KUALA LUMPUR – Former prime minister Datuk Seri Ismail Sabri Yaakob has raised concerns over the removal of about 190 specialist doctors nationwide from insurance companies’ cashless panels, warning that the move could disrupt patients’ access to medical treatment.
The Bera MP said the decision had implications not only for patients but also for doctors and private hospitals, citing cases in which surgical procedures were reportedly interrupted because the attending specialists were no longer covered under cashless arrangements.
In some instances, he said, other doctors from different hospitals had to be called in to continue the procedures.
Speaking during the Finance Ministry’s committee-level debate on Budget 2027 in the Dewan Rakyat today, Ismail Sabri called on Bank Negara Malaysia (BNM) to clarify the criteria insurers use when removing specialists from their panels.
He questioned whether such decisions were based on clinical performance, ethical or professional misconduct, documentation shortcomings, or purely commercial considerations.
He also asked whether affected doctors were given written explanations, supporting evidence and an opportunity to appeal before being removed from the panels.
Ismail Sabri said BNM should clarify whether insurers were subject to specific guidelines requiring them to follow a transparent and fair process when making such decisions.
He also raised concerns over patients who pay insurance premiums regularly but could find their choice of doctor restricted by insurers’ panel arrangements.
He sought clarification on whether insurance companies complied with Malaysian Medical Council (MMC) principles, particularly those recognising patients’ right to choose their doctors.
Separately, Ismail Sabri questioned the retrospective audits conducted by insurance companies, including AIA and Prudential, on claims that had already been approved.
While acknowledging insurers’ right to conduct audits, he said the process needed proper oversight to prevent potential abuse, particularly when it involved access to patients’ confidential and sensitive medical records.
He claimed some hospitals had been asked to refund previously paid claims and offer discounts to avoid being removed from insurers’ panels, while specialists had also lost their cashless facilities.
Ismail Sabri further highlighted the need to modernise medical coding systems, forms, pre-authorisation processes (pre-GL) and insurance reimbursement rates to keep pace with advances in medical technology, including robotic surgery.
He said doctors should not be held responsible for errors or confusion arising from paperwork when existing systems failed to provide appropriate options for newer medical procedures.
“Don’t let technology advance while the system remains outdated, leaving doctors and patients to bear the consequences,” he said.
To address the concerns, Ismail Sabri proposed two key measures involving regulators, the Health Ministry and industry stakeholders.
“I propose two main measures. First, Bank Negara and the Health Ministry must establish clear protocols and frameworks governing panel restrictions, guarantee letters and continuity of treatment.
“Second, professional bodies and the insurance industry must review diagnosis codes and medical procedures regularly in line with technological advances,” he said.
He said the proposed measures were necessary to ensure patients could continue receiving treatment without disruption while doctors and hospitals were protected by fairer and more transparent insurance practices. – November 3, 2026