Nationwide Madani Medical Scheme Downscaled To 10 Districts: ProtectHealth

ProtectHealth says the Madani Medical Scheme – which expanded nationwide in Sept 2023 – has been downscaled to the original 10 districts in its June 2023 pilot, describing it as “refinement” to maximise impact. The scheme received RM100mil in Budget 2024.

KUALA LUMPUR, Feb 28 – The scope of the Madani Medical Scheme (SPM) has been reduced to the original 10 districts back when it was piloted in June 2023, according to ProtectHealth Corporation.

The company fully owned by the Ministry of Health (MOH) – which administers the programme that fully subsidises acute outpatient treatment at private panel general practitioner (GP) clinics for the low-income – did not explain the rationale for the downscaling of SPM that expanded nationwide just five months ago last September 15.

“Effective February 26, 2024, the Madani Medical Scheme will be refined to focus on certain districts and recipients to increase effectiveness and sustainability, and to maximise the impact of this scheme,” ProtectHealth said in a statement yesterday.

Implementation of SPM will now only focus on 10 districts: Kuala Lumpur; Gombak, Hulu Langat, Petaling, and Klang in Selangor; Johor Bahru (Johor); Kinta (Perak); North East (Penang); Kota Kinabalu (Sabah); and Kuching (Sarawak).

These are the same 10 districts where SPM first piloted last June 15, before expansion to 11 additional districts in August and the nationwide expansion in September. The 11 extra districts announced last August included those in Kedah, Terengganu, Kelantan, Pahang, Melaka, Negeri Sembilan, and Perlis.

“Besides that, eligibility of Madani Medical Scheme recipients will focus on registered households in only these 10 districts and patients who previously received treatment can continue to use it until allocations for the scheme are fully utilised,” said ProtectHealth.

“Active private clinics under the Madani Medical Scheme in the set districts can continue to provide Madani Medical Scheme services.”

SPM panel clinics operating outside the 10 districts have until tomorrow (February 29) to file delayed claims for treated patients.

“This refinement is important for the effective implementation of the Madani Medical Scheme in achieving the main objective of this scheme. By focusing resources on certain areas and recipients, ProtectHealth is committed to increasing health care access and quality for those who need it.”

The reason for SPM’s cutbacks is unclear, especially considering that ProtectHealth’s statement yesterday noted that the scheme had successfully improved congestion in MOH facilities in the districts under the pilot phase of the programme.

SPM received an RM100 million allocation in Budget 2024, with ProtectHealth saying last October that the programme would benefit approximately 700,000 households this year.

“As of 12 October 2023, 240,000 Skim Perubatan Madani treatments had been administered, with around 150,000 households benefiting from the programme,” ProtectHealth said then.

Then-Health Minister Dr Zaliha Mustafa – in her September 19 statement announcing the expansion of SPM throughout Malaysia – noted that since the introduction of the programme, more than 130,000 outpatient treatments have been provided by over 1,300 private panel GP clinics.

The benefit limits for SPM beneficiaries until December 31 are RM75 for singles, RM125 for senior citizens, and RM250 for households. Combined consultation and medication is limited to RM70 per visit.

If budget issues are indeed the problem, it is unclear why this would occur so early in the year in February. CodeBlue has asked the MOH for an explanation.

You may also like