The Financial Supervisory Service will share with the Ministry of Health and Welfare the status of claims for indemnity insurance payouts related to noncovered treatments for some inpatients at long-term care hospitals. The ministry launched a probe after signs surfaced that some long-term care hospitals illegally offered so-called "paybacks," returning a set percentage of treatment costs taken from patients. The FSS holds data on noncovered treatment claims for indemnity insurance, while the Ministry of Health and Welfare, which oversees national health insurance, has lacked that information and has faced limits in its investigation.
On the 23rd, according to the financial authorities, the Financial Supervisory Service agreed to share key information, including the status of claims for indemnity insurance payouts related to noncovered treatments for inpatients at long-term care hospitals that the Ministry of Health and Welfare is investigating. On the 18th, the ministry formed a "task force on abnormal and fake treatments" and said it would launch on-site inspections into suspected improper and illegal medical practices.
The Ministry of Health and Welfare plans to focus on cases suspected of seeking revenue through illegal and evasive tactics, including paybacks. To that end, the ministry will work with related agencies such as the National Health Insurance Service, the Health Insurance Review & Assessment Service (HIRA), and the Financial Supervisory Service. The FSS's provision of data is part of this cooperation.
Recently, some long-term care hospitals have provided expensive noncovered treatments aligned with cancer patients' indemnity coverage limits and then handed out cash. President Lee Jae-myung shared related news reports on social media (SNS) and directed, "This seems illegal, yet such practices continue. We need corrective action."
Until this cooperative framework was set up, oversight authority was spread across multiple agencies, making a coordinated response difficult. Under current law, the authority to investigate detailed materials such as medical records held by long-term care hospitals and information on attending medical staff rests with the Ministry of Health and Welfare.
For that reason, even if an insurer reported a suspicious case to the Financial Supervisory Service, it was difficult to conduct additional investigations smoothly without the ministry's help. Lacking data on indemnity insurance, the Ministry of Health and Welfare often did not initiate probes unless the matter involved health insurance fraud, according to reports.
An official at the Financial Supervisory Service said, "We plan to share relevant data in line with the Ministry of Health and Welfare's request for cooperation."