified system to register clinics.