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(영문) 서울행정법원 2018.05.17 2017구합66039

요양급여비 환수결정 처분 등 무효확인 청구의 소

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The disposition taken by the head of Bupyeong-gu Incheon Metropolitan City on May 19, 2016 to recover medical benefits costs to the Plaintiff is null and void.

Reasons

1. Details and details of the disposition;

A. B is an intention to establish and operate a F Council member (hereinafter “instant Council member”) in the name of the Plaintiff, who is a doctor, in the name of the Plaintiff from April 5, 2012 to February 28, 2014, when opening and operating D Council member in Gangnam-gu Seoul, Seoul (hereinafter “instant period”) from around April 5, 2012 to February 28, 2014.

B. On September 7, 2015, the Defendant National Health Insurance Corporation (hereinafter “Defendant Corporation”) rendered a disposition to the Plaintiff on the ground that “The instant member was a medical institution established in violation of Article 3(8) of the former Medical Service Act (amended by Act No. 11252, Feb. 1, 2012; hereinafter the same shall apply) and Article 33(8) of the Medical Service Act (hereinafter “the Medical Service Act”) and the Plaintiff cannot be a medical care institution under the National Health Insurance Act. However, the Plaintiff was given medical care benefits to the Plaintiff on the ground that “the Plaintiff received medical care benefit costs of KRW 1,442,846,610 in total from Defendant Corporation after receiving medical care benefits from the instant member, and received medical care benefit costs at KRW 1,442,610 in total from Defendant Corporation (amended by Act No. 1141, Dec. 31, 201; hereinafter the same shall apply) and restitution of medical care benefit costs based on the National Health Insurance Act (hereinafter “National Health Insurance Act”).

C. On May 19, 2016, the head of Bupyeong-gu Incheon Metropolitan City (hereinafter “the head of the Gu”) is based on Article 23(1) of the former Medical Care Assistance Act (amended by Act No. 11878, Jun. 12, 2013); Article 23(1) of the same Act, and Article 23(1) of the Medical Care Assistance Act, on the ground that “The instant member was a so-called office hospital established by non-medical personnel B in violation of Article 33(2) of the Medical Care Act during the instant period and cannot be an institution providing medical benefits under the Medical Care Assistance Act.”