Regulations Governing the National Health Insurance Referral Article 3

Where a contracted hospital or clinic provides referral service for a beneficiary, the referral shall be made based on medical necessity and conform to the Medical Care Act.Referral in the preceding paragraph shall mean that a beneficiary who agrees to the arrangement made by a contracted hospital or clinic to be sent to another suitable level contracted hospital or clinic to continue to receive treatment. This includes the arrangement of sending a beneficiary receiving point of care or mobile medical services under an Insurance plan or project at a correctional institution or any mountain regions, outlying islands, or areas with inadequate medical resources under the Insurance to the contracted hospital or clinic providing the aforementioned medical care services to continue receiving medical treatment.Referral in the preceding paragraph shall not be restricted by the category or level of the medical care institution.In the event that a beneficiary is referred to a contracted hospital or clinic and no longer requires care there due to his or her medical condition and none of the circumstances in Article 11 apply, the contracted hospital or clinic shall recommend the beneficiary return to the original referring hospital or clinic, or to another suitable contracted hospital or clinic, for continued treatment if follow-up care is still required.