의사면허자격정지처분취소
1. The plaintiff's appeal is dismissed.
2. The costs of appeal shall be borne by the Plaintiff.
Purport of claim and appeal
The first instance court.
1. Details and details of the disposition;
A. The Plaintiff is an intention to establish and operate C Council Members in Gyeyang-gu Incheon (hereinafter “instant Council Members”) from September 1, 2011 to May 2, 2016.
B. The National Health Insurance Corporation requested the Defendant to conduct an on-site investigation on the grounds that the Plaintiff filed a claim for medical care benefit costs on the grounds that the Plaintiff received non-benefit treatment, such as cosmetic treatment from the instant council member, and then requested the Defendant to conduct an on-site investigation on the grounds that the Plaintiff claimed medical care benefit costs.
C. The Defendant set the investigation period from October 201 to March 2012, 201, and from June 2014 to August 2014, 2014, and extended the said period to “from September 201 to June 2012, and from June 2014 to August 2014” (hereinafter “the investigation period in this case”) and around September 2014, the Defendant conducted a field investigation (hereinafter “instant field investigation”).
On January 3, 2017, the Plaintiff received the payment of KRW 13,671,110 from the National Health Insurance Corporation (hereinafter “instant false claim”) by filing a claim for medical care benefits by stating the name of the sick and wounded in the form of “unclassifiedd injury after wound,” which is the subject of medical care benefits in the electronic medical register, despite the Plaintiff’s removal of the benefit subject to national health insurance from September 1, 201 to June 30, 201, the Plaintiff received non-payment from the instant member of the National Health Insurance Service (hereinafter “the instant request”). On the ground that the criminal facts constitute fraud against the National Health Insurance Corporation, the Plaintiff received a summary order of KRW 3 million from the Busan District Court Branch Decision 2016Da7115, which became final and conclusive due to the lack of objection to the summary order.
E. On June 14, 2017, the Defendant rendered the Plaintiff a disposition suspending qualification for a period of seven months based on Article 66(1)7 of the Medical Service Act on the ground of the instant false claim.