장기요양급여비용 환수결정 취소 청구의 소
1. The plaintiff's claim is dismissed.
2. The costs of lawsuit shall be borne by the Plaintiff.
1. Details of the disposition;
A. From May 1, 2012, the Plaintiff established and operated the Masan-si building B and the C, a long-term care institution under the Act on Long-Term Care Insurance for the Aged (hereinafter “instant medical care institution”).
B. From March 23, 2015 to February 27, 2015, the Ansan City: (a) conducted on-site investigations (the period subject to investigation: May 23, 2012 to February 2015; hereinafter “instant on-site investigations”) with the Defendant’s support; and (b) determined that the Plaintiff was paid for expenses for long-term care benefits by unfairly claiming the expenses therefor.
C. On April 23, 2015, the Defendant gave prior notice to the Plaintiff, and thereafter received opinions from the Plaintiff seven times thereafter, and on February 19, 2016, the Defendant issued a disposition to recover expenses for long-term care benefits in KRW 204,167,760 to the Plaintiff based on Article 43 of the Act on Long-Term Care Insurance for the Aged (excluding the part related to physical therapy D) on the ground of the result of the instant on-site investigation conducted by the Plaintiff.
On May 3, 2016, the Plaintiff filed an objection with the Defendant pursuant to Article 55 of the Long-Term Care Insurance Act for the Aged.
On July 29, 2016, the Defendant: (a) decided on July 29, 2016 that “from November 2013, 2013 to November 2014, evidentiary materials are insufficient; and (b) accordingly, revoked the disposition to recover expenses for long-term care benefits in KRW 33,492,70, out of KRW 204,167,760.
E. On October 27, 2016, the Plaintiff filed a petition for review with the Long-Term Care Examination Committee pursuant to Article 56 of the Long-Term Care Insurance Act.
On January 12, 2017, the Minister of Health and Welfare set the premium rate for caregivers upon partial acceptance of an objection. However, in April 2013, the Minister did not apply the special case for recognition of working hours (30 days of paid leave) to full-time employees for at least 90 days, even though the special case for recognition of working hours (30 days of paid leave) was applied, and if property is re-determined by applying the special case, the premium rate is changed from 20% to 10%, and 3,039,840 won is confirmed to have been excessively recovered.