Medical group set to sue bureau

The Taiwan Medical Association (TMA) has decided to file a lawsuit against the Bureau of National Health Insurance, after failing to reach an agreement on a plan to reimburse the bureau for overpayments to the nation's hospitals and clinics.

Earlier this month, the BNHI demanded that NT$10.6 billion (US$321 million) be reimbursed to it by the nation's hospitals and clinics, saying that this was the amount of overpayments to medical facilities in 2004 and last year.

The TMA discussed the issue with the bureau but failed to secure a reimbursement plan that would allow the funds to be paid back in 24 interest-free installments, said chairperson of the association's Kaohsiung branch Chang Ching-yun (張清雲). The TMA is an organization of the country's physicians that mediates affairs between medical institutions, the government and the public. It currently leads 24 local medical associations across the nation.

Although TMA and its sub-branches are still in the process consulting with the Department of Health on the matter, they nonetheless "have to take some action," he said.

Chang said that the association's branches nationwide will file civil, criminal and administrative suits against the BNHI for malfeasance.

If the associations win the civil suit, the BNHI would have to cover half of the overpayments itself, Chang said.

Chang told the Taipei Times that the associations hope the public understands that "the medical community did not sneak away with people's money" and that "both sides should take equal responsibility" for the bureau's troubled finances.

Chang said that the bureau should not have had increased the number of subsidized services in the first place, since its budget for the past two years could not cover such expenditures.

"It's like catering. You should prepare what your budget can afford," Chang said.

Chang added that the TMA had made suggestions to the bureau in the past few years, but that the BNHI had "turned a deaf ear to them."

According to former chairman of the Kaohsiung branch Hsiao Chih-wen (蕭志文), more than 300 doctors have shuttered their businesses in the past 10 years due to failing to settle payment issues with BNHI.

In response, BNHI's manager of the Medical Affairs Section Shen Mao-ting (沈茂庭) yesterday said it was unreasonable to charge the bureau with malfeasance because of a delay in the calculation of the overpayments.

Shen said the bureau had settled the overpayment for clinics in the middle of last year.

The TMA itself requested that the bureau calculate and collect the overpayments to hospitals and clinics after the 2004 SARS allocation for medical institutions was settled, he added.

He said the bureau then kept its promise by demanding the reimbursements after that allocation was settled this April.