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(영문) 서울행정법원 2015.03.26 2014구합62111

영업정지처분취소

Text

1. All of the plaintiff's claims are dismissed.

2. All costs of lawsuit are assessed against the Plaintiff.

Reasons

Details of the disposition

The plaintiff is a medical corporation that has established and operates an effective convalescent hospital (hereinafter referred to as the "instant hospital"), which is a medical care institution providing medical benefits under the National Health Insurance Act, in 1063 due to efficiencies.

As a result, the Defendant’s Ministry of Health and Welfare conducted a field investigation on the period from October 15, 2012 to October 19, 2012 with respect to the Plaintiff (hereinafter “instant field investigation”) from April 2010 to August 2012, the Defendant discovered the following matters: (a) violation of the standards for differential calculation of hospitalization fees in a convalescent hospital; (b) violation of the standards for calculating hospitalization fees in a convalescent hospital; (c) violation of the standards for calculating the cost of meals in an in-patient; (d) false claim for hospitalization fees; and (e) the claim for medical care benefit

Among them, the issues in this case are as follows.

The differential level of nursing fees for convalescent patients shall be calculated according to the average number of nursing personnel ( nurses and assistant nurses) in exclusive charge of nursing services for patients in the immediately preceding quarter. However, the following matters shall be reported differently from the actual number of nursing personnel, and the name and details of confirmation of the type of nursing class A from April 1, 201 to December 8, 201, 10 to December 10, 201, 10 to December 8, 201, 10; 206. 8. 10 to December 8, 2012; 3. 4. 7. 5% of the total amount of nursing expenses in consideration of the average number of patients in the immediately preceding quarter; 4. 8. 5% of the total amount of nursing expenses in consideration of the report on the type of nursing class; 4. 5% of the unfair monthly total amount of nursing expenses in consideration of the number of patients in consideration of the number of patients in the immediately preceding quarter; 3. 5. 10. 5% of the unfair monthly total amount of expenses in consideration;