beta
(영문) 서울행정법원 2014.10.30 2014구합11526

요양급여비용환수처분취소

Text

1. The plaintiff's claim is dismissed.

2. The costs of lawsuit shall be borne by the Plaintiff.

Reasons

1. Details of the disposition;

(a) B, C, Plaintiff, D, and E are all doctors;

B. On January 31, 2008, B and C jointly established a hospital in the name of “G Hospital” (hereinafter “instant hospital”) using the specialized department F in Ansan-si, Ansan-si, Masan-si as its major department of medicine, negoical surgery, gymical surgery, and image medicine. From August 11, 2010 to October 17, 201, the founder of the instant hospital was changed to B.

C. On August 21, 2012, the title holder of the instant hospital was changed to B and the Plaintiff, and on August 24, 2012, the change was again made to the Plaintiff, and B, on August 31, 2012, the G Hospital was established in Gangdong-gu Seoul Metropolitan Government H (hereinafter “I Hospital”).

On January 24, 2014, as the name of the founder of the instant hospital was changed to D, the name of the hospital was changed to J Hospital. On February 13, 2014, the name of the founder of the instant hospital was changed to E.

E. On April 1, 2014, the Defendant rendered a decision to recover KRW 7,46,715,150 paid for medical care benefit to the instant hospital from August 24, 2012 to December 10, 2013, on the ground that “B violated Articles 33(8) and 4(2) of the Medical Service Act by establishing two or more medical institutions under the Plaintiff’s name” (hereinafter “the instant disposition”).

【Ground of recognition】 The fact that there exists no dispute, Gap’s evidence 1, Gap’s evidence 2-1, 2, and 4, the purport of the whole pleadings

2. Whether the instant disposition is lawful

A. The Plaintiff’s instant disposition is unlawful for the following reasons.

1) In order to constitute a “medical care institution that received insurance benefit costs by prompt or other unjust means” as stipulated in Article 57(1) of the Act, a fraudulent and other unfair means regarding individual medical practice.