Private Healthcare Facilities and Services Act 1998 · Updated to 1 Dec 2015 · Part XV · Managed Care Organization
85. Information by managed care organization
Official textFrom Laws of Malaysia Online, unchanged
A managed care organization or the owner of a managed care organization having a contract or an arrangement with a licensee
managed care organization
“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.
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of a private healthcare facility or service or a holder of a certificate of registration shall furnish such information relating to the organization as may be required by the Director General.
private healthcare facility
“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;
A managed care organization or the owner of a managed care organization who fails to furnish the information required under subsection (1) commits an offence and shall be liable on conviction—
in the case of a sole proprietor, to a fine not exceeding one hundred thousand ringgit; or
in the case of a body corporate, partnership or society to a fine not exceeding three hundred thousand ringgit.
Where an offence under subsection (2) is committed by managed care organization or the owner of the managed care organization which is a body corporate, a partnership or a society—
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, 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.
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;
Director General
Defined · s 2“Director General” means the Director General of Health, Malaysia;
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.
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;
Part XVI
Enforcement
Part XVII
Power of Minister
Part XVIII
Miscellaneous
Part XIX