Sunday, July 24, 2016

Singapore - MOH considers making itemised billing at clinics compulsory

SINGAPORE: The Health Ministry (MOH) is “seriously considering” making it mandatory for clinics on the Community Health Assist Scheme (CHAS) to issue invoices with an itemised breakdown of fees, said Minister of State for Health Dr Lam Pin Min, adding that details would be announced soon.

He said this in Parliament on Monday (Jul 11) in response to questions from Members of Parliament regarding the scheme, which allows low and middle-income households to receive subsidies when they visit participating General Practitioners (GPs) and dental clinics.

Dr Lam said close to 300 complaints were made against General Practitioner (GP) and dental clinics on CHAS between 2013 and last year - or about about 100 a year.

The Minister of State said about half the complaints were related to charges at participating clinics, including incorrect billing and high fees. He added that other complaints included operational issues, such as incorrect subsidy amounts, refusal by the clinic to provide itemised billing and concerns over the professionalism of the medical practitioner.

For each of the complains, the Agency of Integrated Care (AIC) has engaged the clinic involved to seek clarification, said Dr Lam. Where the complaint was due to fees, AIC would review the bill breakdown and explain to the patient if the fees were due to a lengthy consultation period or due to medications prescribed.

Dr Lam said the Agency would also work with the clinic if there was a need to correct the bill.

The scheme came under scrutiny recently, when reports surfaced of two dental clinics being suspended for fraudulent claims, including claiming for procedures that were not carried out. The clinics are in Ang Mo Kio and Marine Parade.

Dr Lam said these two clinics have been referred to the Police for investigation. “A couple” of other clinics have also been referred to the police for investigation, he added.

“MOH conducts very regular audits on CHAS claims and we do look into the clinics compliance according to the existing CHAS guidelines," said Dr Lam. "If we do receive feedback or complaints from residents, we will audit the clinic in more detail to ascertain the rationale and how charges are being made. If we find that there is misconduct, we will not hesitate to take action against the doctors”.


Dr Lam also refuted that these incidents were "the tip of the iceberg". He said that despite concerns of overcharging, the fact was that the number of complaints were small in relation to the total number of claims made, which shows that most clinics are reasonable in their charges and practice.

There were close to 5.8 million claims made during the 2-year-period, he noted.

Nonetheless, Dr Lam encouraged clinics to actively engage their patients, and to display their clinics’ common charges prominently, as well as provide itemised receipts upon request. He added that patients should also check their bills and alert the Ministry on any concerns, especially since different CHAS clinics have different charges.

Member of Parliament for Holland-Bukit Timah GRC, Mr Liang Eng Hwa, also asked if there were plans to merge the Blue and Orange CHAS cards into one, as there were more low-income Blue chardholders.

“The cut-off for the household monthly income per person criteria set at S$1,100 is too low to qualify for the Blue card," Mr Liang said. "Will the Ministry consider reviewing this threshold given that medical expenses have gone up. Are there plans to merge the Blue and Orange cards given that the Orange cards are not as popular?"

Dr Lam said the Health Ministry will regularly review the subsidy quantum and scope of coverage of the Scheme, including its eligibility criteria.

Currently, blue CHAS cardholders receive more subsidies than orange cardholders as they come from families that earn a household monthly income of S$1,100 of below per person.

There are currently close to 1.4 million Singaporeans under the scheme, of which about 400,000 are those from the Pioneer Generation. Excluding the Pioneer Generation, close to 600,000 were blue CHAS cardholders, while 400,000 were orange cardholders.

- CNA/mo

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