Litigation costs shall be borne by the plaintiff.

A. The Plaintiff is opening and operating a building B in Busan Metropolitan City and a council member with C in the third floor in Jeonju-si (hereinafter “instant council member”).

B. On March 2014, the National Health Insurance Corporation conducted on-site verification examinations on the instant member (hereinafter “on-site verification examination”), and as a result, determined that there exists a probability that the Plaintiff conducted a medical examination that is excluded from the medical care benefits pursuant to attached Table 2 (hereinafter “non-benefit”) pursuant to Article 9(1) [Attachment 2] of the Regulations on the Standards for Medical Care Benefits in National Health Insurance (hereinafter “Rules”), and requested the Defendant to conduct an on-site inspection on the instant member.

C. Accordingly, on November 17, 2015, the Defendant conducted an on-site investigation with respect to the instant member by setting the investigation period from October 17, 2012 to April 2014, and from July 2015 to September 22, 2015 as “the total of 22 months” (hereinafter “instant on-site investigation”).

On October 23, 2017 based on the results of the instant on-site investigation, the Defendant rendered the Plaintiff the instant disposition that “the Plaintiff rendered a double claim for medical care benefits or made a false claim for medicine expenses, while providing medical treatment that is exempt from medical care benefits pursuant to Article 9(1) [Attachment 2] of the Medical Care Benefit Standard Rules as follows.” Article 98(1)1 of the National Health Insurance Act and Article 70(1) [Attachment 5] of the former Enforcement Decree of the National Health Insurance Act (amended by Presidential Decree No. 2743, Aug. 2, 2016; hereinafter the same shall apply) on the ground that “the Plaintiff rendered a double claim for medical care benefits or made a false claim for medicine expenses.”

AB made it.

1. Current status of medical care institutions members of this case;

2. Details of unfair amount calculation;

(a) Unfair amount: 19,393,085 won shall be expected to be collected by the National Health Insurance Corporation;

(b) double claims for medical care benefit costs and unfair claims for medicine costs after diagnosis and treatment subject to the detailed calculation of the unjust amount: 19,393,085 won - the Health Care Benefit Standard Rules.