PAC: GL holders charged excessively compared to cash-paying patients

THE Public Accounts Committee (PAC) has revealed that some private hospitals are imposing excessive charges on patients who use Guarantee Letters (GL), with rates higher than cash patients and the pay-first-claim-later method.

The PAC also found the practice of "unbundling", which is where separate charges are imposed for basic items that are usually included in hospital room charges.

PAC member Dr Halimah Ali said the findings were obtained from 19 proceedings conducted between February to August last year.

She said examples of separate charges detected included the disposal of clinical waste, pillowcases and alcohol swabs that should have been included in the room charges.

In addition, the PAC also revealed the practice of "unbundling", which caused basic medical charges to be broken down into small components, even though they are usually included in the treatment package.

She said there was also a lack of transparency in the practice of cross-subsidisation when the billing structure of private hospitals did not reflect the actual cost of services.

Halimah said this when delivering the PAC chairman's statement on issues relating to medical insurance in the Dewan Rakyat today.

PAC also informed that drug and medical supply charges were found to have experienced a significant markup increase, sometimes reaching 300% to cover mandatory operating costs that are not charged directly or subsidized such as ward charges, intensive care unit (ICU) and 24-hour emergency services.

Among the PAC's recommendations, Bank Negara Malaysia (BNM) should impose strict punitive action against any insurance company that misinterprets or fails to comply with interim measures to the detriment of policyholders' welfare.

BNM was also advised to ensure that the insurance and takaful industry shifts to smaller and more stable annual premium adjustments to avoid financial shocks to consumers.

PAC also proposed a review of cohort-based premium prices and a more balanced approach to ensure fair risk sharing without affecting the ability of the people.

The Malaysian Competition Commission (MyCC) was also urged to guide stakeholders regarding discount negotiations between hospitals and insurance companies so that the process would be fairer and not affect patient access.

She said the Ministry of Health needed to ensure that the amendment to the Private Healthcare Facilities and Services Act 1998 was implemented to give it the power to control charges for private hospital services in addition to doctors' fees.

MOH and BNM also need to strengthen complaint channels and mechanisms for resolving issues related to insurance and medical costs so that they can be handled more efficiently and effectively.

The government was also urged to work with the Ministry of Domestic Trade and Cost of Living to establish a mechanism to control the price of medicines and medical equipment to prevent excessive price increases and excessive profit-making activities. – June 25, 2026