Skim Peduli Kesihatan for the B40 group or PeKa B40 is a Government initiative via the Ministry of Health which aims to sustain the healthcare needs of low income groups by focusing on non-communicable diseases (NCDs).
PeKa B40 is offered to Malaysian citizens in the bottom 40% household income range, also known as the B40 group.
Recipients of the Sumbangan Tunai Rahmah (STR) and their spouses aged 40 and above are automatically eligible for PeKa B40. No special registration is required to join PeKa B40.
Clinic registration must be made in the name of the “Person Incharge” as stated in the Certificate of Registration of Clinic. Documents that need to be uploaded are:
Disclaimer :
3 March 2026: PeKa B40 Engagement with GP Providers
5 March 2026: PeKa B40 Engagement with GP Providers
PMPs from private clinics already empanelled under PeKa B40 are still required to register for this pilot programme if interested and will only be deemed eligible upon registration as a PeKa NCD Management Pilot Programme provider.
Movement between panel clinics is not encouraged. The programme is designed around continuity of care with a single PMP across the twelve-month cycle, and beneficiaries are expected to remain with the clinic at which they enrolled for the duration of the pilot. A transfer should be considered only where continuing at the original clinic is not possible — for example, where that clinic ceases to provide the service, or where the beneficiary relocates or faces other unforeseen circumstances.
Where a transfer is unavoidable, verify attendance by OTP so that the beneficiary’s programme records created at the previous clinic are visible to you, and continue care from that baseline rather than repeating the initial workup.
Yes, based on clinical condition — but document the clinical justification in the record where you depart from the recommended schedule.
Attempt contact not fewer than three times within 14 days of the missed appointment, using the contact details recorded at enrolment, and record each attempt and its outcome in PRIMIS. On making contact, reschedule at the earliest available date.
No, not for work already done. Bundled clinical services already delivered are paid at the staggered full stage rate (not pro-rated) for each compulsory visit completed before the beneficiary became uncontactable, and FFS items delivered are paid as rendered — subject to the claim meeting all criteria and being submitted on time. No further capitation is paid once defaulter status is applied.
Record the two components separately in PRIMIS so each is claimed under the correct pathway. A service performed once is claimed once, under the pathway for which it was clinically indicated — claiming under both is double billing.
A bundled mechanism combining capitation, pay-for-performance and fee-for-service:
Capitation (fixed rate per beneficiary per year) — consultation, clinical assessment, blood specimen collection, review of results, non-pharmacological counselling, medication and compliance review, referral; plus Urine FEME/urinalysis, ECG and glucometer testing
Fee-for-service — acute primary care against the annual allocation, and pharmaceuticals at fixed price per medication
Pay-for-performance — a reserved share of the capitation rate against predetermined clinical outcome targets, assessed yearly
PeKa is expanding its benefits to include Non-Communicable Disease (NCD) Management, and we’re looking for healthcare partners to join this pilot programme.
If you’re interested in coming on board as a panel provider, register your interest today.
