Regulations Governing Contracting and Management of the National Health Insurance Contracted Medical Care Institutions Article 43
Significant offenses referred to in Subparagraphs 2 and 4 of Paragraph 1 of Article 40 of any of the following circumstances:1. Falsely reported over 100,000 points and providing beneficiaries with non-medically necessary medications, nutritional supplements, or other items;2. Falsely reported over 100,000 points, collecting National Health Insurance Cards, recording medical visits, and claiming medical expenses for beneficiaries who were not treated;3. Falsely reported over 150,000 points and falsely reporting hospital treatment for beneficiaries;4. Falsely reported over 250,000 points.
中文原文 全民健康保險醫事服務機構特約及管理辦法第43條
第四十條第一項第二款、第四款所稱情節重大，指下列情事之一：
一、違約虛報點數超過十萬點，並有發給保險對象非醫療必要之藥品、營養品或其他物品。
二、違約虛報點數超過十萬點，並有收集保險憑證，或有未診治保險對象，仍記載就醫紀錄，虛報醫療費用。
三、違約虛報點數超過十五萬點，並有虛報保險對象住院診療。
四、違約虛報點數超過二十五萬點。
一、違約虛報點數超過十萬點，並有發給保險對象非醫療必要之藥品、營養品或其他物品。
二、違約虛報點數超過十萬點，並有收集保險憑證，或有未診治保險對象，仍記載就醫紀錄，虛報醫療費用。
三、違約虛報點數超過十五萬點，並有虛報保險對象住院診療。
四、違約虛報點數超過二十五萬點。