The Health Insurance Review and Assessment Service (HIRA) has sparked controversy by requesting photos of a female patient's vulva, taken before and after benign tumor removal surgery, from an obstetrics and gynecology clinic to review medical expenses.
HIRA explained that it requested the data to conduct an accurate review.
However, the Korean Medical Association (KMA) warned of legal action, and the National Assembly's Health and Welfare Committee also said it would call for countermeasures.
“HIRA is asking to send the photos of genitals of female patients who have had benign tumors removed from their vulva without their consent,” said the director of an obstetrics-gynecology Clinic on his Facebook page on Tuesday. The physician expressed his frustration, saying, “I protested but the agency remains silent.”
On Thursday, HIRA issued a separate press release after the news spread through the media.
“We are requesting and accepting data for the accurate and fair review of the cost of nursing care benefits,” the agency said, explaining that it was to check whether the doctor had performed a vulvar abscess incision and billed it as a tumor resection.
HIRA noted that in November 2023, the physician billed for both a vulvar tumor resection and a skin benign tumor resection. After reviewing the outpatient surgical records and procedure records submitted by the physician, the agency confirmed that it was an abscess, not a vulvar tumor, and was recognized as a “vadoline gland abscess incision” rather than a tumor resection.
According to the insurance claim reviewing agency, the physician also billed for surgery for the same type of injury and requested review data this month.
“Even if it is not necessarily a before-and-after photo, we requested to submit a range of materials that can be proven,” HIRA explained, saying, “We thoroughly implement follow-up measures, including destroying sensitive information after using it only within the purpose for which it was collected.”
“We will continue to make efforts to provide prompt responses to inquiries regarding future reviews, including guidance on how to file claims properly,” HIRA said, noting that the agency conveyed its position to the clinic on Wednesday.
However, the controversy continues.
“The insurance claim reviewing agency treated doctors as thieves and fraudsters. They made ridiculous demands that patients would never tolerate if they knew,” KMA President Lim Hyun-taek said on Facebook. “We will consider legal actions against responsible officials at HIRA.”
Rep. Park Joo-min of the Democratic Party of Korea, chairwoman of the National Assembly's Health and Welfare Committee, also said on Instagram, “This is beyond common sense. I will check the facts of how this could have happened, and demand thorough measures to prevent this from happening again.”