Its president, Dr Pearl Leong, said TPAs remained outside of regulatory oversight and were not monitored by Bank Negara Malaysia, the health ministry, or the international trade and industry ministry.
“These platforms (TPAs) have gradually taken control of patient treatment processes and data, establishing medical guidelines that severely interfere with clinics’ autonomy and medical decision-making,” she said in a statement in conjunction with the Black Monday campaign to demand urgent reforms for the sector.
Citing a survey by PMPASKL from Oct 21 to Nov 3, Leong said TPAs have had a significant impact on clinic operations, financial stability, and patient care quality.
The survey found that 48.5% of doctors depended on TPAs to maintain operations, which meant that without intermediaries, clinics would struggle to survive, she said.
In addition, 83.1% of doctors expressed dissatisfaction with the added administrative burden by TPAs while 74% voiced frustration with the dispute resolution mechanisms, particularly with delayed payments, worsening existing financial challenges for clinics.
“80.5% of doctors noted that TPAs have not improved healthcare decision-making but have instead introduced unnecessary complexity,” Leong added.
She also said that only 13% of doctors had expressed willingness to continue supporting the TPA’s cashless payment system.
“Doctors suggest that patients or employees directly seek reimbursement from TPAs for medical expenses rather than having clinics bear the financial burden upfront, which would alleviate the financial strain on clinics,” she said.
Leong urged the government to review the existing policies and regulate the operation of TPAs to ensure the sustainability of clinic operations while safeguarding patients’ healthcare rights.
“Without substantial reforms, the excessive interference of TPAs in community clinics will continue to undermine the autonomy of private clinics, erode public trust in the healthcare system, and threaten the overall quality of medical services in the country.”