한의사 자격정지 4개월 처분 취소
1. The plaintiff's claim is dismissed.
2. The costs of lawsuit shall be borne by the Plaintiff.
1. Details of the disposition;
A. The Plaintiff, who acquired a license for herb doctor (license number: herb doctor B) under the Medical Service Act, opened and operated Dental Medical Center (hereinafter “Korea Medical Center”) from December 2004, which is a medical institution in Busan Dong-gu C (hereinafter “instant Medical Center”).
B. From August 4, 2010 to July 28, 2011, the Plaintiff entered false medical records and electronic bits as if the Plaintiff provided 115 medical treatment, including E, for 199 times, to 115 persons, including E, for non-health insurance benefit items. Around that time, the Plaintiff filed a claim with the National Health Insurance Corporation for the payment of health insurance benefit costs on the basis of the medical records falsely prepared, and then filed a claim for the payment of health insurance benefit costs with the National Health Insurance Corporation and received KRW 2,677,530 in total as the name of the health care benefit amount from the National Health Insurance Corporation.
(hereinafter “instant act”). C.
around 2012, the head of the Dong-gu Public Health Center received data related to medical treatment from a member of the Korean Council of this case on the grounds of filing a civil petition.
The scope of investigation: The period subject to investigation into various matters concerning health insurance and medical benefits: Documents submitted on August 201 to April 7, 2011; from April 2013 to June 15, 2013 (the amount of 15 months’ medical examination): Article 58 of the Enforcement Rule of the National Health Insurance Act; documents and other related materials necessary for investigation under Article 11 of the Enforcement Rule of the Medical Care Assistance Act;
D. On August 16, 2013, pursuant to Article 97 of the National Health Insurance Act and Article 32 of the former Medical Care Assistance Act (amended by Act No. 14003, Feb. 3, 2016), the Defendant issued an investigation order to the effect that one member of the instant medical institution, who conducts an investigation, requests the survey to faithfully respond to the investigator’s relevant documents inspection, questioning, and request for submission of materials (hereinafter “instant investigation order”).
E. According to the instant investigation order, the Defendant conducted a field investigation on the medical records from August 201 to July 201, 201, and from April 2013 to June 2013, and the Plaintiff thereafter.