Kidney patients overcharged by RM140k

By Stephanie Sta Maria - Free Malaysia Today

KUALA LUMPUR: Kidney failure is a heavy load to carry in life. More so when the hospital where treatment is sought overcharges.

The Auditor-General's 2009 report, tabled in Parliament yesterday, found that 10,101 patients at five hospitals nationwide paid a total of RM143, 329 in excess fees between 2007-2009.

The five are Sultanah Bahiyah Hospital in Kedah, Kuala Lumpur Hospital, Malacca Hospital, Sultanah Nur Zahirah Hospital in Terengganu and the Sarawak General Hospital.

According to the audit report, outpatients seeking hemodialysis treatment were being charged RM13 based on a charge guideline on daily patient care introduced in November 1998.

Those seeking Continuous Ambulatory Peritoneal Dialysis (CAPD) paid a third-class patient fee of RM100 based on the Nephrology section of the Fee Directive (Medical) 1982.

An audit check revealed that these rates were for patients who were warded. Outpatient treatment for both categories only involved a RM5 fee.

Of the five hospitals, Kuala Lumpur Hospital topped the list of overcharged fees at RM85,296 over the three years.

In view of this, the auditor-general directed the Health Ministry to reimburse the affected patients.

The report added that amendments were currently being made to the Fee Directive (Medical) 1982 in order to gazette the definition of “daily treatment” and the fee for hemodialysis treatment.

A lengthy waiting period for kidney patients was another weakness highlighted in the report. The waiting period for hemodialysis treatment was between 1-2 years and between 1-34 months for CAPD treatment.

Hospitals blamed the delay on shortage of equipment, manpower, space and medical supplies.

In the meantime, these patients sought treatment at hemodialysis centers run by non-government organisations (NGOS) or private medical centers.

Payments made for untested equipment

The ministry had signed 12 contracts between 2007-2009 for the supply of equipment and medicine for kidney patients.

The contracts stipulated that the ministry would pay 75% of the total price upon delivery of the equipment and the balance once it was tested and accredited.

The contract also stated that equipment must be delivered 2-12 weeks after the order date, failing which the contractor would be slapped with a 2% penalty for each month of delay.

The auditor-general, however, discovered that the purchase of a hemdiafiltrarion machine was paid for in full even before the equipment was tested and accredited.

It also found that four hospitals, with the exception of Sultanah Nur Zahirah Hospital, paid RM3.67 million for two other equipment even before delivery was made.

Malacca Hospital, Sultanah Nur Zahirah Hospital and the Sarawak General Hospital, meanwhile, made a prepayment of RM370,000 million for equipment which they only received 13-117 days later.

Another glaring oversight was in the financial assistance given by the ministry to the Klang Hemodialysis Society for the setting up of its second branch.

The ministry provided RM296,000 in aid to the society in September 2009, but when auditors visited the premises in December, all they found was a vacant building.

Further checks revealed that when the financial aid was made, the society had not received approval to set up another center nor had the ministry granted it an operational license.

The auditor-general said that the ministry had since sent a letter to the NGO involved to request that it be reimbursed for the total amount.