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Enforcement Decree of the National Health Insurance Act

국민건강보험법 시행령

Article 18 (Medical Institutions, etc. Excluded from Medical Care Institutions)

제18조 요양기관에서 제외되는 의료기관 등

Ministry
보건복지부
In force
2026-02-19
Articles
123
Original (Korean)

법 제42조제1항 각 호 외의 부분 후단에서 "대통령령으로 정하는 의료기관 등"이란 다음 각 호의 의료기관 또는 약국을 말한다. <개정 2017.3.20>

  1. 1. 「의료법」 제35조에 따라 개설된 부속 의료기관

  2. 2. 「사회복지사업법」 제34조에 따른 사회복지시설에 수용된 사람의 진료를 주된 목적으로 개설된 의료기관

  3. 3. 제19조제1항에 따른 본인일부부담금을 받지 아니하거나 경감하여 받는 등의 방법으로 가입자나 피부양자를 유인(誘引)하는 행위 또는 이와 관련하여 과잉 진료행위를 하거나 부당하게 많은 진료비를 요구하는 행위를 하여 다음 각 목의 어느 하나에 해당하는 업무정지 처분 등을 받은 의료기관

    1. 가. 법 제98조에 따른 업무정지 또는 법 제99조에 따른 과징금 처분을 5년 동안 2회 이상 받은 의료기관
    2. 나. 「의료법」 제66조에 따른 면허자격정지 처분을 5년 동안 2회 이상 받은 의료인이 개설ㆍ운영하는 의료기관
  4. 4. 법 제98조에 따른 업무정지 처분 절차가 진행 중이거나 업무정지 처분을 받은 요양기관의 개설자가 개설한 의료기관 또는 약국

In the latter part of the main clause of Article 42 (1) of the Act, "medical institutions, etc. prescribed by Presidential Decree" means the medical institutions or pharmacies listed in the following subparagraphs. <Amended by Presidential Decree No. 27832, Mar. 20, 2017> 1. Affiliated medical institutions established in accordance with Article 35 of the Medical Act. 2. Medical institutions established with the primary purpose of treating persons accommodated in social welfare facilities under Article 34 of the Social Welfare Services Act. 3. Medical institutions that receive disposition of suspension of business, etc. as listed in any of the following subparagraphs, by attracting subscribers or dependants through methods such as not receiving or reducing the co-payment under Article 19 (1), or by providing excessive medical treatment or demanding unreasonably high medical fees in relation thereto: a. Medical institutions that have received a disposition of suspension of business under Article 98 of the Act or a disposition of a penalty surcharge under Article 99 of the Act two or more times within a period of five years. b. Medical institutions established and operated by a medical practitioner who has received a disposition of suspension of qualification under Article 66 of the Medical Act two or more times within a period of five years. 4. Medical institutions or pharmacies established by the establisher of a medical care institution for which a disposition of suspension of business under Article 98 of the Act is pending or has been imposed.

제1항제1호 및 제2호에 따른 의료기관은 요양기관에서 제외되려면 보건복지부장관이 정하는 바에 따라 요양기관 제외신청을 하여야 한다.

Medical institutions under subparagraphs 1 and 2 of paragraph (1) shall apply for exclusion from medical care institutions in accordance with the method prescribed by the Minister of Health and Welfare to be excluded from medical care institutions.

의료기관 등이 요양기관에서 제외되는 기간은 제1항제3호의 경우에는 1년 이하로 하고, 제1항제4호의 경우에는 해당 업무정지기간이 끝나는 날까지로 한다.

The period during which medical institutions, etc. are excluded from medical care institutions shall be: for the case of subparagraph 3 of paragraph (1), not exceeding one year; and for the case of subparagraph 4 of paragraph (1), until the date when the period of suspension of business ends.

Translation

Machine translation. The Korean text is authoritative.

Statute text is reproduced from 법제처 국가법령정보센터. This is information, not legal advice.

Enforcement Decree of the National Health Insurance Act 제18조 — Article 18 (Medical Institutions, etc. Excluded from Medical Care Institutions) · Law4Kor