Case News
The TCC delivers its Judgment 113-Hsien-Pan-10 (2024)
The Taiwan Constitutional Court (TCC) delivered its Judgment on the "Case on the Standard for Medical Fees" (TCC Judgment 113-Hsien-Pan-10) on October 28, 2024.
Facts, Issues, and Procedure of the Case
Article 21 of the Medical Care Act (hereinafter "Provision I") stipulates that "Standards for medical fees charged by the medical care institution shall be determined by the municipal or county (city) competent authority." Article 22, Paragraph 2 of the same act (hereinafter "Provision II") stipulates that "Medical fees charged by medical care institutions shall not violate or exceed the standard for the fees, nor shall medical institutions charge for items without authorization." Article 11, Paragraph 3 of the Enforcement Rules of the Medical Care Act (hereinafter "Provision III") stipulates that the term "authorization" under Provision II means the authorization following Provision I. Per competent authorities, without authorization, charging prepayments in the name of "preordered medical treatments or procedures" violates said provision. In other words, medical care institutions shall not ask for prepayments for their services unless authorized by competent authorities.
The petitioner of this case is a doctor at a private clinic. The petitioner's clinic was reported to the Department of Health of the Taipei City Government for charging an upfront payment for six laser hair removal sessions. The Department of Health fined the clinic 50,000NTD for violating the Medical Care Act. After unsuccessful administrative appeal and judicial litigations, the petitioner filed a constitutional complaint against the court's final decision and pertaining regulations. The petitioner mainly argued that: (1) Relevant medical care laws did not explicitly prohibit medical institutions from charging for multiple authorized medical treatments or procedures upfront, which violates the principle of clarity of law; and that (2) Even if the provisions were explicit enough, the burden imposed on practitioners to obtain authorization disproportionately restricts their freedom to practice an occupation, particularly when it involves only a different payment option for authorized medical treatments or procedures.
Judgment 113-Hsien-Pan-10 (2024) was announced on October 28, 2024. Justice Chong-Wen CHNAG authored this Judgment. All Justices decided unanimously and no opinions were filed.
Decision of the Court
The TCC upheld the constitutionality of Provisions I and II, ruling that the provisions did not violate the principle of clarity of law. The TCC pointed out that under current medical practices, it is comprehensible and foreseeable for the medical institutions that: (1) the term "standard of fees," other than simple items and prices, also includes fees for medicaments, treatments, and facilities; and that (2) multiple authorized medical treatments or procedures charged upfront is an individual kind of "(charged) item" under Provision II, thus requires authorization.
The TCC further upheld the constitutionality of Provisions I, II, and III. The TCC stressed that these provisions are proportionate to protect people's right to health and to reduce the information asymmetry between patients and medical service providers. The TCC ruled that these provisions did not violate the doctors' freedom to practice an occupation and freedom of contract under Articles 15 and 22 of the Constitution.
Notes:
- The full texts of the TCC Judgment as well as the concurring and dissenting opinions of individual Justices are available on the TCC website in Traditional Chinese. An English summary of this Judgment will be available later on the TCC English website.
- The TCC's Case News is prepared by the Department of Clerks for the Constitutional Court (Judicial Yuan) for information only and does not constitute as a part of the decision.
- In case of any conflict of meaning between the Traditional Chinese version and the translated English version, the Traditional Chinese version shall prevail.