"Manual Therapy Restricted? There Are Alternatives"... Hydrojet Therapy Indemnity Claims Surge by 218%

Claims for Manual Therapy Drop by 92% in One Year at Indemnity Insurers
Surge in Other Non-Reimbursed Musculoskeletal Treatments... Mixed Billing on the Rise

After the government designated manual therapy as managed care in July this year, imposing restrictions on price and frequency, insurance claims for manual therapy under indemnity insurance sharply declined. However, claims for other non-reimbursed treatments rose significantly.

Physical therapy. Photo is not directly related to the content of the article. Photo by The Asia Business Daily Database

According to data compiled from five indemnity insurance companies (Meritz, Hanwha, Samsung, Hyundai, and DB) by Assemblyman Kim Yoon of the National Assembly Health and Welfare Committee from the Democratic Party of Korea on September 20, the number of manual therapy claims in August this year was 45,735. This is a 92% decrease compared to 555,204 cases in the same month last year.

The total amount claimed for manual therapy also plummeted by 96% from KRW 48.14 billion during the same period last year to KRW 1.934 billion this year. The average claim amount per case was also halved, dropping from KRW 86,643 to KRW 42,281.

In contrast, claims for other non-reimbursed musculoskeletal treatments substantially increased. Most notably, the number of hydrojet therapy (cold therapy) claims soared by 53%, from 142,924 cases in August last year to 218,074 this August. Claim amounts for this treatment also surged by 218%, jumping from KRW 4.553 billion to KRW 14.465 billion. The average amount claimed per session more than doubled, from KRW 31,885 to KRW 66,330.

Looking at the total claims for physical therapy expenses, which include hydrojet therapy, proliferative therapy, painless signal therapy, and functional intramuscular stimulation (FIMS), the total amount of indemnity insurance claims in August this year was KRW 29.28 billion. This represents a 41% increase compared to KRW 20.841 billion during the same period last year.

This phenomenon appears to be due to cases where, following the managed care designation for manual therapy, hydrojet therapy—a non-reimbursed item—was prescribed, and insurance claims were submitted under hydrojet therapy even when both treatments were administered together. From the patient's perspective, it has become more difficult to receive prescriptions for manual therapy due to stricter requirements. From the medical institution's perspective, as the price for manual therapy has dropped, the practice of 'mixed treatment' involving other non-reimbursed services has become widespread.

At a rally held on June 28 in front of Daehanmun, Jung-gu, Seoul, the Korea Medical Association, along with the Korean Orthopedic Society, the Korean Neurosurgical Society, the Korean Society of Anesthesiology and Pain Medicine, and the Korean Academy of Rehabilitation Medicine, shouted slogans opposing the transition to fee-for-service management for manual therapy. Photo by Yonhap News

Meanwhile, the Korean Medical Association will file a constitutional petition against the managed care system with the Constitutional Court on September 22. The association stated, "We will challenge the constitutionality of the managed care system, which infringes on the basic rights of both doctors and patients by regulating non-reimbursed services."

On September 19, the National Clinical Physical Therapists Coalition urged the Ministry of Health and Welfare and the Korean Physical Therapy Association to release information related to managed care for manual therapy and to hold a roundtable discussion with participation from patients and on-site physical therapists. The coalition raised concerns that it is difficult to ascertain what kind of communication took place between the government and the association during the introduction of the managed care system.

The effectiveness of managed care is also expected to become a major subject of scrutiny in this year's National Assembly audits.

This content was produced with the assistance of AI translation services.