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(영문) 창원지방법원 2016.05.31 2016구합50165

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 December 8, 2009, the Plaintiff is a person who operates C in Jinsung-gun B.

B. As a result of an on-site investigation conducted with respect to the above medical care institution from September 7, 2015 to September 10, 2015, the Busan Regional Headquarters of the National Health Insurance Corporation (hereinafter “the former Enforcement Rule of the Act on Long-Term Care Insurance for the Aged”) decided to recover the benefits from all beneficiaries of the pertinent month by deeming that a social welfare worker D satisfied working hours even though it had worked for a period of more than the working hours from February 2015 to March 2015 and calculates the amount of additional benefits differently from the actual working hours and unfairly receiving the total amount of long-term care benefits of KRW 2,642,540, in comparison with the criteria for placement of human resources under Article 23(2) of the former Enforcement Rule of the Act on Long-Term Care Insurance for the Aged (amended by Ordinance of the Ministry of Health and Welfare, Dec. 31, 2015).

C. According to the above investigation, on October 30, 2015, the Defendant claimed expenses for long-term care benefits in violation of Article 35 of the former Long-Term Care Insurance Act (amended by Act No. 13647, Dec. 29, 2015; hereinafter “former Elderly Insurance Act”) and Articles 23 and 24 of the Enforcement Rule of the former Elderly Insurance Act, and the unfair ratio was 3.05% [the amount of unfair claims 2,642,540, total amount of long-term care benefits 86,593,660] x 100]; the average monthly amount was 330,317 won; and the Plaintiff was subject to business suspension for 30 days against the Plaintiff.

(hereinafter referred to as “instant disposition”). [This case’s disposition ] without dispute, entry in Gap evidence 1, 8, and Eul evidence 3 (which include each number; hereinafter the same shall apply) and the purport of the whole pleadings.

2. Whether the instant disposition is lawful

A. The Plaintiff’s assertion 1) The instant disposition is publicly notified regarding the criteria for providing long-term care benefits, methods for calculating expenses for benefits, etc. (see, e.g., June 26, 2014).