德國健康保險「聯邦醫療服務基本協定」的法律性質為公法人之間所簽訂的行政契約，並成為共同自治行政性的基本規範。該行政契約由聯邦健保醫師公會 (Die Kassenaerztliche Bundesvereinigung BKV) 以及聯邦健保保險人協會 ( Bundesverband der Krankenkassen ) 簽訂，分別對雙方當事人及其所屬的各會員發生拘束力，並為其公法上的義務。「聯邦醫療服務基本協定」的功能有二，其一為公法義務的轉移。其二則為共同自治的形成，為這項傳統色彩頗濃的專業自治，確立法源的基礎以及自主權力發揮的空間。本文並分析德國健康保險如何在行政契約的架構下，進行單一支付標準的協商以及爭議的調解。與此相較，我國健保合約同為行政契約，但是功能僅為公法義務的轉移，在目前中央行政的特性下，自治行政似乎並非我國健保合約的制度功能。此外，我國健保制度保險人與醫事服務機構間形成「機構簽約」以及「機構管理」的模式，也不同於德國健保制度的「公法人簽約」以及具體規範個別醫療行為的模式，如果健保法令及特約的規範意旨與效果，不能具體直接的規範所有醫事服務機構內個別的醫療行為，是否表示我國健保特約在制度層面必須重作檢討，思考如何避免「機構簽約」以及「機構管理」的盲點，進而有效的落實健保法令的目的，具體的規範個別醫療行為。

The focus of this project located in the Analysis of the Bundes­mantelvertrag under the German Health Care Insurance Law. The enrollee receives medical service from the health care provider in turn receives payments from the Krankenkasse for services rendered under the both Medical Service Contract: Bundesmantelvertrag and Gesamtvertrag which legal nature schall be administrative contract. According to the Gesamtvertrag receive the individual health care provider Honorar from his Organisation (as a Membership). The both administrative contracts and other autonome Regulations, such as Richtlinien, Satzungen, are the most important regulatory framework which legal nature schall be autonome Regulation. The aim of the Bundesmantelvertrag shall provide the legal base for administrative autonomy, further transfer this administrative contract the legal duties of the Krankenkasse which provide national health care on the health care provider. This Transfereffect is the same fundemental funktion both in German and the Medical Service Contract in Taiwan. The funkional difference between both sides will be systematisch studied. In the light of German experience, the result of this project could be useful and be transferred if necessary for the legal practice of the National Health Insurance AcA in Taiwan. The practiced Global Budget Payment in many Medical Service sections has indeed oper­ated from the German Model.