요양급여비용환수처분 취소 등
1. The defendant's appeal is dismissed.
2. The costs of appeal are assessed against the defendant.
Purport of claim and appeal
1...
1. The reasons for the court's explanation concerning this case of this case are as follows: ① in the first instance court's judgment, ② in the second instance court's judgment, ② in the second instance's 7 deleted "the 27 November 201," ② between the second and third parties, and ② in the second instance, the hospital of this case was a medical institution established by a doctor under the Medical Service Act, and ② in the second instance, unlike the so-called "office-general hospital" established by a non- doctor in violation of Article 33 (2) of the Medical Service Act, the two opening itself cannot be subject to recovery of medical care benefits under Article 57 (1) of the National Health Insurance Act, and thus, the disposition of this case is unlawful. ③ The 6th instance court's 5th instance judgment is identical to the corresponding part of the judgment of the first instance court's judgment, and thus, the 6th instance court's citing it as it is in accordance with Article 8 (2) of the Administrative Litigation Act and the main sentence of Article 420 of the Civil Procedure Act.
Judgment
1) As a medical care institution providing medical care benefits under Article 42(1)1 of the National Health Insurance Act, Article 57(1) provides that “medical care institutions established pursuant to the Medical Service Act” may collect all or part of the amount equivalent to the cost of the insurance benefits in return for unjust enrichment with respect to “medical care institutions that have received the insurance benefits costs by speed or other unjust means,” and the instant disposition also is based on the foregoing provision.
2) However, “other improper means” stipulated as one of the grounds for the collection of unjust enrichment can be seen as referring to cases where the relevant laws and subordinate statutes are violated or the relevant claim for expenses incurred in providing benefits is inappropriate due to lack of validity, even though it is not an active method such as deception (see, e.g., Constitutional Court Order 2014HunBa298, Jul. 30, 2015). Meanwhile, Article 33(2) of the Medical Service Act, which restricts the scope of medical personnel, such as a medical doctor’s license, is limited to medical personnel.