요양급여비용 환수처분 취소의 소
1. The instant lawsuit shall be dismissed.
2. The costs of lawsuit shall be borne by the Plaintiff.
1. Details of the notification of restitution;
A. On July 1, 2008, the Plaintiff, as a doctor, took over D Council members (hereinafter “instant Council members”) established in the name of medical corporation C (hereinafter “instant legal entity”) from B from July 1, 2008, and operated the instant Council members under the name of the instant legal entity from the same day.
B. B On August 30, 2011, in the branch court of the Busan District Court, he was convicted of imprisonment with prison labor for 6 months and 2 years of suspended execution due to the following crimes of violation of the Medical Service Act, and the said conviction was finalized on December 17, 2011.
Criminal facts
- E is the representative of the instant legal entity, and F is a “reception broker for the name lending of a medical corporation to a non-medical person who wishes to establish a medical institution by borrowing the name of the medical corporation.”
- B, despite being a non-medical person, was willing to establish a medical institution by lending the name of the instant legal entity from E through F, around March 2007, through F, promised to pay KRW 20 million as the fee for the name lending, and to pay KRW 1.5 million per month as the monthly management fee in the future, and paid KRW 10 million as the fee for the name lending, and opened and operated the instant member from April 3, 2007 to June 2008.
As a result, B established a medical institution in collusion with E/F, which is a non-medical person.
C. On December 20, 2016, the Defendant notified the Plaintiff that, from July 1, 2008 to November 21, 2009, the Plaintiff would recover KRW 149,949,370 of the medical care benefit cost (the Defendant charges) that the Plaintiff would have received while operating the instant member from July 1, 2008 to November 21, 2009.
(hereinafter referred to as the “pre-determined Notice”) 1. He confirms that (a) medical care institutions violate Article 33(2) of the Medical Service Act or Article 20(1) of the Pharmaceutical Affairs Act (a violation of the standards for the establishment of medical institutions) and (b).
2. The above facts are subject to restitution of medical care benefit costs under Article 57 of the National Health Insurance Act (Collection of Unjust Enrichment) and Articles 741 and 750 of the Civil Act.
Therefore, it is true.