On the 5th, the Life and Non-Life Insurance Association and the Korean Ophthalmological Society announced that they will conduct an awareness and promotional campaign targeting over 1,500 ophthalmology clinics nationwide regarding patient referral, inducement, and mediation practices related to cataract surgery.
[Asia Economy Reporter Oh Hyung-gil] The Life and Non-life Insurance Associations and the Korean Ophthalmological Society announced on the 5th that they will conduct an educational publicity campaign targeting over 1,500 ophthalmology clinics nationwide regarding patient referral, inducement, and mediation related to cataract surgery.
Recently, some minority ophthalmology clinics have been engaging in patient referral, mediation, and inducement for cataract surgery through brokers, and false insurance claims have emerged as a social issue.
Some ophthalmology clinics lure patients enrolled in indemnity health insurance by offering partial refunds of medical fees and excessively charge for non-reimbursable items such as multifocal lenses for vision correction, passing these costs onto indemnity insurance claims.
This not only increases the insurance premium burden on indemnity insurance subscribers but also worsens the health insurance finances and raises the insurance premium burden on the public.
The number of cataract surgery patients increased from 346,184 in 2015 to 459,062 in 2019, growing at an average annual rate of 7.3% over five years.
Recently, insurance companies have requested investigations into some problematic ophthalmology clinics for violations of the Special Act on Insurance Fraud Prevention and the Medical Service Act, and have reported ophthalmology clinics that provided monetary benefits to induce patients to the Fair Trade Commission.
The Korean Ophthalmological Society has submitted petitions to investigative agencies to protect honest medical practitioners from some unethical clinics and has sent letters urging self-purification to ophthalmology clinics nationwide.
An official from the Insurance Association stated, "This has become a well-established educational publicity campaign representing cooperation and coexistence between the life and non-life insurance industries and the medical community," adding, "We will continue to strive for publicity and institutional improvements to establish the proper use of medical culture through collaboration with medical organizations."
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