KUALA LUMPUR, Sept 5 – The government is reviewing reimbursable fees for general practitioners (GPs) empanelled with the Madani Medical Scheme (SPM) after doctor groups complained about low rates.
The Federation of Private Medical Practitioners’ Associations, Malaysia (FPMPAM), the Medical Practitioners Coalition Association of Malaysia (MPCAM), and the Malaysian Medical Association (MMA) have all noted that the government medical subsidy scheme, administered by ProtectHealth Corporation Sdn Bhd, offers panel GPs below market prices for tests, basic therapeutic procedures, and medications.
FPMPAM was particularly incensed with the low consultation fee of RM30 per visit, even lower than the RM40 payment for the government’s health screening programme Peka B40; doctor groups have asked for an RM50 consultation fee under SPM.
“We have capping to our price that we give to our GPs, of course, but we are also reviewing our prices because our GPs think that perhaps – one is for treatment, and also consultation fees, the other thing, and then we also giving our GPs for X-rays, as well as blood investigations and procedures,” Health Minister Dr Zaliha Mustafa told reporters at the sidelines of the Hospital Management Asia 2023 conference here today.
“So it goes up to RM170 cap for the visit for the patients.”
It is unclear what the RM170 amount the minister was referring to.
According to ProtectHealth, the fee structure for SPM panel clinics is limited to RM60 per visit for combined consultation and medication, RM50 per visit for investigations, and RM50 per visit for basic therapeutic procedures.
Until December 31 this year, SPM benefits – which provide low-income earners fully subsidised treatment at private GP clinics for acute conditions – are limited to just RM250 per household, RM75 per single, and RM125 for senior citizens aged 60 years and older.
This story is the fifth part of CodeBlue’s series on SPM:
- Part 1: Madani Medical Scheme Faces Resistance From Underpaid GPs
- Part 2: MPCAM: ProtectHealth Promised To Approve Excess Madani Medical Scheme Claims
- Part 3: MMA Praises Madani Medical Scheme, But Admits Doctor Fees Inadequate
- Part 4: FPMPAM Questions ‘Lofty’ 1,000 Madani Patients Monthly Target Per Clinic