KUALA LUMPUR (Nov 3): Finance Minister II Datuk Seri Amir Hamzah Azizan said he would discuss insurers’ restrictions on specialists’ access to direct billing with Bank Negara Malaysia (BNM), after concerns were raised over patients’ choice of doctors and continuity of treatment.

Responding to former prime minister Datuk Seri Ismail Sabri Yaakob in the Dewan Rakyat on Tuesday, Amir Hamzah said BNM, which oversees the insurance industry, would examine insurers’ procedures. At the same time, the senator also warned industry players to comply with rules and avoid practices that could drive up medical costs.

“If medical inflation rises, everyone will have to pay more,” Amir Hamzah said when winding up the committee-stage debate on Budget 2027, adding that those permitted to use cashless facilities must also comply with the applicable rules.

Ismail Sabri, the five-term Bera MP and Malaysia's ninth PM, had earlier questioned insurance companies' practice of removing specialists from their cashless panels, while calling for greater oversight to protect patients' access to treatment.

Under a cashless facility, insurers pay hospitals directly for approved treatments, while patients cover any cost not included in their policies.

Ismail questioned the criteria used by insurers to remove specialists, asking whether the decisions were based on clinical performance, professional conduct, documentation issues or commercial considerations.

He said he had been informed of a case in which a surgery was interrupted because the attending specialist was not covered under the insurer's cashless facility, forcing the hospital to call in another doctor.

Citing the Malaysian Medical Association, Ismail said about 190 specialists nationwide had reportedly lost their cashless facilities, potentially affecting patients' choice of doctors and continuity of care.

Ismail questioned whether BNM was monitoring insurers' audits of medical claims, particularly those involving patients' confidential medical records.

While acknowledging insurers' right to conduct audits, he said the process needed proper oversight. He also claimed some hospitals had been asked to repay claims or offer discounts to avoid being dropped from insurers' panels.

Ismail proposed that BNM and the Health Ministry establish clear protocols governing panel restrictions, guarantee letters and ongoing treatment. He also called for medical diagnosis and procedure codes to be reviewed regularly to keep pace with advances in medical technology.

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