Agreement aims to plug fiscal leaks in public and private insurance, easing the premium burden on the public

Health Insurance Review and Assessment Service President Hong Seung-kwon (left) and Financial Supervisory Service Director General Lee Chan-jin pose for a photo after signing an MOU on preventing improper billing by medical institutions and eradicating insurance fraud at the FSS headquarters in Yeouido, Seoul, on Wednesday. [Health Insurance Review and Assessment Service]
Health Insurance Review and Assessment Service President Hong Seung-kwon (left) and Financial Supervisory Service Director General Lee Chan-jin pose for a photo after signing an MOU on preventing improper billing by medical institutions and eradicating insurance fraud at the FSS headquarters in Yeouido, Seoul, on Wednesday. [Health Insurance Review and Assessment Service]

The Health Insurance Review and Assessment Service and the Financial Supervisory Service signed an MOU on Wednesday at the FSS headquarters in Yeouido, Seoul, to strengthen their capacity to respond to insurance fraud and improper billing by medical institutions and to prevent fiscal leaks in both public and private insurance.

The agreement aims to link the two agencies' data and expertise to enable faster and more effective responses to insurance fraud and improper billing, while supporting the sound operation of public and private insurance schemes.

Under the MOU, the two agencies plan to cooperate on sharing information to detect medical institutions suspected of insurance fraud and improper billing, coordinating efforts to prevent fiscal leaks in public and private insurance, and exchanging expertise to improve operational efficiency and raise public awareness.

In line with the agreement, the two agencies will expand information sharing on medical institutions suspected of fraud or improper billing. They plan to make faster use of relevant data, cooperate on analyzing billing records in connection with fraud investigations, and improve the overall effectiveness of probes and inspections.

The agencies will also use data related to indemnity insurance to build a close coordination framework for detecting and responding promptly to irregularities in insurance claims and medical service use, with the goal of preventing fiscal leaks across public and private insurance.

Alongside this, the two agencies plan to strengthen the stability of auto insurance reviews and prevent insurance payment leakage, while expanding personnel exchanges and public outreach to improve operational expertise and efficiency.

"Insurance fraud and improper billing are directly linked to the premium burden borne by the public, which is why information sharing and close cooperation between our two agencies are so important," HIRA President Hong Seung-kwon said. "Through this agreement, we will work to create a medical and insurance service environment where the public can feel secure."


thlee@heraldcorp.com