NHI to cancel insurance for physical therapy treatment
By Queena Yen, The China Post
February 22, 2014, 12:03 am TWN
TAIPEI, Taiwan -- The National Health Insurance Administration (NHI) said yesterday that it is planning to cut insurance payments for long-term and high-frequency physical therapy treatments in order to prevent improper waste of medical resources within the health care system.
In addition, the NHI will also strengthen the censorship for costly medical examinations such as computer tomography (CT) and nuclear magnetic resonance computer tomography (NMR-CT).
The NHI pointed out that about 1.5 million CT scans take place each year, costing around NT$3,800 each. Meanwhile, an NMR-CT can cost even more, with the NHI spending between NT$6,500 and NT$15,100 for each.
In order to solve the problem of medical resource waste, the NHI proposed a raise in the National Health Insurance fee last year, allowing patients to pay part of their medical bills. However, this proposal was not approved. Therefore, the NHI came up with new policy to control the waste of medical resources.
The new policy will enhance the control of high resource consumption medical therapies such as long-term physical therapy treatment, radiation therapy and shock wave lithotripsy.
According to the NHI, the new policy will not make payments to hospitals that undertake more physical therapy treatments than clinical cases. In addition, the NHI will cancel payments for a case if a patient has been continuously treated in one hospital too frequently.
Lin Shu-fan (林淑範), who works for the NHI, said the best time for a stroke patient to have physical therapy treatments should be within six months of suffering from the stroke. However, they found that there are patients who have been in rehabilitation for one and half years, which may be an example of medical waste.
“Some of the patients even go to the hospital every day to have physical therapy treatments. This phenomenon should be further reflected on,” said Lin.
The NHI said it will start to discuss this policy with professionals in the medical field in March. After setting up clear indicators to carry out the policy, the NHI will send the proposal to the National Health Insurance Committee (NHIC). The policy will be put into practice in July if possible, said the NHI.
The NHI hopes that the new policy can reduce the medical waste in current medical system.
Long-term Treatments Don't Equal Waste: Groups
Some nongovernmental organizations said that long-term physical therapy treatments don't necessary equal a waste of medical resources, although the new NHI policy is a well-intentioned proposal.
According to one nongovernmental organization, patients who need physical therapy treatments can vary from case to case. Therefore, the new policy may be too arbitrary to cancel the insurance payments for all physical therapy treatments.