Regulations Governing Contracting and Management of the National Health Insurance Contracted Medical Care Institutions Article 5
The medical care institution or the responsible medical personnel applying to be a contractor will be disqualified in five years should any of the following circumstances occur:1. The institution at the same address sees its franchise contract suspended or terminated twice or more within the last five years;2. The franchise contract is suspended or terminated again within five years after the completion of the previous franchise contract termination;3. The franchise contract is terminated or will be terminated for the second time within five years after the completion of the previous contract termination.No contract shall be granted to any applicant should any of the above situations repeat within five years of being given the contract.It is possible to suspend the contract to specific service items or categories of a medical care institution if the Insurer deems such service items or categories to violate the Insurance’s provisions based on on-site investigations or if there are factual violations of the Insurance’s provisions and the situation of violation or related facts sustained.No contract shall be granted within five years after the five suspensions or terminations of specific service items or categories or three suspensions or terminations of the same service item or category within five years in pursuant to the situations described in each Subparagraph of Paragraph 1.
中文原文 全民健康保險醫事服務機構特約及管理辦法第5條
申請特約之醫事機構或其負責醫事人員有下列情事之一者,於五年內不予特約:
一、同址之機構最近五年內,受停約或終止特約二次以上。
二、終止特約執行完畢後五年內,再次受停約或終止特約。
三、停約執行完畢後五年內,再次受終止特約或停約二次以上。
前項情事,已逾五年,經予以特約後,再有前項各款情事之一,不予特約。
醫事機構之部分服務項目或科別,經保險人實地訪查認有違反本保險規定之情事,或有具體事實認有違反本保險規定之虞者,於該情事或具體事實未消失前,得僅就該部分之服務項目或科別,不予特約。
第一項各款所定情事,屬部分服務項目或科別停約或終止特約者,應以五年內累計達五次或同一服務項目或科別累計達三次,始於五年內不予特約。
一、同址之機構最近五年內,受停約或終止特約二次以上。
二、終止特約執行完畢後五年內,再次受停約或終止特約。
三、停約執行完畢後五年內,再次受終止特約或停約二次以上。
前項情事,已逾五年,經予以特約後,再有前項各款情事之一,不予特約。
醫事機構之部分服務項目或科別,經保險人實地訪查認有違反本保險規定之情事,或有具體事實認有違反本保險規定之虞者,於該情事或具體事實未消失前,得僅就該部分之服務項目或科別,不予特約。
第一項各款所定情事,屬部分服務項目或科別停約或終止特約者,應以五年內累計達五次或同一服務項目或科別累計達三次,始於五年內不予特約。