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국민건강보험관련법규(2021년)
 
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· 판매가격 : · 출판사 : 에듀팩토리
· 페이지 : 752 · ISBN : 979-11-5823-436-2
· 저자 : 김승희 · 발행 : 2021.02.10
· 제본 : 188*257(1색) · 포 인 트 :
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도서소개 목 차 배송관련정보 상품평 교환/반품정보 ▲ TOP

우리나라의 의료보험제도는 1963년 제정된 이후 1977년 7월 1일부터 사회보험방식

으로서의 의료보험을 본격적으로 시작하였다. 이후 1989년 7월 1일에 전 국민의료보

험을 달성하였고, 2000년 7월 1일 국민건강보험으로 일원화되었다.

국민건강보험법 제정에서부터 건강보험관련분야의 각종 고시에 이르기까지 많은

변화가 시도되어 나날이 바뀌는 제도라고 할 만큼 건강보험관련 내용은 시시각각으

로 변화하고 있는 현실에서 건강보험과 관련되는 분야에서 건강보험 실무에 직접⋅

간접으로 관계를 맺으면서 이 업무에 종사하는 사람이 수십만 명이 될 정도이며, 또

한 이러한 업무에 대하여 더욱 전문성이 요구되고 이에 따른 전문 인력이 절실히 요

청되고 있는 실정이다.

의료보험법에서는 질병을 치료하기 위해 소요되는 비용 및 의료서비스를 제공하는

것을 주 된 내용으로 한 반면, 국민건강보험은 진료비 보장, 질병치료를 포함함은 물론

건강진단⋅재활 및 예방의 범위까지 포함하는 적극적이고 포괄적인 급여를 제공하기

위하여 의료보험을 건강보험으로 명칭을 바꾸어 국민건강보험법으로 일원화했다.

우리나라 건강보험은 전 국민을 대상으로 실시하고 있기 때문에 일선에서 건강보

험업무를 담당하는 종사자가 국민건강보험공단, 건강보험심사평가원에만 약 1만5천

명에 해당되며, 보건⋅의료계에 종사자들까지 포함하면 수십만명이 건강보험제도와

직접 또는 간접적으로 관계를 맺으며 생업에 종사하고 있다.

이러한 수요를 충족하기 위하여 보건행정분야에서 건강보험관련법에 대한 교재를

개발하여 현장에서 요구하는 체계적인 교육을 실시하고, 졸업 후 건강보험과 관련된

산업체 현장 환경에 쉽게 적용할 수 있는 동기를 부여하는 반면, 건강보험업무의 경

쟁력을 높일 수 있는 계기를 마련하기 위하여 건강보험관련법규 교재를 연구하게 되

었다.

본 교재는 건강보험 요양급여 비용청구의 중요성을 감안하여 건강보험의 기본적

이론인 국민건강보험법, 국민건강보험법 시행령, 국민건강보험법 시행규칙, 의료급

여법, 의료급여법 시행령, 의료급여법 시행규칙, 국민건강보험 요양급여의 기준, 국

민건강보험공단 정관, 건강보험관련법규 및 핵심 문제 등으로 구성되어있다.

그동안 건강보험 관련 저서가 다수 있었으나 건강보험 이론에 기초가 되는 저서가

부족한 실정이어서 저자가 15년 이상 실무를 담당한 경험과 대학 강의경험을 토대로

대학이나 건강보험 업무를 담당하는 실무자를 위하여 교육용 교재로 집필하게 되었

으며, 앞으로도 자료를 보완하고 정리해야할 부분이 많이 남아 있다.

 

2021년 2월 말에

편 저 자


목  차 ▲ TOP

제1편 국민건강보험법 ································································································ 1

제1장 총 칙 ···································································································· 3

제2장 가입자 ···································································································· 7

제3장 국민건강보험공단 ·············································································· 16

제4장 보험급여 ······························································································ 27

제5장 건강보험심사평가원 ·········································································· 64

제6장 보험료 ·································································································· 69

제7장 이의신청 및 심사청구 등 ······························································ 102

제8장 보칙 ··································································································· 108

제9장 벌칙 ··································································································· 139

제10장 부칙[건강보험법] ·········································································· 143

제11장 부칙[건강보험법 시행령] ···························································· 157

제12장 국민건강보험법 시행령 별표 ····················································· 193

제13장 부칙[건강보험법 시행규칙] ························································ 233

제14장 국민건강보험법 시행규칙 별표 ················································· 247

 

제2편 국민건강보험 요양급여의 기준에 관한 규칙 ··································· 365

 

제3편 국민건강보험공단 정관 ············································································ 453

제1장 총칙 ··································································································· 455

제2장 임원과 직원 ······················································································ 457

제3장 이사회 ································································································ 461

제4장 재정운영위원회 ················································································ 464

제5장 사업 등 ····························································································· 466

제6장 자산, 회계, 예산 및 결산 ··························································· 471

제7장 의료시설 ···························································································· 475

제8장 장기요양기관 ···················································································· 478

 

제4편 의료급여법 ···································································································· 487

제1장 의료급여법 ························································································ 489

제2장 의료급여법 부칙 ·············································································· 544

제3장 의료급여법 시행령 부칙 ································································ 554

제4장 의료급여법 시행규칙 부칙 ···························································· 567

제5장 의료급여법 시행령 별표 ································································ 585

제6장 의료급여법 시행규칙 별표 ···························································· 603

 

제5편 건강보험관련 핵심문제 ············································································ 671

[국민건강보험법 관련문제 Ⅰ] ································································ 673

[국민건강보험법 관련문제 Ⅱ] ································································ 706

 


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