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A look at the National Assembly's passage of the law on the basis of recovery of nursing care benefits when illegal office-based hospitals are detected, and the amendment to the National Health Insurance Act.

Media E2 News
Date

2023-03-24

Views 281

불법 사무장병원 적발 시 요양급여환수처분 근거법 국회 통과, 건보법 개정안 살펴보면

As a bill clarifying the basis for the recovery of nursing care benefits for illegal office-based hospitals passed the Health and Welfare Committee of the National Assembly, in the future, caught office-based hospitals will be able to receive recovery of nursing care benefits in addition to criminal and administrative measures.


Previously, even when an office-based hospital was detected, it was difficult to recover medical care benefits due to the lack of provisions in the National Health Insurance Act. However, institutional supplementation was made when the National Health Insurance Act Amendment Bill, which clarifies the basis for recovering nursing care benefits for illegal office-based hospitals and pharmacy pharmacies, was passed by the National Assembly Health and Welfare Committee in February.


An illegal office-based hospital refers to a hospital where a person who cannot open a medical institution rents the name of a medical professional to establish a hospital and hires doctors to operate it, or opens and operates a hospital under the name of another doctor even though he or she is not allowed to operate multiple hospitals.


Under the Medical Service Act, the establishment and operation of such a hospital is punishable by imprisonment for up to 10 years or a fine of up to 100 million won, and all medical care benefits received by requesting from the National Health Insurance Corporation during the period of illegal operation are recognized as fraud, and punishment and recovery measures are taken.


In addition, the longer the operation period, the higher the chance of being sentenced to imprisonment or higher, and there is a high possibility that doctors hired even after knowing that the hospital in question is an office hospital will have their medical license revoked. Even in the case of service, the charge of aiding and abetting is applied and is subject to criminal punishment and suspension of qualifications for up to one year.


According to Article 33, Paragraph 2 of the current Medical Service Act, the qualifications to open a medical institution are strictly limited to medical personnel, and non-medical personnel cannot open a medical institution. The reason the Medical Service Act has such regulations is to establish a sound medical order and prevent risks to public health that may arise when medical institutions are opened for profit.


Attorney Kim Eun-young of Daeryun Law Firm (Limited) advised, “If it is recognized as an office-based hospital, the level of punishment under the medical law is very high, and the administrative measures that follow, such as recovery of health insurance nursing benefits and cancellation of doctors’ licenses, are also severe.” He added, “If you worked without knowing that it was an office-based hospital, you must deal with it clearly with the help of a medical lawyer.”


View full articleA look at the National Assembly's passage of the law on the basis of recovery of nursing care benefits when illegal office-based hospitals are detected, and the amendment to the National Health Insurance Act.

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