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(영문) 수원지방법원 2015.11.26 2015구합66005

업무정지처분취소

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 May 15, 2008, the Plaintiff operated a long-term care institution for older persons (Article 2 subparag. 4 and Article 31(1) of the Act on Long-Term Care Insurance for Older Persons (hereinafter “instant medical care institution”) with a mutual name “C” (Article 34(1)1 of the Welfare of Older Persons Act), starting from May 15, 2008, and offered facility benefits (Article 23(1)2 of the Act on Long-Term Care Insurance for Older Persons).

B. As a result of the instant on-site investigation of the instant medical care institution from December 1, 2014 to December 4, 2014 (hereinafter “instant on-site investigation”) conducted by public officials in charge of Yangyang-gun and employees in charge of the National Health Insurance Corporation, the Plaintiff determined that the Plaintiff unduly claimed expenses for long-term care benefit (facility benefits) as follows:

The period of investigation shall be from June 1, 2013 to October 31, 2014 (17 months) falsely claiming details of violations: 7,446,060 won.

1. To register D who did not have worked at the instant medical care institution as a physical therapy and report D who had worked for 128 hours in May 2014 and 96 hours in June 2014 and receive expenses for long-term care benefits.

2. A request for a violation of the criteria for calculation of long-term care benefits costs after registering E that has not worked at the instant medical care institution as a caregiver and reporting E that it has worked for at least 160 hours each on February 2, 2014 and March 2014: 14,970,250 won;

1. AF registered as a caregiver who takes exclusive charge of administrative affairs, such as claims for expenses for long-term care benefits, but files a report on his/her service as a caregiver for at least 160 hours on August 2014 and receives expenses for long-term care benefits;

2. G registered as a caregiver is to receive expenses for long-term care benefits reported as a caregiver who has worked for at least 160 hours each month from July 2013 to September 2013, even though he/she does not actually provide the beneficiary with long-term care services, such as assistance in physical activities and emotional assistance, as a caregiver, while mainly performing the duties of managing vehicles and equipment;

3. H registered as a caregiver; and