KUALA LUMPUR, Oct 13 — The anaesthesiologist fraternity and MediExpress (Malaysia) Sdn Bhd have agreed to keep communication lines open, after discussing an anaesthesia memo from the third-party administrator (TPA).
At a virtual meeting between the Malaysian Society of Anaesthesiologists (MSA); the College of Anaesthesiologists, Academy of Medicine of Malaysia (COA); the Malaysian Medical Association (MMA), and MediExpress’ senior management last Thursday, representatives from the medical groups reiterated that any directive from health care companies or TPAs cannot supersede clinical decision-making.
“This principle was duly acknowledged and agreed upon by the MediExpress management team,” said Dr Gunalan Palari Arumugam, chairman of the MSA/COA Fee Committee, in his report on the meeting sent to CodeBlue.
“The clinicians present emphasised that the choice of anaesthetic technique must be guided by clinical judgement, patient safety, and the specific procedural context—not by administrative or financial policies.
“It was also noted that advancements in anaesthetic techniques and perioperative care have expanded the range of procedures that can safely be performed as daycare surgeries, further supporting evidence-based and individualised clinical decision-making.”
CodeBlue previously reported outrage from the medical fraternity, including from the anaesthesiologist groups, triggered by MediExpress’ October 1 memo that directed panel hospitals to prioritise local anaesthesia (LA) as the first-line anaesthesia modality over general anaesthesia (GA) for daycare procedures and surgeries.
According to Dr Gunalan’s report, MediExpress clarified at the meeting that the intent of its circular wasn’t to interfere with clinical management, but to “ensure clarity in the claims review and approval process.”
“They explained that their goal was to understand the rationale behind certain choices for transparency and claims verification purposes, not to dictate or restrict clinical decisions,” said Dr Gunalan.
“It was highlighted that any communication regarding claims decisions or financial explanations should be the responsibility of the financial planner, agent, or TPA representative, rather than the attending doctors.
“Clinicians are not in a position to address insurance-specific terms or reimbursement justifications, and such communication should be handled directly by the relevant administrative parties.”
Dr Gunalan’s report said all parties at the meeting agreed on the need to curb unethical practices and potential abuse, including instances where unnecessary procedures may be performed for financial gain.
“The meeting concluded on a positive note, with all parties agreeing to maintain open communication and foster collaborative relationships between clinicians, hospitals, TPAs, and insurers,” he said.
“Ultimately, all participants reaffirmed that patients must remain at the centre of all decision-making, and that trust, professionalism, and transparency should guide every aspect of health care delivery and financing.”