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(영문) 수원지방법원 안산지원 2018.02.20 2015고단3705

사기

Text

A defendant shall be punished by imprisonment for one year.

However, the execution of the above punishment shall be suspended for a period of two years from the date this judgment becomes final and conclusive.

Reasons

Punishment of the crime

The Defendant is the representative of the “C”, which is a sanatorium for older persons, on the third and fifth floor of the Gu building B in Ansan-si.

The National Health Insurance Corporation, through the long-term care insurance for older persons, has a sanatorium for older persons who have difficulty in performing a mixed-child daily life for at least six months due to dementia cerebrovascular diseases, etc. among older persons aged 65 years or older and persons under 65 years of age provide them with facility benefits such as support for physical activities and education and training to maintain and improve their mental and physical functions.

The operator of a sanatorium for older persons may claim expenses for long-term care without reduction to the National Health Insurance Corporation, in accordance with the criteria for the placement of human resources of a sanatorium for older persons, such as one physician for medical care for older persons who is 2.5 beneficiaries, one nurse for older persons who is 25 beneficiaries, one nurse for older persons who are 30 beneficiaries, one physical clinic for older persons per 30 beneficiaries (in cases where the monthly working hours of one long-term care worker are at least 160 hours, or where the monthly working hours of one long-term care worker for the same kind of long-term care worker are at least 160 hours, one long-term care worker shall be deemed assigned), and where the above criteria for the placement of human resources are not met, he/she shall claim expenses for long-term care care for older persons according to the rate of vacancy, and where a beneficiary is absent, he/she shall claim expenses for long-term

Around December 2012, the Defendant applied the reduction rate of 10% due to failure to meet the standards for the placement of human resources, such as not having served as a medical care worker, at the office of the above medical care center by accessing the information system of the National Health Insurance Corporation by using a computer, and applied the reduction rate of 10% to the office of the above medical care center, but filed a false report as if D had served as a medical care worker for at least 160 hours, thereby satisfying the above standards for placement of human resources.