Regulations Governing Contracting and Management of the National Health Insurance Contracted Medical Care Institutions Article 38
The Insurer shall suspend the contract for one month if the contracted medical care institution has any of the following circumstances during the term of the contract. Notwithstanding, in the case of contracted hospitals, the Insurer may suspend the medical department or specific service item that violates the requirement or the outpatient inpatient services in whole or in part for one month in accordance with the seriousness of the violation.1. Violation of Article 68 or Paragraph 1 of Article 80 and again after three disciplinary actions by the Insurer;2. Violation of Article 36 and subject to the punitive measure of three contract-violation points and the same violation again;3. One of the subparagraphs in the preceding article after medical expenses being deducted three times;4. Refusal to provide appropriate medical services to insurance beneficiaries and such offense being significant;
中文原文 全民健康保險醫事服務機構特約及管理辦法第38條
保險醫事服務機構於特約期間有下列情事之一者,保險人予以停約一個月。
但於特約醫院,得按其情節就違反規定之診療科別、服務項目或其全部或一部之門診、住院業務,予以停約一個月:
一、違反本法第六十八條、第八十條第一項規定,經保險人分別處罰三次後,再有違反。
二、違反依第三十六條規定受違約記點三次後,再有違反。
三、經扣減醫療費用三次後,再有前條規定之一。
四、拒絕對保險對象提供適當之醫事服務,且情節重大。
但於特約醫院,得按其情節就違反規定之診療科別、服務項目或其全部或一部之門診、住院業務,予以停約一個月:
一、違反本法第六十八條、第八十條第一項規定,經保險人分別處罰三次後,再有違反。
二、違反依第三十六條規定受違約記點三次後,再有違反。
三、經扣減醫療費用三次後,再有前條規定之一。
四、拒絕對保險對象提供適當之醫事服務,且情節重大。