The Ministry of Health (MOH) has taken enforcement action against 10 doctors between January and October 2025 following the detection of inappropriate MediShield Life claiming patterns.
- Violations: Issues identified included “upcoding” (claiming for more complex procedures than performed), “multi-coding” (submitting multiple unnecessary codes for a single surgery), and misrepresenting cosmetic procedures as medically necessary.
- Enforcement: The affected practitioners, spanning specialities such as ophthalmology and general surgery, must undergo mandatory training on claims governance and clinical guidelines.
- Monitoring: These doctors will be subject to heightened scrutiny for future submissions, with potential suspension of MediSave and MediShield Life accreditation for further breaches.
This summary is based on a report by AsiaOne.