MOH appoints healthcare insurance committee to look at issues related to Integrated Shield Plans

SINGAPORE: The Ministry of Health (MOH) has appointed a committee tasked with looking at issues related to Integrated Shield Plans (IPs) - which have been the subject of debate between healthcare insurers and private sector doctors.

The row stems from insurers excluding many specialists from their IP doctor panels, which guide policyholders on selecting medical providers.

The 12-member Multilateral Healthcare Insurance Committee (MHIC) will come into effect on Apr 27, said MOH in a press release on Wednesday (Apr 14).

It will be the primary platform for the Government, doctors, insurers and hospitals to work together on issues related to health insurance.

It comprises representatives from the Academy of Medicine, Singapore (AMS), Consumer Association of Singapore (CASE), Fee Benchmarks Advisory Committee (FBAC), Life Insurance Association (LIA), Singapore Medical Association (SMA) and private hospitals Mount Alvernia Hospital and IHH Healthcare Singapore.

The committee is co-chaired by MOH's Deputy Secretary for Policy Ngiam Siew Ying and Deputy Director of Medical Services for Health Performance Group Daphne Khoo.

The MHIC stems from an earlier pro-tem committee – established last October between the AMS, LIA and SMA – that facilitated discussions related to IPs, said the ministry.

READ: Government committee to be set up to look into management of Integrated Shield Plans, panel doctors

"The Pro-Tem Committee has made progress over issues such as the amendment of IP contracts' exclusion clauses to cover medically indicated diagnostic procedures, improving consumer education on IP, improving panel sizes and facilitating the setting of panel fees to be within the MOH Fee Benchmarks," said the ministry.

It added that the MHIC will build on the work of the pro-tem committee.

The MHIC will focus on "key priority areas including improvements to the accessibility and transparency of IP doctor panels, enhancements to the claims pre-authorisation process for treatment, and improving transparency across the board", said MOH.

"It will work in the public and patients' best interest in providing recommendations on ensuring quality, safe, cost-effective and affordable healthcare for Singaporeans."

The committee will also recommend improvements to manage rising healthcare costs in the insurance system, and guide the establishment of platforms to address complaints and conflicts arising from insurance claims, said MOH.

"MOH will continue to work collaboratively with all stakeholders to strike a balance between preserving patient choice, while ensuring quality, cost-effective and sustainable care," said the ministry.

More details on the MHIC's recommendations will be released when ready, it added.

DOCTORS, INSURERS HAVE "SPARRED"

In a Facebook post on the appointment of the committee earlier this month, Senior Minister of State for Health Koh Poh Koon said that doctors and insurers have "sparred" recently over the issue of IP panels.

IPs comprise two parts – a MediShield Life component managed by the Central Provident Fund Board, and additional benefits offered by private insurers.

In a statement on Mar 27, the SMA said that insurers had formed "highly exclusive" medical panels that excluded many private specialists", and that there was "opacity" in the selection criteria.

The association also called on the authorities to "instil cost discipline in IP insurers" and ensure that premiums collected are "not frittered away on non-healthcare cost items".

In response, LIA, which represents insurers, said there were cases of "over treatment" by medical providers, and called SMA's analysis of insurers' costs and claims costs "misleading".

In a later statement on Apr 2, LIA said that insurers have since expanded their panels and will continue to do so, with current IP panels ranging from 250 to 400 private specialists.