As of December 2019, the Medical Equipment Act, enacted in May 2012, is not yet in force. This means that there is a legal requirement to obtain marketing approval for medical devices. The MOH nonetheless operates a MAD division (medical accessories and devices), which registers and grants marketing authorisations for medical devices. On a formal level, such registration and approval is voluntary. In practice, hospitals and health maintenance organisations (“HMO”) will not purchase non-approved devices. In addition, the MOH guidelines govern the process of obtaining MOH approval to import and sell medical equipment.