CHAS claims closely monitored by MOH

MOH's Reply

The Straits Times, 31 January 2015

We thank Mr Chan Chong Pak and Paul Chan Poh Hoi for their suggestions to ensure a system of checks for claims made by general practitioner and dental clinics under the Community Health Assist Scheme (CHAS) (“Simple way to rein in abuse of health-care claims”, 22 Jan; “Clamp down on doctoring of claims”, 23 Jan).

CHAS has allowed private medical and dental clinics to partner the Ministry of Health (MOH) in making subsidised primary care more accessible for lower to middle-income Singaporeans and Pioneers within the community. We would like to assure our CHAS beneficiaries that the CHAS claims submitted by clinics are closely monitored by the Ministry, and clinics have been and will continue to be called upon to account for any exceptional claims.

Charges can differ from clinic to clinic and from patient to patient, depending on the condition, treatment provided, medications prescribed, and length of consult.  All licensed clinics are strongly encouraged to display their common charges such as consultation and procedural fees prominently, and issue itemised receipts with a breakdown of the treatment costs and subsidy received to their patients. This will make the charges more transparent to their patients. In addition, upon a patient’s request, it is compulsory for clinics to issue an itemised breakdown of charges.

As members of respected professions, doctors and dentists are expected to adhere to the highest standard of professionalism and always act in the best interest of the patient. The Singapore Medical Council’s and Singapore Dental Council’s Ethical Codes and Ethical Guidelines state that doctors and dentists cannot abuse the doctor/dentist-patient relationship for personal gain. Indeed, the vast majority of our doctors and dentists do observe these codes and guidelines closely.  

MOH will continue to monitor the situation closely and would like to encourage patients to actively engage their doctors and dentists, and vice versa, to address potential queries on treatment and charges.

Ms Lim Bee Khim
Director, Corporate Communications
Ministry of Health

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Forum Letters

(a)    The Straits Times, 22 January 2015

Simple way to rein in abuse of health-care claims

I used my Pioneer Generation card to claim for health-care subsidies on three occasions - twice for dental treatment and once for treatment by a general practitioner.

On all three occasions, no invoices were issued until I asked for them.

The invoices issued by the general practitioner clinic and one dental clinic displayed only the money that I had paid after the government subsidy - there was no breakdown of the treatment costs and the subsidy I had received. Only the invoice issued by the other dental clinic listed these amounts.

It is clear that most patients do not know what they have been charged for and the subsidies they have received ("Checks needed to prevent doctoring of claims"; Tuesday). Part of the blame lies with them as most do not bother to ask for an invoice.

Hence, the Ministry of Health should require all clinics to issue invoices to their patients, to give a breakdown of the charges and subsidies, just like what polyclinics do.

This would reduce abuses of claims by health-care professionals; it would also be good for patients to know the amount of subsidies they have received.

Chan Chong Pak

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(b)    The Straits Times, 23 January 2015

Clamp down on doctoring of claims

There is no reason why the public should accept the opaque business practices of health-care practitioners, as described by Mr Chan Chong Pak ("Simple way to rein in abuse of health-care claims"; yesterday).

To safeguard taxpayer funds as well as the integrity of the health-care industry, we need to create a unit, known perhaps as the Healthcare Fraud Bureau, to monitor subsidies claimed by the 1,300 general practitioner and dental clinics that accept the Community Health Assist Scheme and Pioneer Generation cards. The unit could use sophisticated software to pick up anomalies in billing and claim patterns.

For starters, health-care professionals should be required to issue detailed invoices to patients, as suggested by Mr Chan. With actual patient invoices, fraudulent claims can be detected easily.

We need stringent and punitive legislation to deter doctoring of claims. The "soft" approach of clawing back excessive claims is not effective.

Abusing social welfare subsidies is a crime against society, and offenders should be dealt with in the criminal courts, and not in a disciplinary council hearing.

Paul Chan Poh Hoi