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(영문) 서울행정법원 2018.09.13 2017구합83218

과징금부과처분취소

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. From August 7, 2012, the Plaintiff is an intention to operate a “C internal clinic” (hereinafter “instant clinic”), which is a health care institution under the National Health Insurance Act, from around Asia-si B and the second floor.

B. On November 4, 2014, the National Health Insurance Corporation conducted on-site verification as to whether the instant member’s claim for medical care benefit costs is appropriate.

(hereinafter referred to as “on-site verification of this case”).

On December 4, 2015, at the request of the National Health Insurance Corporation, the Defendant conducted a field investigation on whether the instant council members’ claim for medical care benefit costs is appropriate.

(Period of Investigation: From October 2012 to November 2014, and from July 2015 to September 2015; hereinafter “instant on-site investigation”). D.

On August 2, 2017, the Defendant imposed a penalty surcharge of KRW 103,437,00 on the Plaintiff based on the “Article 99(1) of the National Health Insurance Act” as follows.

(hereinafter “instant disposition”). double claim for medical care benefit costs after non-benefit treatment: 25,859,250 won - National Health Insurance Medical Care Benefit Standard Rule 9(1) [Attachment 2] of Article 9(1) of the Rules on the Medical Care Benefits under the National Health Insurance Act; medical examination fees, etc. are claimed as medical care benefit costs, even though the examination of employment, etc. subject to non-benefit is conducted

E. Specific penalty surcharge calculation details for the instant disposition are as follows.

The fact that there is no dispute over the amount of KRW 1,178,172,050,250, 259,250, 891, 691, 698, 2.19% 2.19% 40% 40% / 103,437,000 for 103,40% / 40% / The fact that there is no dispute over the basis for recognition, evidence No. 1, 5, 7 evidence No. 1, 5, 7 (including the number of additional evidence; hereinafter the same shall apply) of the total amount of costs of health care benefit in the investigation period (including the number of pages), and the purport of the whole pleadings and arguments.

2. Whether the instant disposition is lawful

A. On November 4, 2014, at the time of on-site verification of the instant case, the Plaintiff signed and sealed the confirmation document with the following contents and submitted it to the National Health Insurance Corporation.

This is the non-benefit treatment.