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Rules
Terms and conditions of approval under the MediSave scheme and the MediShield Life scheme
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Terms and conditions for medical practitioners
General terms & conditions
Medical practitioners who have been approved by the Minister for Health to provide medical, psychiatric or other approved treatments as an “approved medical practitioner” as defined in regulation 2(1) of the Central Provident Fund (Medisave Account Withdrawals) Regulations (“the Regulations”), shall be bound by the following terms and conditions:
1. Medical practitioners shall only make claims for Medisave moneys in relation to the provision of medical, psychiatric or other approved treatments in an approved medical institution, in accordance with the Regulations. Medical practitioners shall observe the guidelines and requirements of Medisave claims imposed by the MOH and shall exercise due diligence before making claims for Medisave monies. In case of error, the medical institution and the medical practitioner shall be jointly and severally responsible for ensuring that Medisave monies inappropriately deducted shall be promptly refunded to the relevant accounts.
2. Medical practitioners shall treat patient medical information with confidence.
3. Medical practitioners shall attend or shall send an appropriate staff to attend such training programmes or meetings as may be required by MOH from time to time, in relation to the Medisave scheme.
4. Medical practitioners shall inform MOH immediately of any changes in the information given in their application for approval as an approved medical practitioner.
5. Medical practitioners shall ensure that his patient is informed, on or before his first consultation at the medical institution, of the estimated total charges which are likely to be incurred in respect of his treatment by the medical practitioner.
6. The medical practitioner shall be jointly and severally responsible with the medical institution to pay all fees, costs and expenses to the relevant parties in making the necessary deductions from the CPF member’s Medisave Account for settlement of the member’s bills and for any other work related thereto.
7. Where a medical practitioner has a patient who is undergoing treatment at an approved hospital (acute hospitals only) as an inpatient or day surgery patient under his care, the medical practitioner shall submit information on the size of all bills rendered by him or on his behalf. Such information shall include the bills size of his professional fees and charges for medication, consumables and other supplies, levied in relation to the management of the patient for that admission. This is to enable the hospital to fulfil its obligation to report Casemix data to MOH under clause16 of Part A.
8. MOH may conduct periodic reviews and audits on the Medisave claims that have been submitted. Where possible, such reviews shall be conducted in consultation with medical practitioners in the Medisave Scheme. MOH may revoke or suspend the approval granted to any medical practitioner who has not submitted Medisave claims in accordance with the requirements stipulated by MOH.
9. Medical practitioners shall upon notification and within such time as may be stipulated therein, furnish to the MOH, with the informed consent of the patient1 , medical and treatment records relating to the Medisave claim; a Letter of Certification (See Annex A) for Medisave claims relating to surgical procedures; or such other documents or information required by MOH for the purpose of conducting audits on Medisave claims.
10. Medical practitioners shall inform MOH of any anticipated delay in submission of information or documents to be submitted under clause 9, at least 7 working days ahead of the stipulated deadline for submission.
11. Where inappropriate or incorrect Medisave claims have been made, medical practitioners may be subject to administrative sanctions as set out in the table below:
 
Number of infringements within a five year period  Administrative sanctions
1st infringement Audit Findings Letter
2nd infringement Letter of Advice
3rd infringement Letter of 1st Warning
4th infringement Letter of 2nd Warning
5th infringement Letter of Probation, followed by probation period of 1 year
Subsequent infringement(s) Suspension for at least 6 months or revocation of accreditation as Approved Practitioner
12. In the event of breach of any regulations, circulars, guidelines (including the Medisave Manual), or terms or conditions specified herein, MOH may revoke, or suspend for such period of time as MOH may deem fit, the approval granted to any medical practitioner. MOH may, at any time, vary or revoke any of the requirements specified in existing circulars, the Medisave Manual, or in these terms and conditions, or may impose new requirements. This is without prejudice to any other action that may be taken under law.
13. A medical practitioner whose approval has been revoked and which wishes to be reconsidered for approval shall submit a fresh application for approval. A medical practitioner whose approval has been suspended and who wishes to have its suspension lifted shall submit a statement to the MOH explaining the steps taken to rectify any non-compliance with any regulations, circulars, guidelines or terms and conditions.
 
The following additional terms and conditions apply only to medical practitioners providing approved chronic illness treatment under the Chronic Disease Management Programme.
14. Medical practitioners shall provide approved chronic illness treatment2 to patients suffering from chronic illnesses through evidence-based disease management programme(s). These programme(s) shall include the key components detailed in the disease management programme(s) (see Annex B).
15. Medical practitioners shall submit to the MOH, with the informed consent of the patient1, data on patient care delivery for chronic disease patients on an annual basis or as specified by MOH, for the purpose of conducting Medisave audits. The data to be submitted are in Annex B. MOH reserves the right to publish relevant aggregated performance data based on submitted data on patient care delivery for chronic disease patients, which is intended to assist patients to make better decisions.
16. MOH may conduct periodic reviews of the data and key components of care in any disease management programme(s) provided by a medical practitioner. Where possible, such reviews shall be conducted in consultation with the medical practitioners in the programme. MOH may revoke or suspend the approval granted to any medical practitioner who fails to satisfy minimum standards of clinical performance as stipulated by MOH.
   
1 Patient’s consent will be sought via the Medisave Authorisation Form.
2 The list of approved chronic illness treatments can be found in the CPF (Medisave Account Withdrawals) Regulations, as well as on MOH’s website.
Annex A
  Letter of Certification
 
Annex B
  Disease Management Programmes