MOH takes enforcement action against six doctors over non-compliant MediShield claims

Ministry Of Health News

MOH takes enforcement action against six doctors over non-compliant MediShield claims
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Two doctors had their MediSave and MediShield Life accreditation suspended, while another four will be required to undergo mandatory training.

Severe non-compliances in some claims were uncovered. SINGAPORE: Two doctors had their MediSave and MediShield Life accreditation suspended on Monday , while another four will be required to undergo mandatory training after they were found to have made inappropriate MediShield Life claims.They are Dr Teo Ching Ching Melissa, the sole director of The Surgical Oncology Clinic and Melissa Teo Surgery, and Dr Lim Pei Yi Natasha, the sole director of Natasha Lim Eye Centre.

The more complex the surgical procedure, the higher the claim limit on the surgeon’s fees. According to MOH guidelines, practitioners should only use one TOSP code if it adequately describes the procedure performed. Dr Teo had previously been warned by MOH about similar non-compliances found in her claims in June last year. However, no enforcement action had been taken against her as this was before an enforcement framework came into force in April last year.

She had also claimed for two surgical treatments of corneal ectasia but the panel found that the patients did not have the condition. MOH said it has instructed both doctors to inform their patients of this prior to providing treatment. The panel found that the patients were assessed to be at low risk for serious cardiac conditions and did not warrant inpatient admission as all of the investigations could have been performed safely in an outpatient setting.

“We would basically re-educate them about the entire MediSave, MediShield life claim framework, the Table of Surgical Procedures framework, the coding rules, what constitutes appropriate and inappropriate behaviour,” said MOH.

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