Article 62 (Establishment)

In order to review the costs of medical care benefits and evaluate the reasonableness of medical care benefits, the Health Insurance and Assessment Service shall be established.

Article 63 (Services, etc.)

(1) The Review and Assessment Service shall be in charge of the services referred to in the following subparagraphs:
1. Review of the costs of medical care benefits;
2. Evaluation of the reasonableness of medical care benefits;
3. Development of criteria for review and evaluation;
4. Investigative research and international cooperation related to the operations referred to in subparagraphs 1 through 3;
5. Services delegated to it in connection with review of the costs of benefits or evaluation of the reasonableness of medical care that are provided for under the provisions of other Acts;
6. Services determined by the Minister of Health and Welfare to be necessary in connection with the health insurance program;
7. Other services prescribed by Presidential Decree in connection with review of the costs of insurance benefits and evaluation of the reasonableness of insurance benefits.
(2) The criteria, procedures, methods, etc. relevant to the evaluation of the reasonableness of medical care benefits referred to in paragraph (1) 2 and 7, and other necessary matters shall be prescribed by Ordinance of the Ministry of Health and Welfare.

Enforcement Ordinance

Article 64 (Legal Personality, etc.)

(1) The Review and Assessment Service shall be a juristic person.
(2) The Review and Assessment Service shall come into existence with the registration of its establishment at the seat of its principal office.

Article 65 (Executives)

(1) The Review and Assessment Service shall have as its executives the president, 14 directors and one auditor. In this case, the president, three trustees, and the auditor shall be standing.
(2) The president shall be appointed by the President of the Republic of Korea from among the plural number of persons recommended by the Minister of Health and Welfare.
(3) Standing directors shall be appointed by the president following the recommendation procedures prescribed by Ordinance of the Ministry of Health and Welfare.
(4) As non-standing directors, 10 persons from among the persons falling under the following subparagraphs and one relevant public official recommended as prescribed by Presidential Decree shall be appointed by the Minister of Health and Welfare:
1. One person recommended by the Corporation;
2. Five persons recommended by a medicine related organization;
3. Persons, each one of whom is recommended respectively by a labor unions' group, an employers' organization, a consumer organization, and an agricultural and fishing organization.
(5) The auditor shall be appointed by the President upon recommendation of the Minister of Strategy and Finance from among the plural number of persons recommended by executive recommendation committee.
(6) Non-standing directors prescribed in paragraph (4) may receive reimbursement for actual expenses, as prescribed by the articles of incorporation.
(7) The term of office of the president shall be three years, and that of directors (excluding the director who is a public official) and the auditor shall be two years, respectively.

Enforcement Ordinance

Article 66 (Medical Treatment Review Committee)

(1) In order to efficiently conduct the operations of the Review and Assessment Service, a medical treatment review committee (hereinafter referred to as "review committee") shall be established under the Review and Assessment Service.
(2) The review committee shall be comprised of no more than 50 full-time review members, including the chairperson of the committee, and no more than 100 part-time review members, and it may establish a subcommittee for each area of medical specialization.
(3) Full-time review members referred to in paragraph (2) shall be appointed by the president of the Review and Assessment Service from among the persons prescribed by Ordinance of the Ministry of Health and Welfare.
(4) Part-time review members referred to in paragraph (2) shall be commissioned by the president of the Review and Assessment Service from among the persons prescribed by Ordinance of the Ministry of Health and Welfare.
(5) If a review member falls under any of the following subparagraphs, the president of the Review and Assessment Service may dismiss or remove him/her:
1. Where he/she is deemed incapable of performing his/her duties due to a physical or mental disability;
2. Where he/she breaches or neglects an official duty;
3. Where he/she causes loss to the Review and Assessment Service, either intentionally or through gross negligence;
4. Where he/she does an act that causes damage to his/her dignity, regardless of whether while on duty or off duty;
(6) Necessary matters concerning the qualifications and the term of office of the members of the review committee, the organization and operation of the committee, etc. other than those prescribed in paragraph (1) through (5) shall be prescribed by Ordinance of the Ministry of Health and Welfare.

Article 67 (Raising, etc. of Funds)

(1) The Review and Assessment Service may collect contributions from the Corporation to conduct the operations referred to in Article 63 (1) (excluding the operations referred to in Article 63 (1) 5).
(2) Where affairs related to review of the costs of benefits or evaluation of the reasonableness of medical care are entrusted to the Review and Assessment Service under Article 63 (1) 5, the Review and Assessment Service may collect a fee from the delegator.
(3) The amount and collection method of the special assessment and fee referred to in paragraphs (1) and (2) and other necessary matters shall be prescribed by Ordinance of the Ministry of Health and Welfare.

Article 68 (Provisions Applied Mutatis Mutandis)

@Articles 14 (3) and (4), 16, 17 (excluding Article 17 (1) 6 and 7), 18, 19, 22 through 32, 35 (1), 36, 37, 39 and 40 shall apply mutatis mutandis in regard to the Review and Assessment Service. In this regard, the "Corporation" shall be deemed the "Review and Assessment Service" and the "president of the Corporation" shall be deemed the "president of the Review and Assessment Service," respectively.