Non-benefit management policy council guidelines prepared... Reflected in actual loss dispute resolution standards

Non-benefit management policy council guidelines prepared... Reflected in actual loss dispute resolution standards

(Seoul = Yonhap News) Reporter Kim Young-shin = The Ministry of Health and Welfare announced on the 17th that it held the 'Non-benefit Management Policy Council', a discussion body for appropriate management of non-benefit, and prepared guidelines for autonomous correction of extracorporeal shock wave treatment.

According to the guidelines, the number of extracorporeal shock wave treatments is recommended up to 6 times per area and up to 12 times per year. If the number of cases is exceeded, actual cost medical insurance is excluded.

The indications for which extracorporeal shock wave treatment is expected to be effective are limited to diseases in seven areas, including the shoulder joint (calcific tendinitis, rotator cuff tendonosis), elbow joint (lateral epicondylitis, medial epicondylitis), hip joint (greater trochanter pain syndrome), knee joint (patellar tendinitis), ankle joint (Achilles tendonitis), foot (plantar fasciitis), and spine (cervical and lumbar myofascial pain syndrome).

Extracorporeal shock wave therapy for other diseases can be performed at the doctor's discretion. However, please inform them in advance that actual loss insurance coverage may be limited.

The principle of treatment is to administer at least 2,000 strokes per treatment, once a week.

The Ministry of Health and Welfare said that the guidelines for extracorporeal shock wave treatment were prepared through discussions at related academic societies led by the Korean Medical Association. This is a method in which the Korean Medical Association prepares guidelines for appropriate non-reimbursed treatment and encourages autonomous management of medical institutions.

Guidelines are provided to medical institutions and consumers in accordance with the implementation of management benefits. We decided to provide information so that when you search for extracorporeal shock waves through Naver, you can check non-reimbursement prices and safety and effectiveness evaluation results.

The Financial Supervisory Service has decided to promote a plan to reflect this guideline in the actual cost medical insurance dispute resolution standards and utilize it when adjusting insurance payment disputes.

In addition, we plan to provide guidance to actual medical insurance subscribers to help consumers choose the appropriate treatment method.

Ko Hyeong-woo, essential medical support officer at the Ministry of Health and Welfare, said, "We plan to establish standardized guidelines starting with non-covered items that are frequently used, such as extracorporeal shock wave therapy," and added, "We will monitor prices and usage and create an environment where people can receive appropriate treatment with greater peace of mind."