The Legal Muddle Over Healthcare Fraud in Malaysia

Abstract

This article is an analysis of whether the current law in Malaysia is sufficient to tackle healthcare fraud. The main problem of healthcare fraud in Malaysia context is the lack of specific provisions to combat it. The objective of the article is to highlight the gap in the laws by comparing the available local law and the laws in the United States of America. This article will cover the discussion on what is healthcare fraud, the forms of healthcare fraud as well as their effects. It will analyse the available legislation on healthcare fraud between the United States and Malaysia. Several types of healthcare fraud are identified such as billing schemes, kickbacks and medical identity theft. Several types of hospital fraud are identified, for example unnecessary procedures, corruption and unauthorised practice. The article’s finding manages to identify several deficiencies in the law concerning anti-fraud law, anti-kickbacks law, cybercrime law and medical negligence. These weaknesses stem from inadequate laws where they are not specific to the fraud involved. Several recommendations are provided in addition for improvement. To conclude, there is limited data of healthcare fraud to prompt any strengthening of current laws because the current laws does not encourage prosecutors, whistle-blower or victim to report healthcare fraud. A systematic data collection is necessary to further advance the cause in fighting healthcare fraud.