KUALA LUMPUR, Oct 24 — Bank Negara Malaysia (BNM) and the Ministry of Health (MOH) will be meeting the medical fraternity next week to discuss the government’s proposed base medical and health insurance/takaful (MHIT) product.
According to an invite sent to the Malaysian Medical Association (MMA) earlier today, the engagement session will be held next Tuesday in a virtual meeting co-chaired by BNM technical adviser Jessica Chew Cheng Lian and Dr Yap Wei Aun, CEO of the Health Transformation Office at the MOH.
“Following our first engagement session on 21 May 2025, which provided an overview of the Reset strategy and initiatives and included discussions on the practices of medical and health insurers and private hospitals to manage escalating claims costs, the upcoming session will focus on providing further updates on the Reset initiatives,” said the invite, as sighted by CodeBlue.
“These updates will cover the base MHIT product and other matters related to health care reforms.”
The engagement session will be held under the purview of the Joint Ministerial Committee on Private Healthcare Costs (JMCPHC) co-chaired by Finance Minister II Amir Hamzah Azizan and Health Minister Dzulkefly Ahmad. This committee isn’t a statutory body.
It’s unclear if the Tuesday meeting will also discuss proceedings of the Grievance Mechanism Committee (GMC) under BNM, which the central bank cited in a statement to CodeBlue as an avenue for health care providers and medical practitioners to resolve health insurance issues or disputes.
In CodeBlue’s nationwide survey among more than 850 specialists practising in private hospitals, 99 per cent perceived interference from insurers and takaful operators (ITOs) or third-party administrators (TPAs) with their clinical decision-making.
BNM said in response that ITOs and TPAs have no authority to “direct” patient care and that ITOs assess medical claims based on “accepted treatment protocols” and “clinical practice guidelines”. Claims must be honoured if treatments are established to be “medically necessary”.
Hundreds of testimonies provided by participants of CodeBlue’s poll showed denials of inpatient admissions, as insurers insisted that cases be treated as daycare or outpatient procedures, as well as denials of general anaesthesia for surgeries and standard-of-care drugs, among many other types of insurance denials, delays, and revocation of guarantee letters (GLs).
In its statement, the central bank did not answer a question by CodeBlue on whether it would mandate the underwriter of the government’s proposed base MHIT product to approve all GLs or claims, regardless of the policyholder’s pre-existing conditions.
A joint statement by the Life Insurance Association of Malaysia (LIAM), the General Insurance Association of Malaysia (PIAM), and the Malaysian Takaful Association (MTA) yesterday completely omitted mention of clinicians’ allegations of payer “interference” with the practice of medicine.
Following the publication of CodeBlue’s national poll, three lawmakers across PKR, DAP, and MCA – Bayan Baru MP Sim Tze Tzin, Bandar Kuching MP Dr Kelvin Yii, and Ayer Hitam MP Wee Ka Siong – have demanded the establishment of an independent statutory Private Health Care Commission to regulate health insurance and private health care providers.
