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(영문) 서울행정법원 2020.01.16 2019구합66569

장기요양급여비용환수결정 취소

Text

1. On May 8, 2019, the Defendant rendered a decision to recover expenses for long-term care benefits of KRW 2,493,600 against the Plaintiff.

Reasons

1. Details of the disposition;

A. The Plaintiff is a corporation that establishes and operates a long-term care institution for home care on the Yangcheon-gu Seoul Metropolitan Government and the fifth floor.

(b) A field investigation was conducted on the details of the Plaintiff’s long-term care benefits (from March 29, 2018 to December 1, 2018) with assistance from the head of Yangcheon-gu and jointly with the Defendant’s survey personnel during the period from January 29, 2019 to February 1, 2019. Violation of the principle of home visit benefit: 4,808,820 won - Where long-term care institutions provide beneficiaries with long-term care benefits and claim expenses therefor, the Ministry of Health and Welfare’s notice on the relevant Acts and subordinate statutes and the standards for the provision of long-term care benefits, calculation method of expenses, etc. (general principle of home visit benefit), Article 15, Article 16, and Article 18 (Medical Care Benefit Costs, etc.): From 20 days to 30 days to 10 days to 20 days to 20 days to be provided for home visit benefit, the period from 10 days to 20 days to 20 days to be provided for home visit benefit.

C. Article 43 of the Act on Long-Term Care Insurance for the Aged on May 8, 2019, for the following reasons, is applicable to the Plaintiff.