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(영문) 의정부지방법원 2019.01.16 2018고단4794

사기등

Text

A defendant shall be punished by imprisonment with prison labor for not more than ten months.

except that the execution of the above punishment shall be suspended for two years from the date this judgment becomes final and conclusive.

Reasons

Punishment of the crime

The Defendant, who claimed expenses for long-term care benefits to the National Health Insurance Corporation as the actual representative of the C Care Center, and the Korea Health Insurance Corporation, did not directly confirm whether or not the employees of the medical care facilities, such as caregivers, were actually working and paid it as they were, in order to deny the payment of expenses for long-term care benefits by falsely registering as if a caregiver who did not actually work had worked, or falsely registering as if a caregiver had worked more time than the actual working hours.

1. Fraud;

(a) In order to file a claim for medical care benefits with the National Health Insurance Corporation, the institution for long-term care shall comply with the facility standards prescribed by the Ordinance on Long-Term Care Insurance for the Aged and the guidelines for placement of employees based on the number of beneficiaries admitted to the institution, and where the human resources assigned to the institution fall short of the guidelines for placement under the aforesaid Ordinance on Long-Term Care Insurance for

Nevertheless, around May 2015, the Defendant: (a) around March 7, 2015, when a nursing assistant D retires on or around March 7, 2015, and even if the criteria for placement of nursing assistants fall short of the criteria for placement of nursing assistants, the Defendant entered the cost for long-term care benefits as if he/she complied with the criteria for placement of human resources; and (b) as if he/she had worked as a normal caregiver and physical clinic at the aforementioned C Care Center, he/she entered the reduction rate into the cost for long-term care benefits claim system as if he/she had worked as a normal caregiver and physical clinic, and applied for the cost for the cost for long-term care benefits from the National Health Insurance Corporation who did not know it, and received KRW 24,514,830 as expenses for long-term care benefits on May 2015, and received KRW 24,514,830 from that time to April 2016, attached Table 1.