Regulations Governing Contracting and Management of the National Health Insurance Contracted Medical Care Institutions Article 40

The Insurer shall terminate the contract if the contracted medical care institution has any of the following circumstances. 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 year in accordance with the seriousness of the violation.1. Contracted medical care institutions or their responsible medical personnel has been suspended pursuant to the preceding Article, and the same offense was found within five years after the completion of such suspension;2. Unscrupulous behavior or false certifications, reports, or statements to declare medical expenses and such offense being significant;3. Violation of medical laws and regulations and practicing licenses revoked by the competent health authority;4. The contracted medical care institution retains personnel who are not qualified physicians to provide medical services for beneficiaries and declare medical expenses, which is deemed as a serious violation.5. Reporting of false dates in order to declare the expenses for medical services rendered to insurance beneficiaries during the period when the contract is suspended or requesting other contracted medical care institutions to declare such expenses;6. Contract terminated or suspended for a year pursuant to the above subparagraphs 1-5, and aforesaid offenses found within one year of resumed contracting after the previous contract termination or suspension of the contract.No application for contracting is permitted within one year after the termination of the contract pursuant to the preceding paragraph.