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HIRA is dedicated to maintaining and improving national health by fulfilling its commitment to health care review and quality assessment. We will be an organization that is recognized and respected by all the physicians, patients, partners and people in the country.


HIRA, succeeding to the medical claims review part of National Federation of Medical Insurance, was established to combine medical fees review and health care assessment as an independent single agency separated from insurers, providers and other interested parties. HIRA is responsible for reviewing medical fees and evaluating whether health care services are medically necessary and delivered to beneficiaries at appropriate level and cost.
In addition to reviewing and evaluating health care services provided to beneficiaries, HIRA also performs a number of activities such as supporting to establish and revise the standards of health care and the fee schedules, managing the information about medical care institutions, implementing the quality improvement initiatives for the health care services, and conducting various researches and preparing policy proposals, etc.

HIRA?? primary missions are the following activities specified in the National Health Insurance Act:

  • conducting medical fees review
  • evaluating the appropriateness of medical benefits
  • developing the standards for review and evaluation
  • dealing with appeals concerning review and evaluation
  • conducting researches on the subjects related with review and evaluation, and cooperating with other countries or international organizations
  • reviewing and evaluating health care entrusted by other laws and regulations (Medical Aid, Veterans Health Care, etc)
  • conducting additional activities which are approved by the Minister of MOHW as being necessary for health insurance
  • reviewing medical benefits paid in cash instead of benefits-in-kind
  • developing and distributing software program or automated system related to medical fees claim
  • conducting education and public relation related to HIRA?? activities
  • managing assets and properties related to job execution
  • conducting other activities to achieve the purpose of HIRA