Private Healthcare Facilities and Services Act 1998 · Updated to 1 Dec 2015 · Part XV · Managed Care Organization
83. Contracts between private healthcare facility or service and managed care organization
Official textFrom Laws of Malaysia Online, unchanged
The licensee of a private healthcare facility or service or the holder of a certificate of registration shall not enter into a contract or make any arrangement with any managed care organization that results in—
licensee
“licensee” means a person to whom a licence to operate or provide a private healthcare facility or service other than a private medical clinic or private dental clinic granted under paragraph 19(a);
a change in the powers of the registered medical practitioner or dental practitioner over the medical or dental management of patients as vested in paragraph 78(a), and a change in the powers of the registered medical practitioner or visiting registered medical practitioner over the medical care management of patients as vested in paragraphs 79(a) and 80(a);
a change in the role and responsibility of the Medical
Advisory Committee, or Medical and Dental Advisory
Committee as provided under section 78, the Midwifery
Care Advisory Committee as provided under section 79 or the Nursing Advisory Committee as provided under section 80;
the contravention of any provisions of this Act and the regulations made under this Act;
the contravention of the code of ethics of any professional regulatory body of the medical, dental, nursing or
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midwifery profession or any other healthcare professional regulatory body; or
the contravention of any other written law.
The licensee or the holder of a certificate of registration or a managed care organization who enters into a contract or makes any arrangement in contravention of subsection (1) commits an offence and shall be liable on conviction—
certificate of registration
“certificate of registration” means a certificate issued under section 27;
in the case of a licensee or holder of a certificate of registration who is sole proprietor, to a fine not exceeding one hundred thousand ringgit or to imprisonment for a term not exceeding two years or to both;
in the case of a licensee or a holder of a certificate of registration who is body corporate, partnership or society, a fine not exceeding three hundred thousand ringgit; and
in the case of a managed care organization, a fine not exceeding five hundred thousand ringgit.
Where an offence under subsection (2) is committed by a body corporate, a partnership or a society or a managed care organization—
body corporate
“body corporate” means a body incorporated under the Companies Act 1965;
in the case of a body corporate, the person responsible;
in the case of a partnership, every partner in the partnership;
in the case of a society, its office bearers,
in the case of a managed care organization, the person responsible, shall also be guilty of the offence and shall be liable on conviction to a fine not exceeding one hundred thousand ringgit or to imprisonment for a term not exceeding two years or to both.
66 Laws of Malaysia ACT 586
Terms defined in this Act
body corporate
Defined · s 2“body corporate” means a body incorporated under the Companies Act 1965;
certificate of registration
Defined · s 2“certificate of registration” means a certificate issued under section 27;
Committee
Defined · s 64“Committee” means a National Mortality Assessment Committee. Establishment of National Mortality Assessment Committee
healthcare professional
Defined · s 2“healthcare professional” includes a medical practitioner, dental practitioner, pharmacist, clinical psychologist, nurse, midwife, medical assistant, physiotherapist, occupational therapist and other allied healthcare professional and any other person involved in the giving of medical, health, dental, pharmaceutical or any other healthcare services under the jurisdiction of the Ministry of Health; Private Healthcare Facilities and Services 13
licensee
Defined · s 2“licensee” means a person to whom a licence to operate or provide a private healthcare facility or service other than a private medical clinic or private dental clinic granted under paragraph 19(a);
managed care organization
Defined · s 82“managed care organization” means any organization or body, with whom a private healthcare facility or service makes a contract or has an arrangement or intends to make a contract or have an arrangement to provide specified types or quality or quantity of healthcare within a specified financing system through one or a combination of the following mechanisms: (a) delivering or giving healthcare to consumers through the organization or body’s own healthcare provider or a third party healthcare provider in accordance with the contract or arrangement between all parties concerned; (b) administering healthcare services to employees or enrollees on behalf of payors including individuals, employers or financiers in accordance with contractual agreements between all parties concerned.
midwifery care
Defined · s 2“midwifery care” means the assessment or monitoring or care of women during normal pregnancy or labour or during the post-partum period and of their normal newborns, and the conducting of spontaneous normal vaginal delivery;
private healthcare facility
Defined · s 2“private healthcare facility” means any premises, other than a Government healthcare facility, used or intended to be used for the provision of healthcare services or health-related services, such as a private hospital, hospice, ambulatory care centre, nursing home, maternity home, psychiatric hospital, psychiatric nursing home, community mental health centre, haemodialysis centre, medical clinic, dental clinic and such other healthcare or health-related premises as the Minister may from time to time, by notification in the Gazette, specify;
registered medical practitioner
Defined · s 2“registered medical practitioner” means any person who is registered as such under the Medical Act 1971 and who holds a valid practising certificate;
Part XVI
Enforcement
Part XVII
Power of Minister
Part XVIII
Miscellaneous
Part XIX