Measures to Prevent Healthcare Insurance Fraud

Ms Joan Pereira
MP for Tanjong Pagar GRC

Question No. 1205
To ask the Minister for Health how is the Ministry working with doctors and healthcare staff to prevent healthcare insurance fraud.

Written Answer

1        MOH takes a serious view of any attempts to defraud the healthcare system at the expense of Singaporeans. Fraudulent behaviour, such as inappropriate patient referrals for financial gains and making false claims for services, is wrong and unethical. It also raises the overall costs of healthcare in Singapore, leading to Singaporeans paying more for their healthcare services and insurance plans.

2        Various stakeholders have a part to play in combating healthcare insurance fraud. MOH monitors the landscape of MediShield Life and Integrated Shield Plan (IP) claims, and works with IP insurers to identify anomalous trends. For cases where criminal offences are suspected, MOH and insurers will refer them to the police for further investigation.

3        The Singapore Medical Council (SMC) provides guidance to doctors through the Ethical Code and Ethical Guidelines (ECEG) on ethical practice and professional standards to ensure the wellbeing of patients. In particular, the ECEG prohibits doctors from letting business or financial considerations influence the objectivity of their clinical judgement in their management of patients.  Doctors who contravene the ECEG can be subject to disciplinary action by SMC.

4        Doctors, healthcare staff, patients, insurance providers, financial advisors and members of the public should lodge a complaint to MOH, SMC or the police if they suspect any fraudulent behaviour, or receive any suspicious propositions in relation to their healthcare services or health insurance claims.