MOH investigates doctors, insurance agents and clinics in what may be a huge alleged Singapore medical scam

Some experts say a Singapore medical scam at this scale could make premiums and fees much higher for the next generation–your children.

According to a report on TODAY, the Ministry of Health is looking at an industry-wide set of unethical practices that may involve a lot of money, needless treatments, and illegal referral fees.

How big is this?

The report on TODAY said that the MOH is investigating insurance fraud (among other claims) that involves numerous doctors, insurance agents, medical companies and even allied health professionals like therapists.

In several interviews with both named and unnamed people in Singapore medicine, here is what the report revealed:

• Medical concierge companies allegedly offer to refer patients to certain doctors for a cut from their professional fees. This is considered illegal, since it automatically establish a preference for a doctor that has nothing to do with expertise. The legal way to to refer a patient to  doctor should not involve a cut in any form or fee with the doctor or referring company, but should instead be a fee charged to the patient.
• Some patients that require only three or four sessions of a certain treatment are reportedly prescribed 10 sessions without their knowledge. After the required number of sessions is completed by the patient, insurance agents and involved health professionals would write off the “unused” sessions as consumed, which allows them to collect insurance fees from companies without the knowledge of the insured.
• Doctors allegedly receive a cut from certain clinics for referring their patients to physiotherapy or other needed treatments in these clinics.
• Medical concierge companies reportedly offer to handle patients’ complete medical needs such as referrals and processing insurance claims, which allows them to collude with clinics, doctors, and insurance agents into getting the most out of insurance claims without the patient’s knowledge. The collected insurance fees are then split between the professionals involved in the patient’s care.
• Some hospital workers allegedly peruse records to see which patients have extensive medical coverage. They then offer upscale medical packages and other services that allow them to tap into the patient’s medical insurance.

Image from Shutterstock, physiotherapist assisting elderly patient.

What professionals are saying

In the interviews conducted, players in the industry are aware of such practices.

Mr Daniel Choo, 42, chief executive officer of The Medical Concierge Group (TMCG) said that he is aware of such practices and stays away from them. He said, “As soon as you take a fee from a healthcare service provider, that’s a conflict of interest. If you have chest pains, will I then send you to a cardiologist who is giving me more money, or you would rely on me to send you to a doctor who is going to look after you in your best interest at a fair rate?”

He also said that, ““Then there are others who take a percentage of the patients’ total bill. The more you spend on healthcare, the more they earn. They would be inclined to let you stay in the hospital longer than you really should.”

What does the law say?

Aside from legal problems, medical professionals and workers have additional guidelines that govern the way they provide services and accept fees.

According to The Singapore Medical Council, medical workers “must not ask for or receive fee kickbacks, payments or any other compensation in kind for referring patients to other doctors, medical service professionals or healthcare facilities”.

Another guideline would come from The Allied Health Professions Council’s code of professional conduct which states that industry players “must not provide package deals, discounts or coupon discounts for professional services rendered”.

Medical industry experts say that while the patients technically don’t feel anything when it comes to fees and premiums, future generations will have to contend with higher fees and premiums, because financial trends would point to higher costs to insure a person, thanks to the collusion of agents, doctors, and medical firms.

Header image from Shutterstock, doctor talking to patient