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(영문) 서울행정법원 2018.09.20 2017구합77848

장기요양급여비용환수결정 취소

Text

1. All of the plaintiffs' claims are dismissed.

2. The costs of lawsuit are assessed against all the plaintiffs.

Reasons

1. Details of each disposition;

A. On July 2, 2007, the Plaintiff Company established for the purpose of operating and managing a sanatorium, and established and operated the E-care center, which is a sanatorium for the aged under the Welfare of Older Persons Act and a long-term care institution under the Long-term Care Insurance for the Aged Act, and G, which is a sanatorium for the elderly and a long-term care institution for the elderly, in the first week.

B. Plaintiff B and Plaintiff C established and operated Plaintiff B and Plaintiff C as a sanatorium for older persons and a long-term care institution at H in the first week.

C. From March 6, 2017 to the 17th day of the same month, the Defendant conducted an on-site investigation (hereinafter “instant on-site investigation”) with respect to E Medical Care Workers, G, and I, and determined that the Plaintiffs unduly claimed expenses for long-term care benefits in violation of Article 37(1)4 of the Act on Long-Term Care Insurance for the Aged (Amended by Act No. 12067, Aug. 13, 2013; Act No. 13647, Dec. 29, 2015; Act No. 13647).

The period of each investigation of E Medical Care Center, G, and I and the details of the unfair claim based on the results of the instant on-site investigation are as follows:

(1) The E-Medical Center (Plaintiff Company)

(a) Period of investigation: From June 1, 2014 to January 31, 2017 (32 months);

(b) Amount of unfair claims: 58,958,050 won;

C. On January 2014, the Sanitary Board J did not directly perform the work of a social worker on the basis of his/her main place of business from June 2014 to December 2014, but registered as a worker for at least 160 hours a month. - A caregiver K and L reported that they worked for at least a monthly working hours on the basis of the fact that they worked for at least am from October 2016 to January 2017. - A social worker M. is deemed to have worked for at least a monthly working hours every month without performing the work of a social worker on July 2016, August 208, December 2012, and January 2017.