Regulations Governing Contracting and Management of the National Health Insurance Contracted Medical Care Institutions Article 21

Upon the approval from the local competent authority and the consent from the Insurer, contracted medical care institutions may appoint physicians or necessary medical personnel to provide ambulatory medical care services and health rehabilitation diagnoses and treatments in registered old-age care and nursing centers, care institutions or welfare institutions for the mentally and physically challenged and nursing homes (hereinafter collectively referred to as “nursing institutions”) when the following conditions are met:1. The contracted medical care institutions that provide ambulatory medical care services shall be contracted hospitals and clinics. The service institutions that provide health rehabilitation diagnoses and treatments shall be contracted hospitals and health rehabilitation clinics;2. When providing health rehabilitation therapies and services, in accordance with the service categories, it is necessary to appoint physicians, physical therapists, occupational therapists, and speech or hearing therapists who meet the requirements set forth in the Fee Schedule and Reference List for Medical Services;3. Nursing institutions shall be equipped with the diagnosis and treatment facilities as described by the Standards of the Facilities of Medical Treatment Establishments. When offering health rehabilitation treatments and services, it is necessary to be equipped with the facilities required for physical therapies, occupational therapies, and speech or hearing therapies according to the services rendered;4. It is necessary to file a list of insurance beneficiaries that nursing institutions service to the Insurer. This list shall be renewed once every month.The Insurer may reject the application from the contracted medical care institution for support services if the aforesaid institution is found to be violating the regulations.
中文原文 全民健康保險醫事服務機構特約及管理辦法第21條
保險醫事服務機構得報經所在地衛生主管機關之許可,並報經保險人同意,指派醫師及必要之醫事人員至立案之老人安養、養護機構或身心障礙福利機構、護理之家(以下稱照護機構),提供保險一般門診及復健診療服務,並以符合下列條件為限:
一、保險醫事服務機構提供一般門診診療服務應為特約醫院及診所;提供復健診療服務應為特約醫院及復健科診所。
二、於提供復健治療服務時,應依服務類別,指派符合醫療服務給付項目及支付標準規定之專科醫師及物理、職能、語言或聽力治療師(生)。
三、照護機構內設有符合醫療機構設置標準規定之診療空間(設施);於辦理復健治療服務時,應依服務類別,設有符合物理、職能、語言或聽力治療所設置標準規定之設施。
四、應將照護機構內保險對象名冊,報經保險人備查。
其名冊應每月更新一次。
前項保險醫事服務機構有違規情事者,保險人得不予許可其申請支援服務。

English translation for reference only; the Chinese text prevails. Not legal advice.