third party administrators (TPAs) Archives

13 November 2025

Letter

The Double-Dipping Scandal: How TPAs Are Exploiting Both Corporations And Clinics — Dr James Jeremiah

Dr James Jeremiah says TPAs operate on a "double-dipping" model, charging both corporations for being on their panels and appointed clinics that provide the service, slicing off as much as 10% of GP total fees per patient visit.

12 November 2025

Letter

TPAs, Insurers Must Revise GP Consultation Fees — Dr G Nanthakumar & Dr Manmeet Rai

TPAs and insurance companies must revise GP consultation rates to reflect modern primary care. The fees set by some TPAs or insurers remain at levels set over 20 years ago. Stronger primary care saves insurers money, but only if it's properly supported.

12 November 2025

Malaysia

Medical Groups Threaten Legal Action Against TPA, Bank Over Generic-Only Policy

Nine doctors' groups have sent a letter of demand to MiCare and Hong Leong Bank over a generic-only mandate for long-term medications for the bank's staff, saying this policy puts patients at risk and unfairly exposes medical practitioners to legal action.

6 November 2025

Malaysia

MOF: Insurers And TPAs ‘Have No Power’ To Decide Patient Care

Deputy Finance Minister Lim Hui Ying says insurers and TPAs have “no power” to decide patient care and only assess claims. She said treatment decisions are the “exclusive responsibility” of doctors despite complaints of insurer interference in clinical decisions.

5 November 2025

Malaysia

TPA Limits Doctor Visits To One Daily For Hospital Admission

A TPA limits physician visits to one per day for surgical/non-surgical admission. A Penang paediatrician says limiting doctor reviews threatens clinical autonomy and patient safety, as a patient who appears stable in the morning may deteriorate by evening.

28 October 2025

Malaysia

MMA Wants MMC Ethical Advisory On Insurers Blacklisting Doctors, Interference In Medicine

MMA urges the Malaysian Medical Council (MMC) to issue a new ethical advisory to address ITO/TPA blacklisting of doctors and interference in clinical care. Ethical exclusion from practice must remain under MMC's jurisdiction, not outsourced to companies.

27 October 2025

Letter

Everyone Wants To Be A Doctor, Except Doctors — Dr Pearl Leong

When everyone acts like a doctor, no one truly takes responsibility. And in that chaos, the patient always loses.

23 October 2025

Malaysia

Insurance/Takaful Industry Touts 90% Medical Claims Approval Without Specifying GL Denial Rate

In response to CodeBlue’s poll among specialists, LIAM, MTA, and PIAM tout an average medical claims approval rate of over 90% in the insurance/takaful industry. But the associations omit details on the rate of guarantee letter (GL) denials or revocation.

23 October 2025

Malaysia

Insurers, TPAs ‘Crossed The Line’ By Compromising Clinical Decisions: Bandar Kuching MP

Bandar Kuching MP Dr Kelvin Yii slams ITOs/TPAs for interference and compromising clinical decisions in private health care at a huge scale, saying payers have “crossed the line”. The DAP MP demands an independent statutory Private Health Care Commission.

22 October 2025

Malaysia

Senior Oncologist Warns Of Dangerous Insurance Interference In Cancer Care

Senior oncologist Dr Ibrahim Wahid slams ITOs/TPAs for questioning clinical decisions and denying coverage for lifesaving cancer drugs. An ITO demands up to 30% discounts from hospitals; some doctors lose cashless facilities if hospitals don't acquiesce.

Tag: third party administrators (TPAs)

The Double-Dipping Scandal: How TPAs Are Exploiting Both Corporations And Clinics — Dr James Jeremiah

TPAs, Insurers Must Revise GP Consultation Fees — Dr G Nanthakumar & Dr Manmeet Rai

Medical Groups Threaten Legal Action Against TPA, Bank Over Generic-Only Policy

MOF: Insurers And TPAs ‘Have No Power’ To Decide Patient Care

TPA Limits Doctor Visits To One Daily For Hospital Admission

MMA Wants MMC Ethical Advisory On Insurers Blacklisting Doctors, Interference In Medicine

Everyone Wants To Be A Doctor, Except Doctors — Dr Pearl Leong

Insurance/Takaful Industry Touts 90% Medical Claims Approval Without Specifying GL Denial Rate

Insurers, TPAs ‘Crossed The Line’ By Compromising Clinical Decisions: Bandar Kuching MP

Senior Oncologist Warns Of Dangerous Insurance Interference In Cancer Care

Ampang Hospital’s IT System Down For 33 Hours In First Huge Outage

Report: Treasury Wants RM3b Cut To Health Ministry’s 2026 Budget

Too Many Agencies Involved In Doctor Workforce Pipeline: Health DG

Take Action Against Retail Blood Testing In Pharmacies — FPMPAM

Don’t Blame MOH Alone For Health Workforce Shortages — MMA