篇名

論全民健保醫療費用請求權時效:最高行政法院108年度判字第255號判決評析【月旦時論】   免費試閱

並列篇名

On the statute of limitation of national health insurance expenses declared by the contracted medical institutions: Comments on the Supreme Administrative Court Judgment No. 255 in 2019

作者
中文摘要

最高行政法院108年度判字第255號判決肯定全民健康保險法第62條第2項之6個月申報期限在性質上屬於醫療費用請求權的消滅時效期間。然考諸立法沿革,法條文義,以及我國時效制度之規範目的,本文主張健保法第62條第2項應係申報作業規定,而非消滅時效期間。特約醫療機構之全民健保醫療費用請求權係公法上的請求權,立法之初乃是訂2年的短期消滅時效期間,惟該規定嗣因違反「絕對法律保留原則」而被司法院大法官宣告無效,故在法律沒有特別規定之下,應回歸行政程序法第131條之規定,請求權時效期間為10年。考諸全民健保醫療費用係採總額預算制度,10年的長期消滅時效期間實不利於費用計算之安定性,故本文主張,應盡速修改健保法,採取2年的短期時效為妥。

英文摘要

The Supreme Administrative Court’s no. 255 Judgment in 2019 held that the 6-months declaration period provided in article 62, item 2 of the National Health Insurance Act is the statute of limitation for the right to claim medical expenses in nature. However, considering the legislative evolution, the literal meaning of the law, and the purpose of the statute of limitation in our legal system, the authors suggest that the content per se of article 62, item 2 of the National Health Insurance Act is rather the time limit for application procedure than the statute of limitations. The right for the contracted medical institutions of the national health insurance to declare medical service expenses belongs to the public law. At the beginning, the right for the contracted medical institutions of the national health insurance to declare medical service expenses, a two-year short-term statute of limitation was enacted, but the rule was declared invalid for violating the “Principle of Legal Reservation” by the Justice of the Constitutional Court. Therefore, without any special provisions, it should be applied to the provisions of Article 131 of the Administrative Procedure Act which provides that the limitation period for the right to declare medical expenses is 10 years. Considering that the National Health Insurance’s medical expenses payments are based on the global budget payment system, the 10-year long-term statute of limitation is not conducive to the stability of the cost calculation. Therefore, this paper advocate that the related law of National Health Insurance Act should be revised as soon as possible, and a two-year short-term statute of limitation would be appropriate.

起訖頁

130-150

出版單位
DOI

10.53106/241553062021100060009  複製DOI  DOI查詢

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