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(영문) 서울행정법원 2020.01.09 2018구합75184

과징금부과처분취소

Text

1. Defendants, the Minister of Health and Welfare, on July 4, 2018, imposed a penalty surcharge of KRW 96,605,300 on the Plaintiffs, and Defendant.

Reasons

Details of the disposition

A. The Plaintiffs, as a doctor, jointly operate the “in-house Council Members” (hereinafter “instant Council Members”) in Jinju-si from April 2014.

B. Around July 2016, the Defendant Minister of Health and Welfare (hereinafter “Defendant Minister”) conducted on-site investigations on the current status of the instant medical care benefit cost claim of the instant Council members.

[The period subject to the investigation from May 2014 to March 4, 2015, and March 2016 to May 2016 (total of 15 months), hereinafter “instant on-site investigation”).

On July 4, 2018 based on the results of the instant on-site investigation, the Defendant calculated the period of suspension of health care institution business as 60 days on the ground that the Plaintiffs were to bear a total of KRW 19,321,060 in excess of statutory co-payment by improper means to the subscribers, etc. of national health insurance.

Based on this, pursuant to Article 99(1) of the former National Health Insurance Act (amended by Act No. 13985, Feb. 3, 2016; hereinafter the same) and Article 70(1) of the former Enforcement Decree of the National Health Insurance Act (amended by Presidential Decree No. 27296, Jun. 30, 2016; hereinafter the same), the Defendant Minister imposed upon the Plaintiffs a penalty surcharge of KRW 96,605,300 (i.e., unfair amount 19,321,060 x 5) in lieu of the business suspension for the above period.

(hereinafter “Disposition of the instant penalty surcharge”). In the event of providing medical care benefits under Article 41(1) of the former National Health Insurance Act of KRW 19,321,060 on the basis of the disposition of the instant penalty surcharge and unfair amount of calculation for the period of suspension of business: 19,321,060 won - The cost to be borne by the person himself/herself pursuant to Article 44 of the same Act and Article 19(1) of the Enforcement Decree of the same Act shall be accurately calculated and collected; however, in the case of a certain number of persons, the State feed, etc. shall be collected more than the base amount for which the medical care benefits claim can be claimed. The period subject to investigation - The assessment method shall be taken from May 2014 to May 4, 2015; from March 2016 to May 15, 2016 (total 15 months).