The National Health Insurance Administration (NHIA) in February resumed efforts at revising the copayment system and this week announced new copayment changes for emergency room visits. The NHIA shifted from its original plan to base copayments based on the severity of illnesses, to a new plan based on the level of the hospital visited, set to take effect in July.

NHIA Director General Shih Chung-liang said that following discussions with providers and consumers, the NHIA has acknowledged that it is difficult to gauge the severity of the illness of each patient, and that to avoid potential disputes, the copayment system should be based solely on the level of the hospital providing emergency care. In addition, the new copayment rule also considers the fact that during holidays and when outpatient visits are not available, patients have no choice but to visit emergency rooms. As a result, the NHIA has decided that, as part of efforts at promoting the referral system and to avoid instances where the copayment for outpatient visits could become lower than emergency room visits, copayments of NT$150 for district hospitals, NT$400 for regional hospitals and NT$750 for medical centers will be charged for emergency room visits, regardless of the severity of the patient’s illness.

Director General Shih said that preparations for the new copayments will begin in the current week, and that the changes are expected to be implemented in July, along with changes to copayments for outpatient visits and drug prescriptions. Meanwhile, changes to copayments for diagnostic tests will be delayed as authorities work out refund mechanisms for patients who were not able to undergo examination for various reasons. As a result, copayment revisions for diagnostic tests will not be implemented in the second half of 2023 and will be delayed until a later stage of copayment reform.

[2023-3-28/Commercial Times]