Reduction Of Dr Melissa Teo’s Suspension From Medishield Life And Medisave Accreditation

1. The Ministry of Health (MOH) has decided to reduce the suspension of Dr Teo Ching Ching Melissa (“Dr Teo”) and her two clinics from MediShield Life and MediSave accreditation by two months, from the initially announced six months’ suspension to four months’ suspension. This is after MOH agreed to accept and consider the belated representations made by Dr Teo.

2. However, Dr Teo will still be required to complete mandatory training to familiarise herself with MOH’s claim submission requirements before the reduction in suspension period is implemented.

Dr Teo’s Belated Representations after 5 August

3. On 5 August 2024, MOH announced that it had taken enforcement action against six doctors, including Dr Teo, for making inappropriate MediShield Life claims.

4. In the case of Dr Teo, the enforcement action which MOH took was in respect of severe non-compliance detected in a MediShield Life claim submitted on 14 July 2023 for a surgery that she had carried out. The claim involved six Table of Surgical Procedure (TOSP) codes, for procedures which were adequately covered by two codes . This resulted in additional payments from insurance and the patient’s MediSave. Dr Teo had previously been warned by MOH about similar non-compliances found in her claims. It was therefore announced that Dr Teo and her two clinics had their MediShield Life and MediSave accreditation suspended for a period of six months.

5. Prior to the announcement, on 1 July 2024, MOH had notified Dr Teo of MOH’s intention to suspend her accreditation and that of her clinics. At that time, Dr Teo was invited to submit her representations by 15 July, but she did not do so. She was served a second notice on 29 July, informing her that her MediSave and MediShield Life accreditation would be suspended from 5 August. Dr Teo and her clinics acknowledged receipt of the notices and did not submit any representations.

6. On 19 August 2024, two weeks after the suspension took effect, Dr Teo wrote to MOH requesting for an opportunity to submit belated representations against the suspension. MOH agreed to her request and received Dr Teo’s representations on 6 September 2024.

Basis for Reconsideration

7. Upon careful consideration of Dr Teo’s representations, MOH remains of the view that a suspension of Dr Teo and her two clinics is necessary and appropriate in view of her inappropriate coding practices.

8. However, in view of additional information disclosed in Dr Teo’s representations, MOH is prepared to reduce the suspension of Dr Teo and her two clinics by two months, provided that Dr Teo successfully completes the mandatory training arranged by MOH to familiarise herself with the guidelines and requirements. In particular, Dr Teo provided information on a meeting conducted on 9 June 2023 between Dr Teo and representatives of MOH regarding the TOSP guidelines. Having reviewed Dr Teo’s account of the meeting, MOH is prepared to accept that, based on Dr Teo’s account, there is a possibility that she may have misunderstood that it could be appropriate to use multiple TOSP codes in certain situations, in spite of this being against the TOSP coding guidelines.

9. Based on Dr Teo’s submissions, MOH also noted that the fees which were directly attributable to Dr Teo’s non-compliance were not included in MOH’s press release of 5 August 2024. It stated $170,000 as the total hospital bill and $90,000 as the inappropriate claims. Of the $90,000 claimed for the four inappropriate codes, around $54,000 (inclusive of GST) was certified as surgeon fees (comprising Dr Teo’s personal fees and that of her assistant surgeon) and another $10,800 (inclusive of GST) was certified as anaesthetist fees by Dr Teo. The remainder comprised hospital-related fees.

10. For the mandatory training that Dr Teo will be required to participate in prior to the suspension period being reduced by two months, she will have to sit for and pass a proficiency test, to ensure that she properly familiarises herself with MOH’s claim submission requirements. MOH will also be closely monitoring Dr Teo and her clinics for future claims.

Continued Enforcement

11. MOH reiterates that it is inappropriate for doctors to submit multiple TOSP codes where there is an existing TOSP code that sufficiently describes the procedure performed. MOH takes a serious view against doctors who make inappropriate or wrongful financial claims. Such actions result in higher payouts from MediShield Life, premature depletion of MediSave account balances and additional charges for patients, all of which contribute to escalating claims and insurance premiums. The costs are ultimately borne by the wider pool of policyholders. MOH will continue to take strict enforcement actions against inappropriate claim behaviour as part of our broader efforts to ensure that the increase in healthcare costs is effected in a sustainable manner, and that insurance premiums remain affordable for all Singaporeans.