Tag: third party administrators (TPAs)

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9 January 2026
Malaysia

PMCare To Honour Claims By Panel Doctors Without Valid APC

PMCare says it will honour claims for services rendered by existing panel doctors awaiting 2026 APC, but medical practitioners who want to join the TPA's panel must have a valid APC. Problems with APC renewal aren't new, with previous delays up to March.
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16 December 2025
Malaysia

Perdim Recalls Failed TPA Venture, Wants TPAs Regulated

Perdim says establishing a doctor-led TPA is difficult due to high costs, manpower needs, and business risks; its MyTPA venture collapsed in 1.5 years. Rather than doctor groups forming their own TPAs, Perdim demands a new Act to regulate ITOs/TPAs/MCOs.
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9 December 2025
Malaysia

Year Of The Doctor: Recapping Malaysian Health Care In 2025

2025 is the Year of the Doctor in Malaysian health care, with policies favouring medical practitioners across public/private: 40% ETAP allowance hike for medical officers, MOH defending doctors in health insurance issues, and drug price display deferral.
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27 November 2025
Malaysia

PMCare Wants Act To Regulate TPAs Under MOH

PMCare calls for a standalone Act to regulate TPAs and MCOs that should set out an operational framework, including payment terms for panel providers and definitions of "clinical interference". PMCare wants TPA regulation to be under MOH's jurisdiction.
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26 November 2025
Malaysia

PMCare Advocates For Doctors, TPA More Than ‘Middleman’

PMCare says it's more than just a "middleman". The TPA advocates on behalf of doctors/patients by pushing its clients to cover recommended treatments. Despite reporting RM104m in past due claim receivables, PMCare ensures providers are paid within 60 days.
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14 November 2025
Malaysia

MiCare Says Limited By Bank Employees’ Medical Benefits

In response to an LOD by nine medical groups over a generic-only policy, MiCare says it's limited by Hong Leong Bank's staff medical benefits. If a prescribed medicine isn't reimbursable under the employee benefit policies, then the insured must self-pay.