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(영문) 부산지방법원 2018.12.06 2018구합21379

장기요양급여비용 환수처분 취소

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1. On February 23, 2018, the Defendant rendered a decision to recover expenses for long-term care benefits of KRW 15,147,970 to the Plaintiff on February 23, 2018, KRW 15,035,040.

Reasons

1. Details of the disposition;

A. The Plaintiff established and operated a long-term care institution under the Act on Long-Term Care Insurance for the Aged in Busan Dong-gu B and the second floor, and provided the elderly with the benefit of visiting and taking a bath for visiting.

B. From November 20, 2017 to November 23, 2017, the head of the Dong-gu Busan Metropolitan City conducted an on-site investigation on C with respect to the period from July 20, 2016 to November 23, 2017. As a result, the Plaintiff claimed expenses for benefits without claiming additional allowances and providing services in violation of the criteria for additional placement of human resources, and confirmed that the Plaintiff claimed expenses for benefits without paying additional allowances during the period of subscription to professional liability insurance and received them.

C. On February 23, 2018, the Defendant issued a disposition to collect expenses for long-term care benefits in KRW 15,147,970 to the Plaintiff (hereinafter “instant disposition”).

[Ground of recognition] Facts without dispute, Gap evidence Nos. 1-8, Eul evidence Nos. 1-2 and the purport of the whole pleadings

2. Whether the instant disposition is lawful

A. The plaintiff's assertion 1) The head of the Dong-gu Busan Metropolitan City, which did not give prior notice, conducted an on-site investigation with the plaintiff's medical care institution without any prior notice, in the absence of any grounds for exception to prior notice under each subparagraph of Article 17 (1) of the Framework Act on Administrative Investigations. 2) The defendant did not specifically specify how to take measures based on any facts in making the instant

3) The Defendant rendered the instant disposition by misunderstanding the Plaintiff as to the absence of the grounds for disposition. The Defendant conducted an on-site investigation on the basis of the statement of the Plaintiff’s personal source. The Defendant conducted an on-site investigation on the basis of a coercive investigation into the Plaintiff’s employees, and received false statements from the Plaintiff employees or completed a written confirmation, thereby rendering the instant disposition accordingly, but the statement is not reliable. (B) The judgment is as indicated in the relevant Acts and subordinate statutes.