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(영문) 서울행정법원 2013.08.29 2012구합34266

장기요양급여비용 환수처분 취소

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. The Plaintiff established “C” and “D” on the 3rd ground floor above the window B of Changwon, and was designated as a sanatorium for older persons under the Act on Long-Term Care Insurance for Older Persons with C from the Changwon market (hereinafter “ Older Persons Insurance Act”), and operated D as a short-term care institution for older persons with home care.

B. On September 1, 2010 to September 30, 2011, the Defendant conducted a field survey on the details of benefits provided by C and D (hereinafter “the details of expenses for long-term care benefits”), and issued a disposition to recover KRW 38,591,340 in total to C with respect to the Plaintiff on January 26, 2012, and KRW 5,600,380 in total with respect to D, on the following grounds: (a) the Plaintiff claimed expenses for long-term care benefits in violation of the Enforcement Rule of the Elderly Insurance Act, the notice on expenses for long-term care benefits, etc. (hereinafter “Notice on expenses for long-term care benefits”); and (b) the details on expenses for long-term care benefits (hereinafter

(hereinafter “instant disposition”). After providing short-term protection for beneficiaries of facility benefits 10% reduction of 10% for a violation of the standards for reduction of 10% of the reduction of 10% for taking measures for the contents of Nos. C, 10% reduction of the amount of short-term protection for beneficiaries of facility benefits to be claimed as facility benefits after providing short-term protection for a short-term protection, the violation of the standards for calculating the difference recovery of 3% of the amount of short-term protection claim (violation of the rate of 50% of the amount of hospitalization of medical institutions and the number of out-of-door stays) 10% of the claim (the violation of the rate of 50% reduction of the number of out-of-door stays)

C. The Plaintiff filed an objection on April 25, 2012, but was dismissed by the Defendant on July 27, 2012.

[Ground of recognition] Each entry of Gap evidence Nos. 1, 5, Eul evidence Nos. 1 through 3 (including branch numbers), and the purport of the whole pleadings

2. Whether the instant disposition is lawful

A. Attached Form of the relevant statute;

The same shall apply to the records of the relevant statutes.

B. The assertion and determination on C-related disposition are false or fraudulent as stipulated in Article 43(1)3 of the Elderly Insurance Act.