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(영문) 부산지방법원 2014.08.28 2013구합21404

요양급여비용삭감처분취소

Text

1. The plaintiff's claim is dismissed.

2. The costs of lawsuit shall be borne by the Plaintiff.

Reasons

1. Details of the disposition;

A. The Plaintiff is a medical corporation that operates the hospital building located in the hospital building in the area of 101, Nam-gu, Busan (hereinafter “instant hospital building”).

B. On the fifth floor of the instant hospital building which was reconstructed or expanded without permission under the Building Act, the Plaintiff installed a meal service facility under the Food Sanitation Act without reporting the establishment and operation of a meal service facility under the Food Sanitation Act, provided meals to the inpatients, and filed a request for review of the cost of health care benefit with the Defendant

C. Meanwhile, on March 9, 2012, on the ground that the Plaintiff did not report the establishment and operation of meal service facilities pursuant to Articles 101(2)9 and 88(1) of the Food Sanitation Act, the head of Nam-gu Busan Metropolitan City (hereinafter “the head of Nam-gu”) imposed a fine for negligence of KRW 1 million on the Plaintiff on the ground that he/she did not report the establishment and operation of meal service facilities, and a fine for negligence of KRW 80,000 on May 8, 2013, and a fine for negligence of KRW 80,000 was imposed on the Plaintiff on the ground

At around October 2013, the Plaintiff reported to establish a group of facilities providing meals in the hospital in the hospital in this case in the first floor medical facility of the hospital in this case, and the remaining head of the Gu accepted the above report on October 31, 2013.

E. As a result of an on-site investigation conducted by the Ministry of Health and Welfare around September 27, 2013, the Defendant determined that the Plaintiff reduce the amount of KRW 18,249,740 for meal service expenses among the health care benefit costs requested by the Plaintiff on October 16, 2013 and October 17, 2013, on the ground that “the Plaintiff claimed food for hospitalization in an unlawful building as a result of verifying the Plaintiff’s claim for the health care benefit expenses” (= KRW 14,987,070 on October 16, 2013 + KRW 14,987,070 on food service expenses + KRW 3,232,670 on October 17, 2013) to reduce the amount on the grounds of “the amount exceeding the scope of health care benefit for food expenses” and “the amount exceeding the standard of health care benefit for the next patient’s basic food care benefit expenses” and notified the Plaintiff thereof.

(hereinafter “instant disposition”). 【The ground for recognition” has no dispute, and Nos. 1, 2, and 1.