KUALA LUMPUR, Oct 3 — A doctors’ group today urged the Ministry of Health (MOH) and the Malaysian Medical Council (MMC) to investigate an anaesthesia directive by MediExpress (Malaysia) Sdn Bhd.
The Federation of Private Medical Practitioners’ Associations Malaysia (FPMPAM) also noted that based on MediExpress’ own corporate disclosures, the third-party administrator (TPA) is owned by Sumitomo Corporation Group of Japan.
“Its attempt to dictate clinical protocols in Malaysia represents overreach by a foreign-linked entity into national health care practice and warrants urgent regulatory scrutiny,” said FPMPAM president Dr G. Shanmuganathan in a statement.
He pointed out that the MOH’s medical practice division regulates safe-practice standards under the Private Healthcare Facilities and Services Act (PHFSA) 1998 [Act 586].
“FPMPAM calls on the Ministry of Health to investigate MediExpress’ medical director, and if appropriate, refer the matter to the MMC for interference in clinical decision-making and possible infringement of PHFSA provisions,” said FPMPAM.
The doctors’ group further urged MMC, which regulates the medical profession, to probe if MediExpress’ medical director had acted outside her professional competence and legal boundaries.
CodeBlue reported yesterday MediExpress (Malaysia) Sdn Bhd’s instruction to panel hospitals to prioritise local anaesthesia (LA) as the first-line anaesthesia modality over general anaesthesia (GA) for daycare procedures and surgeries, requiring health care providers to provide a “detailed” justification of the need for general anaesthesia.
The TPA’s October 1 memo also directed “appropriate justification” for guarantee letter (GL) approval if MediExpress deemed the procedure to be more suitable as a daycare service rather than inpatient treatment.
MediExpress’ memo was issued by its medical director Dr Cheah Yt Jun, who is a medical doctor but isn’t listed on the National Specialist Register (NSR).
FPMPAM said while LA was appropriate for many procedures, GA remained essential in specific cases, such as when patients suffer from severe anxiety, difficulty remaining still, or when surgical complexity demands it.
“Forcing clinicians to justify decisions to non-specialists for payment approval not only delays care, but also places patients at risk and doctors at medico-legal jeopardy,” said Dr Shanmuganathan.
He pointed out that FPMPAM previously submitted a memorandum to Prime Minister Anwar Ibrahim in September 2023 to urge regulation of managed care organisations (MCOs), including TPAs.
FPMPAM had warned that unchecked cost-containment measures could lead to rationed care, restrictions on doctor and medicine choices, and violations of laws like the Medical Act 1971 and the PHFSA.
“To date, no official response has been received. Inaction in the face of such clear risks cannot be seen as neutral — silence in the face of interference only emboldens further erosion of patient rights and professional standards,” said Dr Shanmuganathan.
“This latest episode underscores the urgent need for long-delayed MCO legislation, first drafted in 1997 under instruction of the minister of health, to address denial of care and corporate interference in medical decisions. Almost three decades later, doctors and patients remain unprotected.”
Health Minister Dzulkefly Ahmad and the MMC, whose president is Dr Mahathar Abd Wahab (also the Health director-general of the MOH), have yet to issue a statement about MediExpress.
The TPA’s LA-first policy triggered swift outrage from the medical fraternity, with a flurry of statements issued by multiple doctors’ groups and individual specialists, including the Academy of Medicine of Malaysia (AMM); the Malaysian Society of Anaesthesiologists and College of Anaesthesiologists, AMM; the Private Medical Practitioners’ Association of Selangor and Kuala Lumpur (PMPASKL); DRSFORALL; the Malaysian Medical Association (MMA); as well as UCSI Healthcare Group chairman and former Health DG Dr Noor Hisham Abdullah.
