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(영문) 서울행정법원 2016.04.07 2015구합70799

장기요양급여비용 환수처분 취소

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1. All of the plaintiff's claims are dismissed.

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

Reasons

1. On April 17, 1992, the Plaintiff, an incorporated foundation established for the purpose of training, missionary work, and social welfare work, etc. of the elderly medical center located in Jinju-ro 1473 (hereinafter “the instant medical care center”), was granted the license of the elderly medical care center from the Defendant Jinju market, and was designated as a long-term care institution on May 22, 2008 by the said Defendant.

The Defendants jointly conducted a field investigation on the details of benefits from September 1, 2011 to January 31, 2015 of the instant sanatorium from March 16, 2015 to January 19, 2015, and confirmed that the Plaintiff failed to meet the standards for the placement of caregiver human resources during the investigation period, but did not claim medical care benefit costs after deducting the standards, and that the Defendants received additional medical care benefit costs even though they did not claim additional medical care benefit costs when they violated the standards for the placement of human resources.

According to the results of the foregoing on-site investigation, Defendant National Health Insurance Corporation notified the Plaintiff of the determination on the collection of long-term benefit expenses that the amount of KRW 37,196,060, out of the expenses for long-term care benefits paid to the Plaintiff from September 1, 2011 to January 31, 2012, and KRW 280,419,760, out of the expenses for long-term care benefits paid from February 1, 2012 to January 31, 2015, was to be collected in an unfair amount (hereinafter “instant recovery disposition”), and Defendant Jinju Mayor suspended the Plaintiff’s business for 82 days (hereinafter “violation of the criteria for human resource assignment and violation of additional criteria for human resources assignment”) on the ground that “the Plaintiff violated the criteria for the collection of long-term benefit expenses,” and on July 21, 2015.

(hereinafter referred to as “instant disposition of business suspension”). [The grounds for recognition] The fact that there is no dispute, each entry in Gap evidence 1 through 6 (including numbers; hereinafter the same shall apply), and the purport of the whole pleadings.

2. Whether the recovery disposition of this case is legitimate

A. The plaintiff's assertion 1 is from 1963 to Jinju-dong.