1. Reasons for Amendment
This amendment aims to improve and complement a number of weaknesses that have emerged in the operation of the current system, such as reflecting the enactment and amendment of related statutes such as the Medical Service Act as well as improvements in the system, including improved criteria for the coverage of upper-grade wards, mandatory medical certificate for long-term treatment of patients with minor injuries, and improvement of the procedure for requesting treatment from other medical institutions during hospitalization in traffic accidents.
2. Major Provisions
ㅇ Improve the criteria for the coverage of upper-grade wards and establish new mental hospitals by type (Article 6 and Attached Tables 2 and 3)
These Rules are improved to apply only to hospital level or higher (excluding medical clinic level) in unavoidable cases due to room circumstances for upper-grade ward fees, and Article 6, Attached Table 2, and Attached Table 3 are partly revised as mental hospitals can be established by type because of the revision of Article 3 of the Medical Service Act.
ㅇ Make a medical certificate mandatory for long-term treatment of patients with minor injuries (Article 12 and Attached Form 2)
Article 12 and Attached Form 2 are partially revised so that insurance companies, etc. must notify the suspension of payment guarantees if a patient with minor injuries (injury grade 12-14) has not submitted a medical certificate for treatment for more than 4 weeks.
ㅇ Request treatment from another medical institution during hospitalization (Attached Table 3 and Attached Form 12)
Attached Table 3 and Attached Form 12 are partially revised so that the medical institution that has been requested to provide treatment can directly claim the relevant treatment details only if a car insurance inpatient is inevitably requested to be treated at another medical institution.
ㅇ Revision according to the enactment and revision of other related statutes (Articles 2 and 5 and Attached Table 2)
In accordance with the enactment of the Living Logistics Service Industry Development Act, the amendment to the Guarantee of Automobile Accident Compensation Act, and the full revision of the Calculation Criteria for Health Care Benefits of Industrial Accident Compensation Insurance, Articles 2 and 5 and Attached Table 2 are partially revised.
