공포번호 17196
공포일 2020-04-07
보건복지부
Ministry of Health and Welfare
전체선택
제1장 총칙
CHAPTER I GENERAL PROVISIONS
제1조(목적)
Article 1 (Purpose)
제2조(관장)
Article 2 (Charge)
제3조(정의)
Article 3 (Definitions)
제3조의2(국민건강보험종합계획의 수립 등)
Article 3-2 (Formulation of Comprehensive National Health Insurance Plans)
제4조(건강보험정책심의위원회)
Article 4 (Health Insurance Policy Deliberative Committee)
제2장 가입자
CHAPTER II THE INSURED
제5조(적용 대상 등)
Article 5 (Eligible Persons)
제6조(가입자의 종류)
Article 6 (Categories of the Insured)
제7조(사업장의 신고)
Article 7 (Reporting on Workplace)
제8조(자격의 취득 시기 등)
Article 8 (Date of Acquisition of Eligibility)
제9조(자격의 변동 시기 등)
Article 9 (Date of Change in Eligibility)
제9조의2(자격 취득ㆍ변동 사항의 고지)
Article 9-2 (Notice of Acquisition and Change of Eligibility)
제10조(자격의 상실 시기 등)
Article 10 (Date of Loss of Eligibility)
제11조(자격취득 등의 확인)
Article 11 (Confirmation of Acquisition of Eligibility)
제12조(건강보험증)
Article 12 (Health Insurance Card)
제3장 국민건강보험공단
CHAPTER III NATIONAL HEALTH INSURANCE SERVICE
제13조(보험자)
Article 13 (Insurer)
제14조(업무 등)
Article 14 (Services)
제15조(법인격 등)
Article 15 (Legal Personality of NHIS)
제16조(사무소)
Article 16 (Office)
제17조(정관)
Article 17 (Articles of Incorporation)
제18조(등기)
Article 18 (Registration)
제19조(해산)
Article 19 (Dissolution)
제20조(임원)
Article 20 (Executive Officers)
제21조(징수이사)
Article 21 (Collection Director)
제22조(임원의 직무)
Article 22 (Duties of Executive Officer)
제23조(임원 결격사유)
Article 23 (Disqualification of Executive Officers)
제24조(임원의 당연퇴임 및 해임)
Article 24 (Obligatory Retirement and Dismissal of Executive Officers)
제25조(임원의 겸직 금지 등)
Article 25 (Prohibition of Concurrent Offices of Executive Officers)
제26조(이사회)
Article 26 (Board of Directors)
제27조(직원의 임면)
Article 27 (Appointment and Dismissal of Employees)
제28조(벌칙 적용 시 공무원 의제)
Article 28 (Legal Fiction as Public Officials in Application of Penalty Provisions)
제29조(규정 등)
Article 29 (Rules)
제30조(대리인의 선임)
Article 30 (Selection and Appointment of Agent)
제31조(대표권의 제한)
Article 31 (Limitation on Representation)
제32조(이사장 권한의 위임)
Article 32 (Delegation of Authority of President)
제33조(재정운영위원회)
Article 33 (Financial Operation Committee)
제34조(재정운영위원회의 구성 등)
Article 34 (Composition of Financial Operation Committee)
제35조(회계)
Article 35 (Accounting)
제36조(예산)
Article 36 (Budget)
제37조(차입금)
Article 37 (Loans)
제38조(준비금)
Article 38 (Reserve Fund)
제39조(결산)
Article 39 (Settlement of Accounts)
제39조의2(재난적의료비 지원사업에 대한 출연)
Article 39-2 (Contribution to Projects for Supporting Disastrous Medical Expenses)
제40조(「민법」의 준용)
Article 40 (Application Mutatis Mutandis of Civil Act)
제4장 보험급여
CHAPTER IV INSURANCE BENEFITS
제41조(요양급여)
Article 41 (Health Care Benefits)
제41조의2(약제에 대한 요양급여비용 상한금액의 감액 등)
Article 41-2 (Reduction of Upper Limit Amount of Costs of Health Care Benefits for Medicines)
제41조의3(행위ㆍ치료재료 및 약제에 대한 요양급여대상 여부의 결정)
Article 41-3 (Determination of Whether Acts, Materials for Medical Treatment, or Medicines Are Health Care Benefit Items)
제41조의4(선별급여)
Article 41-4 (Selective Benefits)
제41조의5(방문요양급여)
Article 41-5 (Home Health Care Benefits)
제42조(요양기관)
Article 42 (Health Care Institution)
제42조의2(요양기관의 선별급여 실시에 대한 관리)
Article 42-2 (Management of Provision of Selective Benefits by Health Care Institutions)
제43조(요양기관 현황에 대한 신고)
Article 43 (Reports on Current Status of Health Care Institutions)
제44조(비용의 일부부담)
Article 44 (Co-Payment of Expenses)
제45조(요양급여비용의 산정 등)
Article 45 (Calculation of Costs of Health Care Benefits)
제46조(약제ㆍ치료재료에 대한 요양급여비용의 산정)
Article 46 (Calculation of Costs of Health Care Benefits for Medicines and Materials for Medical Treatment)
제47조(요양급여비용의 청구와 지급 등)
Article 47 (Claims for and Payment of Costs of Health Care Benefits)
제47조의2(요양급여비용의 지급 보류)
Article 47-2 (Withholding of Payment of Costs of Health Care Benefits)
제48조(요양급여 대상 여부의 확인 등)
Article 48 (Verification of Eligibility for Health Care Benefits)
제49조(요양비)
Article 49 (Health Care Costs)
제50조(부가급여)
Article 50 (Additional Benefits)
제51조(장애인에 대한 특례)
Article 51 (Special Cases concerning Persons with Disabilities)
제52조(건강검진)
Article 52 (Health Checkups)
제53조(급여의 제한)
Article 53 (Restriction of Benefits)
제54조(급여의 정지)
Article 54 (Suspension of Benefits)
제55조(급여의 확인)
Article 55 (Verification of Benefits)
제56조(요양비 등의 지급)
Article 56 (Reimbursement of Health Care Costs)
제56조의2(요양비등수급계좌)
Article 56-2 (Accounts for Receipt of Health Care Costs)
제57조(부당이득의 징수)
Article 57 (Collection of Unjust Enrichment or Unjust Profit)
제57조의2(부당이득 징수금 체납자의 인적사항등 공개)
Article 57-2 (Disclosure of Personal Details on Defaulters Who are in Arrears with Unjust Enrichment or Unjust Profit Collectable)
제58조(구상권)
Article 58 (Rights to Demand Reimbursement)
제59조(수급권 보호)
Article 59 (Protection of Entitlement to Benefits)
제60조(현역병 등에 대한 요양급여비용 등의 지급)
Article 60 (Payment of Costs of Health Care Benefits to Soldiers in Active Service)
제61조(요양급여비용의 정산)
Article 61 (Settlement of Costs of Health Care Benefits)
제5장 건강보험심사평가원
CHAPTER V HEALTH INSURANCE REVIEW AND ASSESSMENT SERVICE
제62조(설립)
Article 62 (Establishment)
제63조(업무 등)
Article 63 (Services)
제64조(법인격 등)
Article 64 (Legal Personality)
제65조(임원)
Article 65 (Executive Officers)
제66조(진료심사평가위원회)
Article 66 (Medical Treatment Review Committee)
제67조(자금의 조달 등)
Article 67 (Fundraising)
제68조(준용 규정)
Article 68 (Provisions Applicable Mutatis Mutandis)
제6장 보험료
CHAPTER VI INSURANCE CONTRIBUTIONS
제69조(보험료)
Article 69 (Insurance Contributions)
제70조(보수월액)
Article 70 (Amount of Monthly Remuneration)
제71조(소득월액)
Article 71 (Amount of Monthly Income)
제72조(보험료부과점수)
Article 72 (Contribution Point)
제72조(보험료부과점수)
Article 72 (Contribution Point)
제72조의2(보험료부과제도개선위원회)
Article 72-2 (Committee on Improvement of Insurance Contribution Imposition System)
제72조의3(보험료 부과제도에 대한 적정성 평가)
Article 72-3 (Evaluating Appropriateness of Insurance Contribution Imposition System)
제73조(보험료율 등)
Article 73 (Insurance Contribution Rate)
제74조(보험료의 면제)
Article 74 (Exemption from Insurance Contributions)
제75조(보험료의 경감 등)
Article 75 (Reduction of Insurance Contributions)
제76조(보험료의 부담)
Article 76 (Burden of Insurance Contributions)
제77조(보험료 납부의무)
Article 77 (Obligation for Payment of Contributions)
제77조의2(제2차 납부의무)
Article 77-2 (Secondary Payment Obligation)
제78조(보험료의 납부기한)
Article 78 (Due Date for Payment of Insurance Contributions)
제78조의2(가산금)
Article 78-2 (Additional Charge)
제79조(보험료등의 납입 고지)
Article 79 (Billing of Contributions)
제79조의2(신용카드등으로 하는 보험료등의 납부)
Article 79-2 (Payment of Contributions by Credit Card)
제80조(연체금)
Article 80 (Arrears)
제81조(보험료등의 독촉 및 체납처분)
Article 81 (Overdue Notice of Insurance Contributions and Disposition on Default)
제81조의2(체납 또는 결손처분 자료의 제공)
Article 81-2 (Provision of Data concerning Disposition on Default or Deficits)
제81조의3(보험료의 납부증명)
Article 81-3 (Certification of Payment of Insurance Contributions)
제81조의4(서류의 송달)
Article 81-4 (Service of Documents)
제82조(체납보험료의 분할납부)
Article 82 (Installment Payments of Insurance Contributions in Arrears)
제83조(고액ㆍ상습체납자의 인적사항 공개)
Article 83 (Disclosure of Personal Details of Payers in Arrear with Large Amount or in Habitual Arrears)
제84조(결손처분)
Article 84 (Dispositions on Deficit)
제85조(보험료등의 징수 순위)
Article 85 (Precedence of Collection of Insurance Contributions)
제86조(보험료등의 충당과 환급)
Article 86 (Appropriation for and Return of Insurance Contributions)
제7장 이의신청 및 심판청구 등
CHAPTER VII FILING OF OBJECTIONS AND REQUESTS FOR TRIAL
제87조(이의신청)
Article 87 (Raising Objection)
제88조(심판청구)
Article 88 (Requests for Trial)
제89조(건강보험분쟁조정위원회)
Article 89 (Health Insurance Dispute Mediation Committee)
제90조(행정소송)
Article 90 (Administrative Litigation)
제8장 보칙
CHAPTER VIII SUPPLEMENTARY PROVISIONS
제91조(시효)
Article 91 (Prescription)
제92조(기간 계산)
Article 92 (Calculation of Periods)
제93조(근로자의 권익 보호)
Article 93 (Protection of Rights and Interests of Workers)
제94조(신고 등)
Article 94 (Reporting)
제95조(소득 축소ㆍ탈루 자료의 송부 등)
Article 95 (Forwarding of Data on Reduction or Omission of Income)
제96조(자료의 제공)
Article 96 (Furnishing of Materials)
제96조의2(서류의 보존)
Article 96-2 (Preservation of Documents)
제96조의2(금융정보의 제공 등)
Article 96-2 (Provision of Financial Information)
제96조의3(서류의 보존)
Article 96-3 (Preservation of Documents)
제97조(보고와 검사)
Article 97 (Reports and Inspections)
제98조(업무정지)
Article 98 (Suspension of Operation)
제99조(과징금)
Article 99 (Penalty Surcharges)
제100조(위반사실의 공표)
Article 100 (Publication of Fact of Violation)
제101조(제조업자 등의 금지행위 등)
Article 101 (Prohibited Acts of Manufacturers)
제102조(정보의 유지 등)
Article 102 (Maintaining Information)
제103조(공단 등에 대한 감독 등)
Article 103 (Supervision of NHIS)
제104조(포상금 등의 지급)
Article 104 (Payment of Monetary Rewards)
제105조(유사명칭의 사용금지)
Article 105 (Prohibition from Use of Similar Names)
제106조(소액 처리)
Article 106 (Disposal of Small Sums)
제107조(끝수 처리)
Article 107 (Disposal of Fractional Sum)
제108조(보험재정에 대한 정부지원)
Article 108 (Government's Subsidies for Insurance Finance)
제109조(외국인 등에 대한 특례)
Article 109 (Special Cases concerning Foreigners)
제110조(실업자에 대한 특례)
Article 110 (Special Cases concerning the Unemployed)
제111조(권한의 위임 및 위탁)
Article 111 (Assignment and Entrustment of Authority)
제112조(업무의 위탁)
Article 112 (Entrustment of Services)
제113조(징수위탁보험료등의 배분 및 납입 등)
Article 113 (Allocation, Payment of Insurance Contributions Entrusted with Collection)
제114조(출연금의 용도 등)
Article 114 (Purposes of Contributions)
제114조의2(벌칙 적용에서 공무원 의제)
Article 114-2 (Legal Fiction as Public Officials in Application of Penalty Provisions)
제9장 벌칙
CHAPTER IX PENALTY PROVISIONS
제115조(벌칙)
Article 115 (Penalty Provisions)
제116조(벌칙)
Article 116 (Penalty Provisions)
제117조(벌칙)
Article 117 (Penalty Provisions)
제118조(양벌 규정)
Article 118 (Joint Penalty Provisions)
제119조(과태료)
Article 119 (Administrative Fines)
제119조(과태료)
Article 119 (Administrative Fines)
부칙 <제11141호, 2011. 12. 31.>
ADDENDA
부칙 <제11787호, 2013. 5. 22.>
ADDENDA <Act No. 11787, May 22, 2013>
부칙 <제12176호, 2014. 1. 1.>
ADDENDA <Act No. 12176, Jan. 1, 2014>
부칙 <제12615호, 2014. 5. 20.>
ADDENDA <Act No. 12615, May 20, 2014>
부칙 <제12844호, 2014. 11. 19.>
ADDENDA <Act No. 12844, Nov. 20, 2014>
부칙 <제13985호, 2016. 2. 3.>
ADDENDA <Act No. 13985, Feb. 3, 2016>
부칙 <제14084호, 2016. 3. 22.>
ADDENDA <Act No. 14084, Mar. 22, 2016>
부칙 <제14183호, 2016. 5. 29.>
ADDENDA <Act No. 14183, May 29, 2016>
부칙 <제14557호, 2017. 2. 8.>
ADDENDUM <Act No. 14557, Feb. 8, 2017>
부칙 <제14776호, 2017. 4. 18.>
ADDENDA <Act No. 14776, Apr. 18, 2017>
부칙 <제14839호, 2017. 7. 26.>
ADDENDA <Act No. 14839, Jul. 26, 2017>
부칙 <제15348호, 2018. 1. 16.>
ADDENDA <Act No. 15348, Jan. 16, 2018>
부칙 <제15535호, 2018. 3. 27.>
ADDENDA <Act No. 15535, Mar. 27, 2018>
부칙 <제15874호, 2018. 12. 11.>
ADDENDA <Act No. 15874, Dec. 11, 2018>
부칙 <제16238호, 2019. 1. 15.>
ADDENDA <Act No. 16238, Jan. 15, 2019>
부칙 <제16366호, 2019. 4. 23.>
ADDENDA <Act No. 16366, Apr. 23, 2019>
부칙 <제16652호, 2019. 11. 26.>
ADDENDA <Act No. 16652, Nov. 26, 2019>
부칙 <제16728호, 2019. 12. 3.>
ADDENDA <Act No. 16728, Dec. 3, 2019>
부칙 <제17196호, 2020. 4. 7.>
ADDENDA <Act No. 17196, Apr. 7, 2020>