Page 11 - 2018-19全民健康保險年報

組織沿革 承先啟後
Organization Structure and History
表1-1 中央健康保險署各分區業務組
Table 1-1 The National Health Insurance Administration’s Regional Divisions
業務組別 Division
總計 Total
臺北業務組 Taipei Division 北區業務組Northern Division 中區業務組 Central Division 南區業務組 Southern Division 高屏業務組 Kaoping Division 東區業務組 Eastern Division
保險對象人數 / 特約醫事服務機構
Number of insured / Contracted medical service organizations
23,848,272 / 28,528 8,901,045 / 9,182 3,820,965 / 3,760 4,308,298 / 6,111 3,074,903 / 4,172 3,276,869 / 4,658 466,192 / 645
註1:各主要縣市及金門、澎湖等地，設立7個聯合服務中心及22個聯絡辦公室，為民眾提供在地化服務。 註2:資料統計至2018年6月。
Note 1: Seven united services centers and 22 liaison offices in major cities and counties, and on Kinmen and Penghu, have been
established to provide local services to the public. Note 2: Dated: June 30, 2018.
The National Health Insurance Administration was previously known as the “Bureau of National Health Insurance, Department of Health, Executive Yuan.” When the Bureau was launched in 1995, only roughly 59% of citizens were eligible to participate in the three major occupational medical insurance systems: Labor Insurance, Farmers’ Insurance, and Government Employee Health Insurance. In line with the principles of sustainability and concern for the disadvantaged, these insurance systems were merged and enlarged to become a social insurance system covering all citizens. The BNHI was repositioned in 2010 as an “administrative agency” and renamed as the National Health Insurance Administration in 2013 as part of a government reorganization plan.
The National Health Insurance is a government- implemented social insurance, and has the Ministry of Health and Welfare as its competent authority. The Ministry of Health and Welfare has established the National Health Insurance Committee to
assist with the planning of NHI policies and to supervise the implementation of insurance matters. It also established the National Health Insurance Mediation Committee to handle disputes concerning health insurance. As the insurer, the NHIA bears responsibility for the implementation of health insurance matters, healthcare quality and information management, research and development, and human resource training. Administrative funding needed by NHIA is provided by the central government through a budgetary process.
In order to effectively promote various NHI services, apart from establishing specialized departments and offices (Chart 1-1) in accordance with the nature of specific services and planning the promotion of service measures, the NHIA has established six regional divisions throughout Taiwan (Table 1-1). These directly handle underwriting, insurance premium collection, medical expense review and approval, and the management of
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