장기요양급여비용환수처분취소
1. Of the instant lawsuit, the part of the “request for the revocation of a disposition to recover expenses for long-term care benefits amounting to KRW 94,340.”
2...
1. Details and details of the disposition;
A. The Plaintiff is operating a long-term care institution that provides home care benefits among long-term care benefits in the trade name of “B”.
(hereinafter “instant medical care institution”). (b)
From June 8, 2015 to June 11, 2015, the Defendant and the Yangyang-gun conducted a field investigation on “the details of long-term care benefits of the instant medical care institution from March 2013 to March 2015” and determined as follows.
(The detailed details are as follows: Gap evidence 2-2; 6,988,850 won of the claim 6,98,850 won (1,138,780 won; 2. Claim 1,236,740 won of the violation of the criteria for additional placement of human resources for disposition; and 3 Claim 86,930 won of the disposition 4. Disposition 9,451,30 won of the total ground for disposition
C. On September 17, 2015, the Defendant notified the Plaintiff that “The Plaintiff shall recover KRW 9,451,300,00 of the expenses for long-term care benefits paid excessively due to the Plaintiff’s unfair claim” pursuant to Article 43 of the Long-Term Care Insurance Act.
On November 23, 2015, the Defendant revoked ex officio a disposition to recover “the amount of expenses for long-term care benefits to beneficiaries C, KRW 94,340,00,000, which was included in an unfair amount of grounds for disposition.”
[This case’s disposition of restitution of expenses for long-term care benefits (i.e., KRW 9,451,300 - KRW 94,340) remaining after ex officio revocation as above]
2. The gist of the Plaintiff’s assertion (3), and (4) The grounds for disposition are recognized.
However, in relation to the grounds for the disposition, the Plaintiff asserts that “the Plaintiff provided a beneficiary with a re-payment and received the cost of long-term care benefits from the Defendant” (hereinafter “instant issues”).