職業傷病診治醫療機構認可管理補助及職業傷病通報辦法

These Regulations are drawn upon in accordance with Paragraph 5 of Article 73 of the Labor Occupational Accident Insurance and Protection Act (hereinafter referred to as the Act).

1The terminologies used in these regulations are as follows:

21. Accredited Medical Institution: refers to a medical institution that provides integrated services for the diagnosis and treatment of occupational injuries and occupational injuries for workers in occupational accidents and handles reporting of occupational injuries and diseases in accordance with Paragraph 1 of Article 73 of this Act, and has been approved by the central competent authority.

32. Network Hospital: refers to a medical institution that has set up occupational medicine outpatient clinics and has joined the regional occupational injury and disease diagnosis and treatment service network established by an accredited medical institution in accordance with Item 3 of Paragraph 1 of Article 73 of this Act.

43. Suspected occupational disease: refers to the fact that the causal relationship between the disease and work cannot be ruled out based on the diagnosis of the disease, the work experience of the patient, and relevant epidemiological evidence, and based on the available data, the possibility or contribution of the occupation causing the disease does not reach fifty percent.

54. Reporting of Occupational Injury and Disease: Refers to the act of registering the information of occupational diseases, suspected occupational diseases or occupational injury cases in the occupational injury and disease reporting system of the central competent authority.

1A medical institution with a business license that meets the following conditions may apply for an accredited medical institution:

21. It is a contracting medical service institution for the National Health Insurance.

32. It has been evaluated as a regional hospital or above by the hospital evaluation of the central health and welfare authority, and the teaching hospital has passed the evaluation, and has at least the occupational medicine, rehabilitation, orthopedics, neurology, thoracic, dermatology, internal medicine, surgery, Ophthalmology, ENT, psychiatry, radiology and pathology and other medical departments.

43. Establish an occupational injury and disease medical committee or group at the hospital level of a medical institution to coordinate and integrate medical resources in the hospital to provide integrated services for occupational injuries and diseases across departments.

54. There is an integrated service center for the diagnosis and treatment of occupational injuries and diseases, and the following personnel are employed:

6(1) More than two full-time specialist physicians in occupational medicine, one of whom is the presiding physician.

7(2) More than four occupational injury and disease case specialists, one of whom may be employed as an occupational injury and disease case manager to assist the presiding physician in handling the overall management of Article 15.

The presiding physician of the integrated service center for occupational injury and disease diagnosis and treatment specified in Item 1 of Paragraph 4 of the preceding article shall be a specialist in occupational medicine and have more than three years of work experience in occupational injury and disease diagnosis and treatment.

1A Occupational injury and disease case specialists specified in Item 2 of Paragraph 4 of Article 3 shall have the following qualifications:

21. Graduated from a college or above in medicine, nursing, occupational therapy, physiotherapy and other related medical disciplines, public health, occupational health, social work or psychology.

32. More than one year of work experience in occupational injury and disease case management or labor health services.

4Those who graduated from junior college or above and have more than three years of work experience in occupational injury and disease case management are not subject to the restrictions stipulated in the first paragraph of the preceding paragraph.

5The medical institution that applies for accreditation in accordance of Article 3 employs four or more occupational injury and disease case specialists, one of them is exempt from the relevant work experience requirements in Item 2 of Paragraph 1.

6The occupational injury and disease case manager specified in Item 2 of Paragraph 4 of Article 3 shall have the qualifications specified in Item 1 of Paragraph 1, and more than two years of relevant work experience in the management of occupational injury and disease cases.

Occupational therapists or physical therapists specified in Item 1 of Paragraph 5 of Article 3, shall have more than six months of work experience related to functional rehabilitation or occupational rehabilitation for occupationally injured and disease labors.

1The central competent authority may periodically announce the acceptance of applications for approval of medical institutions.

2Those who apply for the approval of accredited medical institutions in accordance with the provisions of Article 3 shall have the following documents and submit them to the central competent authority:

31. Application Form.

42. A copy of the business license of the medical institution.

53. Photocopies of supporting documents that meet the requirements of Articles 3 to the preceding article.

64. service plan.

75. Other documents stipulated by the central competent authority.

8The service plan stipulated in Paragraph 4 of the preceding provision shall specify the tasks, composition and operation procedures of the following organizations:

9

1In order to process the approval of medical institutions, the central competent authority shall form a review team for the approval of medical institutions (hereinafter referred to as the Review Team) with the following tasks:

21. Consultation on the approval policy of medical institutions.

32. Matters subject to consideration by medical institutions.

43. Review matters of the approved qualification revocation or annulment for medical institutions.

1The Review Team shall consist of seven to eleven members, and the central competent authority shall designate one representative from the agency as the convener; the remaining members shall be selected and hired by the central competent authority for professionals in occupational medicine, public health, occupational safety health, and law.

2The term of the team members referred to in the preceding paragraph is three-year, and they may be re-appointed upon expiration; if vacancies arise during the term, they may be re-appointed, and their term will expire on the date of expiry of the original term.

3For the members of Paragraph 1, the ratio of any gender shall not be less than one-third.

1At the meeting of the Review Team, the convener shall be the chairman; if the convener fails to attend, one member shall be elected as the chairman by the members present.

2The meeting of the Review Team shall be attended by more than half of all the members before the meeting can be held, and its decision shall be approved by more than half of the members present.

1The withdrawal of committee members or relevant personnel participating in the deliberation, and the prohibition of contact outside the procedure, shall be handled in accordance with the provisions of Articles 32, 33, and 47 of the Administrative Procedure Act.

2The personnel referred to in the preceding paragraph shall keep confidential the content of the deliberation case and relevant discussion matters.

1When a medical institution submits an application according to Article 7, the central competent authority shall review the required documents and qualifications in accordance with the provisions of these Regulations; those approved by the Review Team shall be approved by the central competent authority and announced.

2In addition to the qualifications specified in Article 3, the following matters shall be considered when the Review Team in the preceding paragraph is deliberating:

31. Regional service needs and regional balance of municipalities and counties (cities).

42. The capacity and quality of integrated services for the diagnosis and treatment of occupational injuries and diseases in the medical institutions under review.

5During the validity period of the approval, if the application materials are changed, the approved medical institution shall report to the central competent authority for reference.

6An accredited medical institution that has been approved by the municipal or county (city) competent health authority to change its business license number shall re-apply for approval to the central competent authority without being limited by the application period of Paragraph 1 of Article 7; Its approval procedure shall follow the Paragraph 1 and Paragraph 2.

1The approval of an accredited medical institution is valid for a maximum period of three years.

2Accredited medical institutions that plan to continue the process after the expiration of the validity period of the previous approval, and the original approval conditions have not changed, should provide the documents in Paragraph 2 of Article 7 and participate in the Article 17 training by the 90 days before the expiration of the validity period of approval. Then apply for the approval renewal application.

1The matters that an accredited medical institution should handle are as follows:

21. Setting up occupational injury and disease service windows.

32. Open occupational injury and disease clinics more than five times a week. However, medical institutions in Hualien County, Taitung County, Penghu County, Kinmen County, and Lianjiang County open more than four outpatient clinics per week for occupational injuries.

43. Provide diagnosis and treatment of workers with occupational injuries and diseases; when necessary, may prepare occupational disease assessment reports.

54. Provide referrals for occupational injury and illnesses for medical rehabilitation and other departments.

65. Provide social rehabilitation and functional rehabilitation services or referrals for occupational injury and disease labors.

76. To provide suggestions on the evaluation and methods of resumption or assignment of workers with occupational injuries and diseases.

87. Provide occupational injury and disease case management services and follow-up and referral of subsequent work resumption.

1The presiding physician of the Occupational Injury and Disease Diagnosis and Treatment Integrated Service Center specified in Item 1 of Paragraph 4 of Article 3 shall be responsible for the overall management of the following matters:

21. Diagnosis and treatment of occupational injuries and diseases.

32. On-site visit and evaluation of suspected occupational diseases.

43. Proposals for labor resumption or assignment.

54. Reporting of occupational injuries and diseases.

65. Business promotion and performance management of occupational injury and disease integration services.

76. Promotion, establishment and connection of network hospitals.

87. The personnel, business management, and usage of subsidy funds of the Occupational Injury and Disease Diagnosis and Treatment Integrated Service Center.

Occupational injury and disease case specialists specified in Item 2 of Paragraph 4 of Article 3 shall be exclusively responsible for handling the various services of the Occupational Injury and Disease Diagnosis and Treatment Integration Service Center, and shall not concurrently undertake work unrelated to Article 14.

Accredited medical institutions shall have occupational injury and disease case specialists listed in Item 2 of Paragraph 4 of Article 3 participate in the on-the-job training courses for occupational injury and disease diagnosis and treatment services provided by the central competent authority, for not less than 12 hours per year.

1Accredited medical institutions should guide network hospitals to establish mechanisms and improve quality on the following matters:

21. Diagnosis and treatment of occupational injuries and diseases.

32. Reporting of occupational injuries and diseases.

43. Establish referral of different departments and follow-up case tracking.

54. On-site visit and evaluation of suspected occupational diseases.

65. Other occupational injury and disease service matters.

1When a specialist in occupational medicine assessment is necessary, an accredited medical institution may integrate the functional rehabilitation professional institution specified in Article 66 of this Act to assist occupational accident labors or employers in applying for and formulating work resumption plans.

2In order to assist occupational accident workers in returning to work, accredited medical institutions should cooperate with their functional rehabilitation units and other functional rehabilitation professional institutions to make two-way referrals for occupational injury and disease cases.

1Accredited medical institutions should regularly track occupational injury and disease cases. For cases that require resumption of work, they should be traced to three months after resumption of work, except in one of the following circumstances:

21. Unable to return to work after being assessed by a specialist in the Department of Occupational Medicine.

32. After three months of tracking, it is still impossible to resume work or there is difficulty in resuming work.

4The rate of follow-up of the cases referred to in the preceding paragraph shall be over 70% by accredited medical institutions; for cases where there is no willingness to resume work, the reasons shall be recorded.

5For those who are unable to resume work or have difficulties in resuming work as specified in Item 2 of Paragraph 1, accredited medical institutions may refer them to the vocational rehabilitation and employment service system according to the situation and needs of the individual case.

Occupational medicine specialists in accredited medical institutions and their network hospitals shall conduct on-the-spot visits for suspected occupational diseases according to individual circumstances; when necessary, they may report to the central competent authority to coordinate the labor inspection agency to dispatch personnel for assistance.

1hen the central competent authority deems it necessary, it may request an accredited medical institution to prepare an occupational disease assessment report or an occupational medical evidence investigation report, and the accredited medical institution shall cooperate.

2The report referred to in the preceding paragraph shall be prepared by an accredited medical institution based on the results of on-site visits of suspected occupational diseases and the investigation data of the labor inspection institution.

3If the preparation of the report in Paragraph 1 involves suspected occupational disease clusters, on-site visits to outlying islands, remote areas, or other special circumstances, the central competent authority may designate an accredited medical institution to handle the matter with a project.

When it is necessary for the insurer to review occupational diseases, it may contact an accredited medical institution to provide an occupational disease assessment report, and the accredited medical institution shall cooperate.

Accredited medical institutions shall provide appropriate medical assistance when the insured applies for subsidies or allowances in accordance with the provisions of Paragraph 1 of Article 78 of this Law, and shall provide appropriate medical assistance when he or she needs to seek medical treatment; if it is diagnosed that it is an occupational disease, an occupational disease assessment report shall be made.

In order to review the application for the health follow-up examination specified in Paragraph 2 of Article 63 of this Act, if the insurer finds that there is any doubt about the eligibility, the insurer may contact an accredited medical institution to assist in the evaluation.

Accredited medical institutions shall collect, process and utilize data on occupational injury and disease accidents cases in accordance with the relevant provisions of the Personal Data Protection Act.

Accredited medical institutions should formulate document control procedures to standardize the filing and preservation of occupational disease assessment reports, occupational medical evidence investigation reports, visit records, and service records and other related documents, with a retention period of at least seven years.

1Accredited medical institutions that provide integrated services for the diagnosis and treatment of occupational accidents and occupational injuries and diseases and notification of occupational injuries and diseases, and achieve the annual basic service volume in the following items, may apply to the central competent authority for basic service volume subsidy; the subsidy standards are shown in Appendix 1:

21. Not less than 180 occupational injury reports.

32. There are more than 90 reports of occupational diseases and suspected occupational diseases in total, of which more than 60 are occupational diseases.

43. Occupational disease assessment reports, occupational medical evidence investigation reports, and assessment results in Article 25, totaling more than 40 reports.

54. Open occupational injury and disease clinics more than five times a week, with more than 130 persons seeking medical treatment each year, and more than 500 patients seeking medical treatment.

6The occupational injury specified in Item 1 of the preceding paragraph is an occupational injury or deemed occupational injury as stipulated in the occupational injury and disease review criteria for labor occupational accident insurance, and a specialist in the occupational medicine department of an accredited medical institution provides services related to occupational injury and disease, and has a service record.

1An accredited medical institution that fails to meet the annual basic service volume specified in the first paragraph of the preceding article may still apply for the subsidy specified in the first paragraph of the preceding article. However, the central competent authority may reduce the subsidy amount in proportion to the actual service volume.

2At the end of the year, the Accredited Medical Institutions have not achieved the annual basic service volume specified in the preceding paragraphs, except for those whose accreditation period is less than one year, the central competent authority shall order them to improve within a time limit. However, medical institutions in Hualien County, Taitung County, Penghu County, Kinmen County, and Lienjiang County are exempted from the restriction.

1The accredited medical institutions that handle the following items may apply to the central competent authority for additional subsidy; the subsidy standards are shown in Appendix II:

21. Handling occupational disease notification exceeding the number specified in Item 2 of Paragraph 1 of Article 28.

32. In-hospital referral of occupational injury and disease cases.

43. Handle on-site visits for suspected occupational diseases and complete the visit report. However, no subsidy will be given to visitors of on-site health services.

54. Occupational disease is diagnosed after the visit mentioned in the preceding paragraph, and an occupational disease assessment report is completed.

65. Guiding network hospitals to handle the matters stipulated in Article 18.

76. The integrated service center for the diagnosis and treatment of occupational injuries and diseases employs a presiding physician to handle the matters stipulated in Article 15.

87. Handle occupational disease investigation and assessment cases with a project designated by the central competent authority in accordance with Paragraph 3 of Article 22, and prepare reports.

1Accredited medical institutions should submit the service results and apply for subsidies from the central competent authority during the following periods:

21. Basic service volume subsidy specified in Paragraph 1 of Article 28:

3(1) If the application is processed from January to June each year, it shall be submitted in July of the current year.

4(2) If the application is processed from July to December each year, it shall be submitted in January of the next year.

52. Additional subsidies specified in Paragraph 1 of the preceding article shall be submitted in January of the next year.

6When the central competent authority accepts the application of an accredited medical institution in the preceding paragraph, it shall allocate funds after review and approval in accordance with regulations.

7For an accredited medical institution accredited for the first time, the central competent authority may, within one month from the beginning of the valid period of accreditation, first subsidize half of the subsidy amount for the basic service volume. Accredited Medical Institutions that fail to comply with the provisions of the preceding 3 articles or the preceding 3 paragraphs shall return the subsidy paid in excess or by mistake.

1Network hospitals may apply for subsidies from the central competent authority for setting up occupational injury and disease clinics and handling occupational disease notification.

2The central competent authority may, at its discretion, relax the eligibility requirements for the establishment of network hospitals in Penghu County, Kinmen County, Lienjiang County and other outlying islands, and may add subsidy fees.

1The central competent authority may conduct inspections on the personnel qualifications and service conditions of Accredited Medical Institutions.

2An Accredited Medical Institution shall not evade, obstruct or refuse the inspection in the preceding paragraph.

3As a result of the inspection in Paragraph 1, if the Accredited Medical Institution has issues that should be improved, the central competent authority shall order it to improve within a time limit.

The central competent authority may conduct an evaluation on the service situation and quality of the diagnosis and treatment of occupational injuries and diseases handled by an Accredited Medical Institution, and publicize the evaluation results.

1If an Accredited Medical Institution falls under any of the following circumstances, the central competent authority may revoke or abolish its approval according to the seriousness of the circumstances after deliberation and approval by the Review Team:

21. The application document is false.

32. The specialist physician of the Occupational Medicine Department has not personally treated the patient, failed to handle the notification of occupational injury or disease, or the notification is false.

43. Avoiding, hindering or refusing tracking, visiting or checking by the central competent authorities.

54. According to the evaluation results of the preceding article, the service situation or quality is poor.

65. Violation of medical regulations.

76. The central competent authority ordered the improvement within a time limit in accordance with the provisions of Paragraph 2 of Article 29, but no improvement was made within the time limit.

87. The central competent authority ordered the improvement within a time limit in accordance with the provisions of Paragraph 3 of Article 33, but no improvement was made within the time limit.

1An Accredited Medical Institution shall apply to the central competent authority for abolilion of its accreditation within 30 days after the occurrence of any of the following circumstances; the central competent authority may also directly abolish its accreditation:

21. The original application for approval has changed due to the change of qualifications.

32. Closed or shutdown under the Medical Act.

43. Suspension of matters handled by an Accredited Medical Institution for some reason.

In case of one of the circumstances specified in the preceding two articles, the central competent authority may not grant the subsidy; if the subsidy has been requested, the central competent authority may revoke or abolish all or part of the subsidy, and order it to return within a time limit by written administrative sanctions.

If the central competent authority finds that the Accredited Medical Institution violates medical regulations, it shall transfer it to the municipal or county (city) competent health authority for handling in accordance with the law; if the relevant personnel are involved in criminal responsibility, it shall be transferred to the judicial authority for handling.

1The central competent authority shall establish and announce an occupational injury and diseases notification system as a reference for occupational injury and disease information collection, statistics and prevention, and evaluation of occupational injury and disease labor rehabilitation services.

2The format of the reporting of occupational injury and disease in the preceding paragraph and other matters to be followed shall be announced by the central competent authority.

1The occupational injury and disease diagnosis and treatment integrated service center of an accredited medical institution shall handle the contents of occupational injury and disease notification, which shall include the following items:

21. Basic information of the case: name, personal ID number, name of injury and disease, and contact information.

32. Notification of occupational diseases: information on disease diagnosis, occupational exposure, time series, epidemiological literature and other influencing factors.

43. Notification of occupational injury: information on the diagnosis of injury and disease, the type of occupational injury and the occurrence process.

5The collection of the information in the preceding paragraph shall be the responsibility of the specialists in occupational medicine and the case specialists of occupational injuries and diseases in accredited medical institutions, and shall be conducted in accordance with the relevant provisions of the Personal Data Protection Act.

6The occupational injury and disease diagnosis and treatment integrated service center of an Accredited Medical Institution shall provide analysis reports on the contents of occupational injury and disease notification handled by it.

A The accredited medical institution shall report to the occupational injury and disease reporting system within twenty working days after the case is confirmed as an occupational injury or disease.

Employers, medical service organizations other than the Occupational Injury and Disease Diagnosis and Treatment Integrated Service Centers of Accredited Medical Institutions or other personnel, who know that the worker has suffered from occupational injury or disease, and the worker who has suffered from occupational injury or disease, may report the name of the injury or disease case, the name of the identification document, the name of the injury or disease, and the contact information. Information such as the method and the informant shall be reported to the occupational injury and disease reporting system, so as to provide the necessary services and assistance measures for the worker in a timely manner.

The central competent authority may hold a liaison meeting of the Accredited medical Institution regarding the service situation of the Accredited medical institution; the Accredited medical Institution shall also send personnel to attend.

The central competent authority may entrust the Incorporated Foundation of Occupational Accident Prevention and Rehabilitation Center as a juridical person as specified in Article 70 of this Act to handle the accreditation, management, inspection, evaluation, and review of subsidy fees for Medical Institutions.

The format of the forms prescribed in these Regulations shall be prescribed by the central competent authority.

Before the implementation of these regulations, the medical institutions entrusted by the Occupational Safety and Health Administration of the Ministry of Labor to handle occupational injury and disease prevention and treatment centers, after the implementation of these regulations, they will be regarded as accredited medical institutions within the entrusted period. However, the provisions on subsidies from Articles 28 to 31 do not apply.

1A These Regulations shall be enforced on May 1, 2022.

2Except that the provisions of Article 31 should take effect on July 1, 2025, amendments to this regulation shall take effect from the date of promulgation.