Health Insurance Review and Assessment Service (HIRA)
The introduction of more efficient and equitable health insurance system was an important policy objective of the Korean government
Thus, during 1998-2000, the government pushed for the integration of all medical insurance insurers to reduce administrative costs, to collect insurance contributions effectively, to levy contributions equitably, and to improve financial stability of health insurance system. In October 1998, the first stage of the unified system was achieved by integrating the previous fragmented regional medical insurance societies for self-employed, farmers and fishermen with the medical insurance service for government employees and private school employees.
In order to complete this reform, Korean government enacted National Health Insurance Act in February 1999.By this Act, the full integration of all medical insurance societies, including those for company workers, culminated in national health insurance system, the unified health insurance system on 1 July 2000. Health Insurance Review & Assessment Service(HIRA) and National Health Insurance Service(NHIS) were established as a result.
HIRA, succeeding to the medical fees review part of National Federation of Medical Insurance(NFMI) which was dissolved by the insurance integration on 30 June 2000, was established as an independent single agency separated from insurers, providers and other interested parties. HIRA is responsible for reviewing medical fees as well as assessing quality of health care services provided to health insurance beneficiaries. HIRA serves for the assurance of the appropriate health care provision to the people through the fair and objective review and assessment in the partnership with NHIS.
In addition to the routine, HIRA performs researches and studies to improve reviews and assessment, cooperates with relevant domestic and oversea parties, and develops data and information concerning clinical, social and economic implications of health care. HIRA also provides government with the policy-making resources based on its research results.See more