1.Controlling the Use of Resources and Reducing Inadequate Medical Treatment:

(1)The penalty for deceitful claims of insurance benefits or medical expenses shall be increased to up to 20 times the amount illegally received. In addition, insurance contracts for contracted medical care institutions involved in significant violations may be suspended for a specified period of time or permanently revoked depending on the severity of the violation.
(2)Counseling services or other medical care assistance shall be arranged for insured individuals involved in frequent repeated hospital visits or overuse of medical resources. Failure to observe these relevant regulations may result in rejection of insurance benefits.
(3)It is clearly stipulated that the Bureau of National Health Insurance shall, on a yearly basis, submit and implement an improvement plan to prevent the inadequate consumption of medical resources as well as ensure their effective utilization. The Bureau is also responsible for reasonably adjusting drug prices each year based on the market transaction status.
(4)Yearly targets for pharmaceutical expenses shall be established. Any expenses in excess of the limit shall be deducted from the medical payment.

2.Increase the Government's Financial Accountability on NHI:

(1)The Act clearly stipulates that the annual funds to be allocated by the government for NHI shall not be lower than 36% of the total premium revenue (after deducting other legal incomes, such as the tobacco health surtax). According to the results of a preliminary estimation, the government will need to further invest roughly NT$10 billion during the first year of implementing the revised National Health Insurance Act. This cost would increase in the future corresponding with the growth of medical spending.
(2)Financial deficits accumulated before the implementation of the revised National Health Insurance Act shall be made up by the government through its annual budgeting process.

3.Establishing a Linking Mechanism between the NHI System Revenues and Expenditures: The NHI Supervisory Committee and NHI Medical Expenditure Negotiation Committee shall be integrated under the new name of "The NHI Supervisory Commission". The Commission shall be responsible for the review of significant financial issues on an integrated basis, including premium rates, benefits scope, and the total amount of medical payments for the year, etc. The purpose is to establish a proper linking mechanism between revenues and expenditures, thereby ensuring sound management of the NHI financial system.

4.Ensuring a Stable Financial Income; Expanding the NHI Premium Calculation Base; Reinforcing the Spirit of "Ability to Pay"; Relieving Financial Burdens of Salaried Workers:

(1)Bonuses, stock dividends, business execution income, rental income, interest income, income from part-time jobs, etc. will be included in the basis for calculating supplementary premiums for the insured. This approach will also lead to a reasonable reduction of the existing premium rate and lessen the financial burden on the general public.
(2)A supplementary premium shall be collected from employers based on the difference between the total monthly salary paid by the employer and the sum of monthly claimed insured amount for the employees.

5.Adopting Diversified Payment Methods to Invest in the Health of the People: The principle for payment shall be "Treatments of diseases in the same Diagnosis Related Group (DRG) shall receive the same amount of NHI payment". The "Capitation Payment Methodology" shall also be incorporated into the system and PQRS (Physical Quality and Responsibility System) shall be implemented. These approaches are adopted to invest in the well-being of the people.

6.Keeping Important Information Transparent and  Encouraging Public Participation:

(1)It is clearly stipulated in the Act that the following information should be disclosed publicly: meeting records on major NHI-related issues and interests of the participating members; financial reports; medical quality information and ratio of insured beds of the contracted medical care institutions; as well as the number of insured beds and major violations of contracted hospitals, etc.
(2)Representatives of premium payers shall be invited to participate in all important review/determination processes, including premium rates, benefits scope, total amount of medical payments for the year, fee schedule for medical services and drugs, facilitation of the Global Budget Payment System, and special medical material for "Balanced Billing", etc. If necessary, the NHI Supervisory Commission shall also organize relevant citizen participation activities to obtain feedback from the general public.

7.Protecting the Rights and Interests of the Disadvantaged by Reducing Copayments:

(1)To protect the rights of the disadvantaged receiving medical care, the Insurer shall not suspend the benefit coverage (i.e., to suspend the NHI card) against the following people as a result of delayed payments of the premium or overdue penalties: individuals with financial difficulties, victims of domestic violence who are under protection, and people who have no economic ability and refuse to pay the premium.
(2)Reduction or exemption of copayment shall be granted for those in areas with shortages of medical resources.
(3)The percentage of copayment for home nursing care shall be reduced to 5%.

8.Stricter Restrictions Shall Be Enforced on Access to NHI Benefits by New Residents and Individuals Who Have Stayed Overseas for a Long Period of Time:

(1)Rather than allowing immediate access to the NHI benefits by "any previous NHI enrollment records " upon their return to Taiwan, the regulations shall be amended to allow access to NHI only when the applicant has "ever enrolled in the NHI within the past two years".
(2)For the following applicants, access to the NHI benefits shall only be allowed when the applicant has lived or completed household registration in the country for more than six months: applicants who have returned to Taiwan and completed/regained household registration for the first time, or applicants who are holding resident certificates for living in Taiwan. The rule shall not apply to applicants who are employed in the country, government employees working overseas, or their families.

9.Convicts Are Now Covered by the NHI: The purpose of this approach is to fully realize the spirit of the NHI system in improving the health of all people and to safeguard the basic human right of convicts to stay healthy.