Insurance medical care institutions shall display the designated mark of a contracted medical service institutions in a conspicuous location.
Upon suspension or termination of the contract, insurance medical care institutions shall remove the abovementioned designated mark. However, if the suspension or termination is applicable to specific service items or categories, insurance medical care institutions shall post the notices for the periods and service items or categories suspended or terminated at registration desks (and on the websites) and other conspicuous locations.

Insurance medical care institutions shall issue receipts in compliance with the requirements set forth by the Enforcement Rules of Medical Care Act for the medical services rendered to the insurance beneficiaries. The receipts shall list the serial numbers of the insurance certificate of the insurance beneficiaries for the medical service provided.

In the event that a beneficiary fails to provide the NHI IC card or identification document in timely manner for any reason, the insurance medical care institution shall not only provide medical service, but also retain the payment and refund records.

Insurance medical care institutions shall not cause insurance beneficiaries to pay for the items covered by the National Health Insurance at their own expenses except for fees provided by Article 14, or purchase medications, treatment materials or pay for inspections at their own expenses, or provide non-gratuitous, un-justified medical services upon the request of insurance beneficiaries and report expenses.

In the event that the insurance medical care institution provides a beneficiary with a medical device of difference payment, it shall request the beneficiary for payment in compliance with the following:
1. The payment standard shall be submitted to and approved by the local competent health authority;
2. The item, fee, product features as well as side effects of the medical devise of difference payment and its curative effects compared to the medical devices reimbursed by the Insurance shall be publicized on the website or a place easily seen in the institution.
3. Except in the case of emergency, the relevant manual should be delivered to the patient or the patient’s family two days prior to the operation or treatment. In addition, the institution shall give detailed explanations to the patient or the patient’s family who should then fill out two counterparts of the consent form to the difference payment in person with one copy held by the patient and the other kept with the patient’s medical records; and
The manual set forth in the preceding subparagraph shall clearly stipulate the fee, product features, reasons for use, warnings as well as side effects of the medical device of difference payment and its curative effects compared to the medical devices reimbursed by the Insurance. The consent form shall clearly set out the item name, item code, price listed by the institution, quantity and the difference.

Unless in an emergency or due to unexpected surgeries, examinations, or treatments, insurance medical care institutions may not suggest or request patients or their relatives to use the service items not covered by the National Health Insurance when rendering operations, medical checks or procedures to insurance beneficiaries.

All entries in account books and records related to the contracted medical care services provided by an insurance medical care institution shall be consistent with the costs and expenses thereof declared to the Insurer, and shall be placed under custody for a period of five years.

If the responsible medical personnel(s) of insurance medical care institutions have become incapable of performing duties for more than thirty days, he/she/they shall report such event to the competent authority that issues their practicing licenses according to relevant laws and regulations. Meanwhile, he/she/they shall report to the Insurer within ten days after the aforesaid thirty days. This clause shall also be complied with upon a change of any matter previously reported to and recorded with relevant competent authorities.

In case of name changes of insurance medical care institutions, or changes of the responsible physicians of public medical institutions, the medical institutions of medical legal persons, or medical institutions of legal persons shall report such changes to the Insurer by submitting the practicing licenses issued by the competent authority.

The Insurer may conduct on-site investigations to insurance medical care institutions when necessary.

When applying for insurance payments for labor, clinics shall obtain approvals from local competent authority for the establishment of operation rooms, labor rooms, infant rooms and observation wards. No Cesarean sections will be covered by the Insurance in the absence of operation rooms.

Upon the approval from local competent authority and the consent from the Insurer, insurance medical care institutions may appoint physicians or necessary medical personnel to provide ambulatory medical care services and health rehabilitation diagnoses and treatments in registered old-age care and nursing centers, care institutions or welfare institutions for the mentally and physically challenged and nursing homes (hereinafter collectively referred to as “nursing institutions”) when the following conditions are met:
1. The insurance medical care institutions that provide ambulatory medical care services shall be contracted hospitals and clinics. The service institutions that provide health rehabilitation diagnoses and treatments shall be contracted hospitals and health rehabilitation clinics.
2. When providing health rehabilitation therapies and services, in accordance to the service categories, it is necessary to appoint physicians, physical therapists, occupational therapists, speech or hearing therapists who meet the requirements set forth in Medical Service Payment Items and Standards.
3. Nursing institutions shall be equipped with the diagnosis and treatment facilities as described by the Standards of the Facilities of Medical Treatment Establishments. When offering health rehabilitation treatments and services, it is necessary to be equipped with the facilities required for physical therapies, occupational therapies, speech or hearing therapies according to the services rendered.
4. It is necessary to file to the Insurer a list of insurance beneficiaries that nursing institutions service. This list shall be renewed once every month.
The Insurer may reject the application from the insurance medical care institution for support services should the aforesaid institution is found to be violating the regulations.

The services rendered by the physicians and necessary medical personnel by the insurance medical care institutions specified in the preceding article shall be provided with only in the following timeslots:
1. Ambulatory medical care services and health rehabilitation diagnoses and treatments provided by the physicians of insurance medical care institutions shall be limited to a total of three timeslots each week. Health rehabilitation therapy treatments and services provided by therapists shall be limited to a total of three timeslots each week.
2. Ambulatory medical care services and health rehabilitation diagnoses and treatments provided by the physicians of the insurance medical care institutions offering accommodations to up to 300 mentally or physically challenged patients are limited to a total of six timeslots per week. Health rehabilitation therapy treatments and services provided by therapists shall be limited to a total of six timeslots each week.
3. During the time when the insurance medical care institutions are approved to provide ambulatory medical care services and rehabilitation diagnoses and services in the nursing institutions, other insurance medical care institutions may not apply for the contracting of such services to be rendered to the same nursing institutions. Notwithstanding, the insurance medical care institution which has insufficient medical departments may request other insurance medical care institutions to form a team in order to offer integrated medical service in nursing institutions. The major insurance medical care institution should be responsible for filing expenses and managing medical records.
In the case of the circumstances set forth in the preceding paragraph, there shall only be one physician and one rehabilitation therapist in any given time period. Notwithstanding, in the case of nursing institutions which provide early treatment, there shall be no more than three rehabilitation therapists who provide treatment service in any given time period.

Prescriptions from and artificial limbs installed by physicians working for contracted hospitals in health rehabilitation, orthopedics or cosmetic surgery, as well as physical therapists and occupational therapists, in compliance with the Pharmaceutical Affairs Act, may be covered by insurance. However, the coverage granted before the amendment on September 15, 2010 may be applicable to the regulations before the amendment.

Unless in compliance with laws and regulations and with prior reporting to the Insurer and consent from the Insurer, the medical services rendered outside the premise of insurance medical care institutions by physicians of the service institutions are not covered by insurance.
With consent from the Insurer, insurance medical care institutions may dispatch its medical personnel to off-islands and mountains to provide medical services to insurance beneficiaries via medical care tour programs.

Insurance medical care institutions may not refuse to provide medical services to insurance beneficiaries without any legitimate causes, nor can they demand earnest money from insurance beneficiaries.

The transfers and referrals of insurance beneficiaries by insurance medical care institutions shall be based on medical requirement.
Insurance medical care institutions shall administer appropriate procedures and provide proper assistance to insurance beneficiaries when their conditions are stabilized and they are discharged from the hospital or transferred to chronic care wards.

Contracted hospitals or clinics may delegate contracted medical laboratories or radiological test centers to perform tests, inspections and examinations.
Contracted physical therapy clinics or occupational therapy shall provide medical services in accordance with the Physical Therapists Law or Occupational Therapists Act. Such medical services shall be based on the prescriptions by physicians of contracted hospitals or clinics in health rehabilitation department, neurology department, orthopaedics department, neurosurgery department, plastic surgery department or general medicine department.
The physicians in general medicine mentioned above shall be recognized by the Insurer to have specialty in Rheumatism.
Occupational therapies in Paragraph 2 may also be based on the prescriptions of psychiatrists.

Home nursing care provided by the nursing homes with practicing licenses for home nursing care to insurance beneficiaries living in the accommodation of the nursing homes may be covered by the insurance.