영업정지처분취소
1. The Defendant’s business suspension of 140 days against the Plaintiff on January 25, 2018 shall be revoked.
2...
Details of the disposition
The Plaintiff is an intention to establish and operate B Council Members (hereinafter “instant Council Members”) located in Taecheon-si from January 31, 2004.
Around August 29, 2011, the Defendant conducted an on-site investigation by setting the investigation period as 27 months from April 2009 to June 201, 201 with respect to the instant member.
(2) On January 25, 2018, the Defendant, upon the instant on-site investigation, ordered the Plaintiff to suspend the business of a medical care institution for the following reasons pursuant to Article 98(1)1 of the former National Health Insurance Act (amended by Act No. 13985, Feb. 3, 2016; hereinafter the same shall apply) on January 25, 2018 (from May 21, 2018 to October 7, 2018):
(hereinafter referred to as “instant disposition”). Unfair amount: 554,408,770 won: 554,408,770 won; 554,408,770 won; - In the case of some wounded persons, as if they were hospitalized even if they were not actually hospitalized; or as if they were hospitalized for a long time than the actual number of hospitalization, they recorded in the medical records and as if they were hospitalized, and as they were hospitalized, claim for medical care benefit costs (409,955,740 won) - The details of calculating the specific period of suspension of business of the instant disposition are as follows.
The prosecutor of the Young-gu Office of the District Prosecutors' Office of Chuncheon recognized the Plaintiff's suspicion of fraud only for KRW 87,895,960 out of the medical care benefits for the patients hospitalized in the instant member of the Council, and prosecuted the Plaintiff's suspicion of fraud for the remaining amount without suspicion. The Prosecutor of the District Prosecutor's Office of the District Public Prosecutor's Office of Chuncheon of the Republic of Korea recognized the Plaintiff's suspicion of fraud only for KRW 87,895,960 out of the medical care benefits for the patients hospitalized in the instant member of the Council, and prosecuted the Plaintiff's suspicion of fraud for the remaining amount.
“The Plaintiff received KRW 554,408,770 for medical care benefit costs by fraud or other improper means,” which is the ground for the instant disposition.