KUALA LUMPUR: The diagnosis-related group (DRG) system will be introduced alongside the basic Medical and Health Takaful Insurance (MHIT) starting next year.
Deputy Health Minister Datuk Lukanisman Awang Sauni stated that the basic MHIT will act as a standard platform to ensure DRG-based payment efficiency.
He explained that the private sector DRG is an interim measure to curb rising medical costs burdening the public.
The private sector DRG differs slightly from the national DRG but will eventually integrate through system interoperability.
Lukanisman shared these details during a Dewan Rakyat session in response to Suhaizan Kaiat’s query on healthcare cost reforms.
The national DRG was formulated in 2023 under a five-year plan for full implementation by 2027.
A Joint Ministerial Committee on Private Healthcare Costs (JBMKKS) was formed to oversee cost-control initiatives, including DRG.
The private sector DRG will support a more inclusive national system by improving data integration and analysis.
Government and private agencies are collaborating on technical studies and ICT system development for the national DRG.
This year, clinical coding workshops and system development will take place in both government and private hospitals.
By 2026, the national DRG algorithm and coding model will be finalised before system testing begins.
The official launch of the national DRG system is scheduled for 2027.
Lukanisman confirmed no plans for a patient tribunal but noted existing complaint mechanisms under Act 586.
Complaints against private hospitals are handled by the Private Medical Practice Control Section (CKAPS).
Violations can lead to enforcement actions, including fines, suspensions, or licence revocations. – Bernama