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題名:論全民健保與政府資訊公開--以健保審查醫師姓名之公開為例
書刊名:財產法暨經濟法
作者:林家祺 引用關係
作者(外文):Lin, Chia-chi
出版日期:2014
卷期:37
頁次:頁171-207
主題關鍵詞:資訊公開全民健保審查醫師醫療費用Freedom of informationNational health insurancePhysicians of review committeeMedical expenses
原始連結:連回原系統網址new window
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  • 共同引用共同引用:61
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人民之資訊權從早期被認為僅有反射利益,迄今已被認為具有公權利之性質,人民對政府享有該公權利,世界各主要國家為落實此一人民之權利,多已制定政府資訊公開之相關法律,我國之政府資訊公開法於2005年12月28日公布實施,該法之主要目的亦在於落實人民對國家的「政府資訊公開請求權」,國家依據該法原則上應公開政府資訊,僅在例外時基於公共利益或個人隱私之考量,且符合比例原則之限制下,得以不公開資訊。在健保制度中,全民健康保險署有審核特約醫療院所提報醫療給付之職權,而健保署復將此專業之審查,透過一定之程序仍委由醫師負責審查,此負責審查醫療費用之醫師即本文題目所敘及之審查醫師。由於審查之結果大多是刪除部分申報費用,被刪除醫療費用之醫療院所不服,除就刪除部分會提出救濟外,另亦有要求健保署公開審查核刪醫師姓名,甚至單獨為公告審查醫師姓名提出爭訟,本文將從具體案例為發端,探討此類爭議醫療院所是否真有要求公開審查醫師姓名之資訊請求權。
Citizens' rights to information have been considered to only have reflective interest in the early years to embrace the characteristics of public rights at present. Citizens have the public rights from the government. In order to put the rights of citizens into effect, major countries around the world have made laws related to freedom of government information. The Freedom of Government Information Law in Taiwan was announced to come into effect on the 28th of December 2005, which also aimed to implement citizens' rights of requesting for providing government information. In principle, government information shall be made available to the public in accordance with the Law, except where it is necessary for public interest and personal privacy, the information is restricted from making available to the public or provision. In the health care system, National Health Insurance Administration has the power to review the medical claims by contracted medical care institutions. However, National Health Insurance Administration commissions such a professional review to physicians through certain procedures. The physicians of review committee, as referred to in the title of this article, are those who are responsible for reviewing medical claims. Results of such reviews tended to decline parts of the medical claims, and those medical care institutions whose claims were partially declined were not happy about the results. Accordingly, not only did they apply for relief compensation for the claims declined, they also requested that the National Health Insurance Administration publicly review and delete the physicians' name from the review committee list. They even solely filed a lawsuit for making the names of physicians of review committee publicly available. This article draws upon concrete cases to discuss whether or not such medical care institutions have the rights of requesting for providing the names of physicians of review committee.
期刊論文
1.林明鏘(20000700)。資訊公開與行政程序--評政府資訊公開法與國家機密保護法草案。月旦法學,62,46-57。new window  延伸查詢new window
2.陳愛娥(20000700)。政府資訊公開法制的憲法基礎。月旦法學,62,24-35。new window  延伸查詢new window
3.林明鏘、林子儀(19940700)。公務機密與行政資訊公開。中國比較法學會學報,15,145-217。new window  延伸查詢new window
4.錢建文(2013)。健保審査與醫學倫理--向全國健保審査醫師進言。台灣醫界雜誌,56(7),34-35。  延伸查詢new window
5.江嘉琪(20041200)。行政契約關係與行政處分之容許性。律師雜誌,303,60-70。new window  延伸查詢new window
6.范江真微(20010500)。政府資訊公開與個人隱私之保護。法令月刊,52(5),29-42。new window  延伸查詢new window
7.Maunz, Theodor、Dürig, Günter。GG Kommentar。JR,69,444。  new window
8.李震山(20000700)。論人民要求政府公開資訊之權利與落實。月旦法學,62,35-46。new window  延伸查詢new window
9.王澤鑑(20070800)。人格權保護的課題與展望(3)--人格權的具體化及保護範圍(6):隱私權。臺灣本土法學雜誌,97,27-50。  延伸查詢new window
10.林明鏘(20040100)。行政契約與行政處分--評最高行政法院八十八年度判字第三八三七號判決。國立臺灣大學法學論叢,33(1),93-130。new window  延伸查詢new window
圖書
1.Schlette, Volker(2000)。Die Verwaltung als Vertragspartner。Mohr Siebeck。  new window
2.Druschel(1999)。Die Verwaltungsaktsbefiignis。  new window
3.Georgios, Trantas(1998)。Akteneinsicht und Geheimhaltung im Verwaltungsrecht。  new window
4.法治斌、董保城(2012)。憲法新論。元照出版有限公司。  延伸查詢new window
5.李惠宗(20060900)。憲法要義。臺北市:月旦。  延伸查詢new window
6.陳敏(2003)。行政法總論。臺北:陳敏。  延伸查詢new window
7.李惠宗(2012)。行政法要義。臺北:元照。  延伸查詢new window
8.林鍚堯(2006)。行政法要義。元照。  延伸查詢new window
圖書論文
1.林明鏘(2006)。全民健保特約醫事合約問題之研究。行政契約法研究。台北:翰蘆。  延伸查詢new window
2.李震山(2007)。資訊權--兼論監視錄影器設置之法律問題。多元、寬容與人權保障--以憲法未列舉權之保障為中心。台北:元照。  延伸查詢new window
3.法治斌(199309)。知的權利。人權保障與釋憲法制,憲法專論。台北市:月旦出版公司。  延伸查詢new window
4.林三欽(2010)。政府資訊公開法之執行、保障與救濟制度。資訊法制、土地規劃與損失補償之新趨勢。  延伸查詢new window
5.黃錦堂(2010)。政府資訊公開法的立法目的、基本原則和理論基礎。資訊法制、土地規劃與損失補償之新趨勢。  延伸查詢new window
6.葉俊榮(2010)。超越資訊公開--當代資訊法制之挑戰與發展趨勢。資訊法制、土地規劃與損失補償之新趨。  延伸查詢new window
7.熊愛卿(2010)。値得保護的秘密性--試論作爲政府資訊公開例外之限制。資訊法制、土地規劃與損失補償之新趨勢。  延伸查詢new window
8.李震山(1997)。論資訊自決權。現代國家與憲法--李鴻禧教授六秩華誕祝賀論文集。台北:元照出版社。  延伸查詢new window
9.湯德宗(2007)。政府資訊公開請求權入憲之研究。憲法解釋之理論與實務。中央研究院法律學研究所籌備處。  延伸查詢new window
 
 
 
 
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