요양급여비용환수처분취소
1. The plaintiff's claim is dismissed.
2. The costs of lawsuit shall be borne by the Plaintiff.
1. Details of the disposition;
A. On May 18, 2017, the Defendant was notified by the Busan Regional Police Agency of the fact that “A pharmacy located in Yangsan-si (hereinafter “instant pharmacy”) in the city of Yangsan-si, which is operating as the office-place pharmacy, was to open (C:) the instant pharmacy.”
B. On July 10, 2017, the Defendant notified the Plaintiff that the Plaintiff would recover KRW 4,832,912,950 (based on the date of unfair claim (based on the date of payment of medical expenses) from February 18, 2011 to December 4, 2013) of the costs of medical care benefits paid unfairly to the Plaintiff on July 10, 201, based on the investigation result by the investigative agency, in violation of Article 20(1) of the Pharmaceutical Affairs Act (based on the standard of establishment of medical institutions and pharmacies).
(hereinafter “instant disposition”). Joint principal offenders committed by Defendant C and A (referring to the Plaintiff; hereinafter the same shall apply)
(a) No person other than a pharmacist or herb pharmacist who violates the Pharmaceutical Affairs Act shall register the establishment of a pharmacy;
On January 24, 2011, the Defendants: (a) Defendant C, who is not qualified as a pharmacist, borrowed the name of Defendant C from Defendant C, a pharmacist, and established and operated a pharmacy; (b) in return, the Defendants paid KRW 5 million per month to Defendant A as the name name lending expenses and benefits; and (c) conspired Defendant C to lend the account under the name of Defendant A to Defendant C to use it for receiving medical benefits, etc. from the National Health Insurance Corporation (hereinafter the same shall apply).
Accordingly, from January 24, 201 to December 31, 2012, the Defendants acquired drugs at the instant pharmacy from January 24, 2011 to December 31, 201, and thereafter, the Defendants registered the establishment of a pharmacy under the name of the Defendant C, despite the fact that Defendant C was operating the pharmacy upon the establishment registration of the pharmacy.
As a result, the Defendants conspired to establish and operate a pharmacy by Defendant C, who is not qualified to register the establishment of a pharmacy.
B. Around January 24, 201, the Defendants were in violation of the Specific Economic Crimes Act (Fraud) and the instant pharmacy.