Medical care institutions should apply to the Insurer to become contracted medical care institutions. The Competent Authority shall determine the qualifications, procedure, review standards, disqualification, resolution of violations, and other relevant matters pertaining to contracted medical care institutions.
The medical care institutions of the preceding paragraph are limited to those in Taiwan, Penghu, Kinmen, and Matsu.

Provisions of ward in a contracted hospital shall comply with the criteria for establishment of the insurance ward. The criteria for establishment of insurance ward and the ratio of the insurance ward to the aggregate number of hospital wards shall be established by the Competent Authority.
Contracted hospitals should announce the status of their insurance wards daily.
The Insurer should announce the ratio of insurance ward monthly and conduct quarterly checks.

With regard to the medical benefit provided by this Insurance, unless provided otherwise by this Act, the contracted medical care institutions shall not make up items to charge the beneficiaries.

The contracted medical care institutions shall check the qualification of the insured when they visit, matching it to the information on the health insurance card. The Insurer may refuse to pay medical expenses for those who have not been checked and shall seek reimbursement if the medical expenses have been paid. This is inapplicable to matters not attributable to contracted medical care institutions.

Upon occurrence of an incident under coverage to the insured, the contracted medical care institutions shall provide proper medical service based on their specialties and facilities or assist in referral without any unreasonable refusal due to the status of the insured.

Contracted medical care institutions should give the Insured a prescription after treatment, which shall be according to the dosage, lab tests, and diagnostic examinations.
The Insured’s drug prescription from ambulatory treatment and major lab test items should be stored in the health insurance IC card.

To reduce cases of ineffective treatment and other inappropriate use of insurance medical resources, the Insurer shall draft an annual proposal for controlling inappropriate use of resources; present it to the NHIC for discussion, and submitting it to the Competent Authority afterwards for approval.

Contracted medical care institutions which have received medical insurance payments in excess of a specific amount should present to the Insurer financial reports signed by a CPA or reports from audit institutions on national health insurance business, which the Insurer should make public.
The Insurer shall draft the rules pertaining to the amount, deadline, procedure for providing financial reports, the format, and contents to be presented to the NHIC for discussion and submitted to the Competent Authority for approval afterwards
The financial report of Paragraph 1 should at least include the following reports:
1.Asset-liability statement
2.Surplus balance sheet
3.Changes in net report
4.Cash flow report
5.Medical revenue schedule
6.Medical cost schedule

The Insurer and the contracted medical care institutions should regularly make public information pertaining to quality of care of the Insurance.
The Insurer shall draft the content scope of the quality of care information, how it is made public, and other rules pertaining to it to be presented to the NHIC for discussion and submitted to the Competent Authority for approval afterwards.

When drug expenses applied for by contracted medical care institutions exceeds the amount designated by the Competent Authority, contracts for all transactions with pharmaceutical firms should be signed to define rights and responsibilities, except if purchase of drugs is for rare diseases or other special cases.
The Competent Authority should meet with the Fair Trade Commission, Executive Yuan to draft the definitive contract format for the written contract in the preceding paragraph and other recorded or unrecorded matters.