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History

Korean government prepared health insurance reform to change the health insurance system from being managed by multi-insurers to single insurer. According to this reform, National Health Insurance Act was enacted in February 1999. By this Act, HIRA was established in July 2000.

history
2013 Entrusted with auto insurance review
2008 Entrusted with claim review for Veterans Hospitals
2005 Entrusted with claims review on government-funded medical service for vulnerable social groups
2000 Implementation of Health Insurance Review & Assessment Service(HIRA), inheriting claims review from Health Insurance Union
Establishment of quality assessment of healthcare benefit
1999 Legislation of the National Health Insurance Act
1988 Official tittle was changed to National Federation of Medical Insurance(NFMI)
1981 Official tittle was changed back to Federation of Korean Medical Insurance Societies
1981 FKMIS was reorganized as a special public corporation, Central Federation of Medical Insurance Societies
1977 FKMIS became an affiliation member of international Social Security Association(ISSA)
1977 FKMIS was formed
1976 Establishment of Medical Insurance Union
1971 Amendment of the Medical Insurance Act laid groundwork for the establishment of the Federation of Korean Medical Insurance Societies(FKMIS) as an Insurer`s organization

Background

More efficient and equitable health insurance system

The introduction of more efficient and equitable health insurance system was an important policy objective of the Korean government

Thus, during 1998-2000, the government pushed for the integration of all medical insurance insurers to reduce administrative costs, to collect insurance contributions effectively, to levy contributions equitably, and to improve financial stability of health insurance system. In October 1998, the first stage of the unified system was achieved by integrating the previous fragmented regional medical insurance societies for self-employed, farmers and fishermen with the medical insurance service for government employees and private school employees.
In order to complete this reform, Korean government enacted National Health Insurance Act in February 1999.By this Act, the full integration of all medical insurance societies, including those for company workers, culminated in national health insurance system, the unified health insurance system on 1 July 2000. Health Insurance Review & Assessment Service(HIRA) and National Health Insurance Service(NHIS) were established as a result.

HIRA, succeeding to the medical fees review part of National Federation of Medical Insurance(NFMI) which was dissolved by the insurance integration on 30 June 2000, was established as an independent single agency separated from insurers, providers and other interested parties. HIRA is responsible for reviewing medical fees as well as assessing quality of health care services provided to health insurance beneficiaries. HIRA serves for the assurance of the appropriate health care provision to the people through the fair and objective review and assessment in the partnership with NHIS.
In addition to the routine, HIRA performs researches and studies to improve reviews and assessment, cooperates with relevant domestic and oversea parties, and develops data and information concerning clinical, social and economic implications of health care. HIRA also provides government with the policy-making resources based on its research results.