KUALA LUMPUR, Nov 18 — The Federation of Private Medical Practitioners’ Associations Malaysia (FPMPAM) has urged the Ministry of Health (MOH), the Malaysia Competition Commission (MyCC), Bank Negara Malaysia, and parliamentary committees to launch immediate regulatory reviews into what it describes as widespread abuses by third-party administrators (TPAs) in the country’s primary care sector.
In a statement today, FPMPAM said it “strongly supports” the exposé by Dr James Jeremiah published by CodeBlue, which detailed alleged “double-dipping” practices by TPAs and how these intermediaries extract revenue not only from employers but also from clinics.
FPMPAM president Dr Shanmuganathan TV Ganeson said Dr James’ article reflects “the experiences of thousands of GPs nationwide” who have endured these issues for nearly two decades.”
“It is time to broaden the discussion and address deeper structural problems affecting Malaysia’s primary care system,” Dr Shanmuganathan said.
He added that systemic issues have persisted due to a regulatory vacuum that has allowed TPAs to operate with minimal oversight, despite years of calls by GP groups for governance under the Private Healthcare Facilities and Services Act 1998 (Act 586) or a similar framework.
Foreign Equity, Conflicts Of Interest, And Routing Practices
One of FPMPAM’s central concerns is what it describes as exploitative foreign-linked corporate control over Malaysia’s TPA sector.
The association alleged that a substantial portion of the industry is directly or indirectly owned by foreign entities, resulting in an “extraction” of Malaysian health care spending overseas.
FPMPAM warned that such arrangements may expose Malaysian patient data and utilisation patterns to outside parties, while making local clinics financially dependent on intermediaries whose commercial interests may not align with national health priorities.
“Even more concerning, a foreign corporate entity that is a majority shareholder in at least three TPAs is also the owner of one of the largest clinic chains in Malaysia,” Dr Shanmuganathan said. “This situation raises clear questions about conflict of interest, market fairness, and data security.”
He added that local GPs already struggle with rising operating costs and regulated fee caps. “Such foreign-linked exploitation is profoundly unjust,” he said.
FPMPAM said GPs are also increasingly reporting preferential patient routing within certain TPA networks. While the association said it will not name entities pending verification, it stressed that no TPA should have financial interests in clinics receiving their referrals or act as both gatekeeper and beneficiary.
“These practices distort patient choice and undermine clinical independence,” Dr Shanmuganathan said.
Clinics Hit by Payment Delays, Unregulated Fees
Another major issue highlighted by FPMPAM is chronic delays in reimbursement to clinics, with payment cycles stretching for months. The association said there is growing concern that certain TPAs may be using delayed payments as internal cashflow financing.
According to Dr Shanmuganathan, this effectively makes GP clinics “unwilling creditors, buffers for cashflow, and unpaid financiers of TPA operations”. Smaller clinics, he said, are especially vulnerable and cannot sustainably operate under such conditions.
FPMPAM also criticised what it described as unregulated, unjustified onboarding fees imposed on clinics, reportedly reaching as high as RM5,000. The association said such fees are often imposed without transparency, performance guarantees, or regulatory oversight.
“This ‘pay-to-access’ model has no place in a responsible health care system,” Dr Shanmuganathan said.
Twenty Years Of Inaction And Mounting GP Strain
Dr Shanmuganathan noted that for nearly 20 years, FPMPAM, the Malaysian Medical Association (MMA), Pertubuhan Doktor-Doktor Islam Malaysia (PERDIM), and the Medical Practitioners Coalition Association of Malaysia (MPCAM) have repeatedly urged MOH to regulate TPAs. Yet, he said, “little has changed”.
“We must ask: Why has no substantive action been taken? Why has the TPA sector been allowed to operate as an unregulated authority? Why are intermediaries acting with fewer constraints than licensed clinics?” he said. “This regulatory vacuum has caused real harm.”
Dr Shanmuganathan said that many GPs have begun asking whether they should boycott TPAs amid escalating pressures. “Doctors do not boycott because we care for patients, not corporations,” he said. But he warned that clinic sustainability, professional autonomy, and patient choice are all being eroded by unregulated intermediaries.
FPMPAM said Dr James’ exposé “must be a turning point” and urged regulators to immediately review the TPA ecosystem, including double-dipping, conflicts of interest, foreign equity influence, data governance, payment timelines, onboarding fees, and threats to clinical autonomy.
“Malaysia’s GPs are the backbone of community health care. They deserve fairness, dignity, and protection from exploitation,” Dr Shanmuganathan said.
