Revised guidelines on middlemen fees emphasises patient care comes first: MOH

THE Singapore Medical Council (SMC) has revised its ethical code and ethical guidelines to address financial arrangements between doctors and intermediaries known as managed care companies or third party administrators (TPAs).

"The revised guidelines will explicitly state that doctors must not allow financial arrangements in managed care to lead to any compromise in the care of the patient," said the Ministry of Health (MOH) in a statement.

MOH was replying to a parliamentary question filed by Member of Parliament Desmond Choo (Tampines GRC).

Mr Choo had asked the SMC, a statutory board that regulates doctors, whether the administrative fees paid by doctors to managed care companies will drive up patient costs.

The Business Times reported last Friday that some doctors were upset over the fee practices of managed care companies, and the uproar intensified in recent weeks.

In its reply, MOH noted that it and SMC have received feedback from individual doctors and the Singapore Medical Association (SMA) in recent months, on these intermediaries entering into contracts with doctors where the doctor would commit to pay a fee for each patient referred by the intermediary.

"This raises concerns that TPA's decisions on patient referral may be influenced by the fee arrangement rather than the interest of the patients," MOH said.

The new SMC guidelines were released on Wednesday. They stipulated that doctors "must not allow any financial or other arrangements inherent in managed care to pressure you into making decisions that would compromise the required standard of care".

Fees must be paid to TPAs, among others, in a way that "reflect their actual work in handling and processing the patients". Fees passed on to patients must be disclosed, SMC said.