Deputy finance minister Lim Hui Ying said the exclusive right to determine patient care remained reserved for doctors.

“And if the insurance policy does not cover the treatment, then patients can pay for it out of pocket,” she told the Dewan Rakyat.

Lim was responding to a supplementary question by Sim Tze Tzin (PH-Bayan Baru), who asked about the government’s measures to address the issues highlighted following the imposition of Bank Negara Malaysia’s interim measures to tackle the rise in medical insurance premiums using existing laws.

The issues highlighted by the PKR MP included the interference of ITOs in clinical decisions, retraction of guarantee letters, rejection of claims on the grounds that treatment does not adhere to protocols, a steep hike in insurance premiums due to age brackets, and the slashing of coverage periods.

In her response, Lim said data provided by the ITO industry showed that it had maintained an average approval rate of 90% for claims.

However, the government, together with the central bank, the medical industry, hospitals and ITOs, would be reactivating the Grievance Mechanism Committee (GMC), she said.

The GMC deals with issues related to business operational practices to reduce delays in the issuance of guarantee letters and look into disputes on coverage.

The Malaysian Medical Association (MMA) last month expressed concern over a circular issued by a TPA directing healthcare providers on the choice of anaesthesia and the classification of certain procedures as either daycare or inpatient.

MMA president Dr R Thirunavukarasu said such directives amounted to interference with clinical autonomy and constituted a clear breach of medical ethics.