Jinju City Council Calls for Introduction of Special Judicial Police at National Health Insurance Service to Prevent Over 3 Trillion Won Fiscal Leakage

Proposal Unanimously Adopted by City Council Members
Urging the Government and National Assembly to Amend the Judicial Police Duties Act

The Jinju City Council of Gyeongnam announced on the 10th that during the 264th temporary session, it unanimously adopted a government proposal urging the National Health Insurance Service to promptly introduce a special judicial police system.

In order for the NHIS to operate a special judicial police force, the "Act on Persons Performing Duties of Judicial Police Officers and the Scope of Their Duties," commonly referred to as the Judicial Police Duties Act, must be amended.

A view of Jinju City Council.

Through the proposal, the city council pointed out the reality in which non-medical personnel and pharmacists illegally establish medical institutions and pharmacies by lending or misusing names or licenses solely for excessive profit, stating, "Patients who should be treated based on medical judgment are being used as tools for profit generation, resulting in excessive treatments and prescriptions, causing financial leakage in healthcare budgets and a decline in the quality of medical services."

The council further noted, "Despite ongoing crackdowns and detections, investigations are often prolonged due to a shortage of healthcare investigation professionals in the police and Ministry of Health and Welfare, leading to a significant drop in the recovery rate of unjustly claimed insurance payments," highlighting the limitations of the current enforcement system.

The government and NHIS have consistently cracked down on so-called 'Samujang Hospitals' and other illegally established medical institutions nationwide, uncovering unjust insurance claims amounting to 3.3763 trillion won from 2009 to 2023. However, during the investigation period, which averages over 11 months, assets are often concealed, resulting in only 233.6 billion won recovered, with a collection rate of just 6.9%. In the Gyeongnam region, only 4.3% of the 323.2 billion won from 79 detected cases between 2009 and 2024 has been recovered.

Accordingly, the city council stated, "If NHIS employees continue to conduct crackdowns in the current administrative investigation manner, they lack investigative authority, making account tracing impossible and thorough investigations of those involved virtually unfeasible," and urged the government and National Assembly for legal and institutional improvements, adding, "To eradicate illegally established medical institutions, improve the quality of medical services, and secure the stability of health insurance finances, the NHIS must be granted 'special judicial police' authority to enable swift crackdowns and investigations."

Meanwhile, according to the city council, since 2014, the NHIS has accumulated know-how through administrative investigations of related cases and is equipped with specialized personnel such as healthcare professionals, legal experts, and experienced investigators, as well as health insurance big data and detection systems necessary for investigating illegally established medical institutions.

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