장기요양급여비용 환수처분 취소의 소
1. The plaintiff's claim is dismissed.
2. The costs of lawsuit shall be borne by the Plaintiff.
1. Details of the disposition;
A. From January 5, 2012 to November 4, 2016, the Plaintiff operated the Long-Term Care Insurance for the Aged and the C Care Center, a long-term care institution under the Welfare of the Aged Act (hereinafter “instant medical care institution”).
B. From February 6, 2017 to the 9th day of the same month, the military head of the Gun and the Defendant conducted a field investigation on the instant medical care institution.
(Period subject to Investigation: from November 201 to October 2016, 2016; hereinafter “instant on-site investigation”).
Based on the result of the instant on-site investigation, the Defendant rendered a disposition to recover KRW 205,724,470 on June 16, 2017, based on Article 43 of the former Long-Term Care Insurance Act (amended by Act No. 13647, Dec. 29, 2015) on the ground that the Plaintiff unduly claimed and received expenses for long-term care benefits by violating the criteria for placement of human resources and additional placement of human resources (hereinafter “instant disposition”).
(hereinafter referred to as “instant disposition.” From August 2012 to September 2013, 2013, from July 2014 to January 2015, D, E, and F registered as a caregiver but did not actually serve as a caregiver, reported the cost of benefits and filed a false claim for the cost of benefits.
(D) Even if the D, E, and F excludes them during the period registered as a caregiver, the relevant month during which the Institute is equipped with a caregiver. On the relevant month to which the calculation of reduction is applied due to a violation of the criteria for placement of additional human resources in violation of the criteria for placement of additional human resources, such as violation of the criteria for placement of additional human resources, the additional criteria are not applied even if additional placement of human resources is not applied. However, the additional placement of human resources was received on August 2014 and December 2014, where the reduction of production is applied because it failed to meet the criteria for placement of human resources for caregivers as above.
7,926,540 Won 205,724,470 [based on recognition] A, each entry in Gap evidence 1, 2, 3, and 5 (including branch numbers; hereinafter the same shall apply), respectively,