95% of All Medical Institutions Participate in the 'Non-Reimbursable Reporting System'

A 5% Fine Planned for Medical Institutions Without Reporting

95% of all medical institutions participated in the non-reimbursable medical service item reporting system, which is not covered by health insurance benefits. The non-reimbursable reporting system is a system under the Medical Service Act that requires medical institutions to mandatorily report the costs and details of non-reimbursable medical services to health authorities.

Non-reimbursable report details. [Image source=Ministry of Health and Welfare]

According to the Ministry of Health and Welfare on the 10th, the non-reimbursable reporting system was expanded this year to cover all 72,815 medical institutions. Last year, only 4,245 hospital-level medical institutions participated.

Non-reimbursable medical services are those for which health insurance benefits do not apply, so patients bear the full cost of treatment. The purpose of understanding the status of these non-reimbursable services is to provide necessary information for the public to use medical services rationally.

Medical institutions that did not report information this time, accounting for 5%, will be fined according to the Medical Service Act.

During this year’s reporting period (April 15 to June 30), each medical institution reported the unit price, frequency, diagnosis name, surgery name, and other details of non-reimbursable items from March treatment records. This year, the total number of reporting items was 1,068, an increase of 474 from last year’s 594.

The Ministry of Health and Welfare plans to analyze the collected non-reimbursable reporting data and provide necessary information such as treatment and surgery costs for specific diseases, as well as treatment safety and effectiveness, on the National Health Insurance Service website within this year.

The data will be used as a basis for policies to manage non-reimbursable items that increase health insurance financial demands and the public’s medical expenses burden.

Kwon Byung-gi, Director of Essential Medical Policy at the Ministry of Health and Welfare, stated, "We will analyze the collected reporting data to provide information that helps the public’s actual medical use, and strengthen the management of non-reimbursable services to prevent medical abuse through continuous communication with stakeholders and system improvements."

This content was produced with the assistance of AI translation services.