Starting next year, the period for reducing the outpatient treatment burden for premature babies will be extended to a maximum of 5 years and 4 months, and the upper limit for rewards for reporting fraudulent health insurance claims will be increased to 3 billion KRW. The Ministry of Health and Welfare announced on the 16th that a partial amendment to the ‘National Health Insurance Act Enforcement Decree’ was approved at the Cabinet meeting.
This amendment aims to alleviate the medical expenses burden for premature babies, prevent the leakage of health insurance finances, and strengthen post-management of health check-ups to enhance public convenience. Previously, all premature babies were given the same reduction in outpatient treatment burden for up to 5 years from birth, but now the period will be extended to a maximum of 5 years and 4 months, considering the gestational period at birth.
The reward system for reporting fraudulent health insurance claims will also be improved. The amended enforcement decree standardizes the criteria for calculating rewards regardless of the type of informant and raises the upper limit from 2 billion KRW to 3 billion KRW. This is expected to encourage more reporting of fraudulent claims and prevent the leakage of health insurance finances, thereby enhancing the sustainability of the system.
The exemption period for additional treatment and examination costs following general health check-up results will also be extended. Previously, the exemption was valid until January 31 of the following year after the health check-up, but now it will be extended by 2 months to March 31 of the following year to strengthen the connection between health check-ups and subsequent treatment and management, and to improve the convenience for examinees.