ABUSE OF MEDISAVE (Measures to prevent)

Dr S. Vasoo asked the Acting Minister for Health (a) what is the number of reported or known cases of abuse of Medisave; and (b) what other follow-up measures will be taken to prevent abuse of Medisave besides those reported recently in the press.

Mr Yeo Cheow Tong: Sir, the Ministry has so far detected four cases of abuse of Medisave involving false declaration of relationship between the patient and the Medisave account holder.

Random audit checks also revealed that there were errors in the submission of claims. These included incomplete filling up of the Letter of Certification by the doctor, and incorrect coding and classification of surgical operations. Claims were also made for multi-stage procedures as separate operations instead of as one single operation. We have viewed such errors as having occurred because doctors were initially unfamiliar with the Medisave claim procedures. To minimize such errors, the Ministry has issued comprehensive guidelines to all private hospitals and doctors on the settlement of Medisave claims.

My Ministry plans to monitor more closely the use of Medisave and to check on its possible abuse. The CPF Board and my Ministry will be setting up, by the end of March this year, audit teams to scrutinize the financial and medical aspects of Medisave claims. Private hospitals have also been required to set up their own audit committees. We will also be sending study teams to various countries with well-developed national health insurance schemes. They will study how these countries monitor medical claims and prevent abuses. These measures, when implemented, will allow my Ministry to better monitor Medisave usage and to prevent its misuse or abuse.

Dr Augustine Tan: Sir, is the Minister aware that although the intention of allowing the use of the Medisave Scheme for immediate relatives is a good one for compassionate reasons, at the same time, it really has represented a big drain on the entire scheme because practically everybody who has got relatives would then depend upon their Medisave to foot the bills? At the same time, is he aware that there are many cases where actually the relative is footing the bill indirectly by paying to the person the amount that is actually taken from Medisave? So it is a back-door way of withdrawing from Medisave.

Mr Yeo Cheow Tong: For the Member's information, 40% of the Medisave usage has been for the account holders' own use. The remaining 60% have been split almost equally between the spouse, the children and the parents, ie, 20% each.

I am not aware of any specific instances where relatives other than the approved relatives have been allowed to use the Medisave accounts of account holders. If the Member has any specific knowledge, we will definitely appreciate such information and we will follow up on such information.

Dr Augustine Tan: Approved relatives.

Mr Yeo Cheow Tong: Under the regulations, if the Medisave account has been used to pay for hosipital expense, then any reimbursement by any family member to the account holder should be paid back into the account holder's Medisave account. If the Member has any specific knowledge of such payments being made to the account holder without being reimbursed back into the Medisave account, we will definitely be interested to know.

Dr Augustine Tan: Sir, is the Minister aware of the unintended impact of his scheme whereby a relative who might not otherwise be able to afford class A ward but by virtue of the use of the Medisave scheme of the son or the parent or close relative is able to afford it and it is the doctors, the hospitals, that really benefit from the process.

Mr Yeo Cheow Tong: The Medisave funds belong to the account holder. Singaporeans generally are quite careful about the usage of their money. With the setting up of the audit committees that we have planned, we will have a better knowledge of the amounts and the usage patterns.

Dr S. Vasoo: Sir, would the Minister consider taking serious action against known cases of abuse of Medisave?

Mr Yeo Cheow Tong: We have taken action to recover the money used in the four cases of abuse. If there is extensive abuse, then the Ministry will definitely see how we can further increase the penalties.