장기요양급여비용환수처분 취소 청구
1. The plaintiff's claim is dismissed.
2. The costs of lawsuit shall be borne by the Plaintiff.
1. Circumstances and details of the disposition;
A. The Plaintiff is a person who operated “C” (hereinafter “instant long-term care institution”) that provides home care benefits from December 10, 2014 to Bupyeong-gu, Incheon (hereinafter “instant home care institution”).
B. The third floor above the ground where the instant long-term care institution is located, and the first floor and the second floor above the building that was permitted as the long-term care institution among the buildings was the first floor and the second floor (protective facility).
The third floor of the building was a family living home of the plaintiff and her husband.
C. Around July 2018, the Defendant conducted an on-site investigation as to whether the instant long-term care institution claims expenses for long-term care benefits with the head of Bupyeong-gu Incheon Metropolitan City Bupyeong-gu.
(hereinafter “instant on-site investigation”). D.
As a result of the instant on-site investigation on August 20, 2018, the Defendant issued a disposition to recover expenses for long-term care benefits of KRW 208,182,410 to the Plaintiff on the following grounds based on Article 43 of the Long-Term Care Insurance Act.
(hereinafter “instant disposition”). Article 68 of the Ministry of Health and Welfare’s notification on the criteria for providing long-term care benefits and methods of calculating expenses for long-term care (Notice of the Ministry of Health and Welfare No. 2018-6) related to visiting medical care services (hereinafter “the instant disposition”). Article 68 of the Ministry of Health and Welfare provides that the payment for home visit benefits shall be calculated by 90% of the relevant daily care
On April 24, 2018, E, a caregiver belonging to the instant long-term care institution, filed a claim for 100% of the relevant daily allowance without reducing the amount of daily allowance, even though he/she did not purchase a liability insurance for professionals.
Article 34 of the Ministry of Health and Welfare (Notice of the Ministry of Health and Welfare No. 2016-121) provides for long-term care benefits in violation of the criteria for providing long-term care benefits, methods for calculating expenses for providing long-term care benefits (Article 2016-121 of the Ministry of Health and Welfare).