National Health Insurance Service (NHIS) Improves Re-registration Criteria for Special Calculation Exemptions for Rare and Severe Intractable Diseases

[Financial News] The National Health Insurance Service (NHIS) is simplifying the re-registration process for special calculation exemptions for patients with rare and severe intractable diseases.
According to the National Health Insurance Service (NHIS) on the 14th, the criteria for re-registration of special calculation exemptions have been improved and will be implemented starting on the 15th.
The special medical expense exemption is a system designed to reduce the burden of medical costs for patients with rare or severe diseases. The basic application period for the exemption is five years, and if the disease persists and continuous treatment is required after the period ends, the exemption can be extended through re-registration. Previously, there were cases where diagnostic test results, along with a clinical diagnosis, had to be submitted for re-registration.
Considering the characteristics of rare and severe intractable diseases that are difficult to cure, the NHIS has improved the criteria to allow re-registration without separate test results if a patient's condition is clearly confirmed solely by clinical diagnosis. A method to verify existing treatment history is also applied when necessary.
With this improvement, starting September 15, 95 diseases including Kennedy's disease can be re-registered for special medical benefits based solely on 'clinical diagnosis' or 'confirmation of clinical diagnosis and treatment history' without diagnostic testing.
Kennedy's disease is a progressive neuromuscular disorder that develops in adulthood and causes the gradual deterioration of motor neurons and muscles. Previously, genetic testing, electromyography, and nerve conduction tests were required for the re-registration process, but going forward, re-registration will be possible based solely on a clinical diagnosis.
The NHIS previously applied improved standards to nine rare diseases, including Charcot–Marie–Tooth disease, starting in January of this year. Next year, it plans to improve re-registration standards for 146 diseases, including Nezelof syndrome, which require test results during the re-registration process.
NHIS Chairman Kang Cheong-hee stated, "Through the simplification of the re-registration process for special calculation exemptions, the burden of diagnostic testing for patients with rare and severe intractable diseases has been reduced, enabling them to receive necessary treatment and management more stably." He added, "We will continue to pursue the expansion of coverage that provides tangible benefits to the lives of the people."

[email protected] Jeong Sang-hee Reporter