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(영문) 서울행정법원 2020.10.22 2019구합59981

요양기관 업무정지처분 취소청구의 소 등

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Of the instant lawsuit, the Defendant National Health Insurance Corporation’s medical care benefit costs of KRW 647,440,000 against the Plaintiff on February 15, 2019.

Reasons

Details of the disposition

The Plaintiff is a doctor who establishes and operates a “C Council member” (hereinafter “instant Council member”) on the level B and 3 in Scheon-si.

The Defendant Minister of Health and Welfare (hereinafter “Defendant Minister”) conducted an on-site investigation on April 10, 2017, setting the investigation period from January 1, 2016 to February 2, 2017 as a total of 14 months and changed the investigation period from March 13, 2014 to February 2017 to 36 months, and conducted an on-site investigation.

(hereinafter “instant on-site investigation.” As a result of the instant on-site investigation, on December 21, 2018, the Defendant Minister suspended the business of a medical care institution for 30 days (from August 26, 2019 to September 24, 2019) based on the “Article 98(1)1 of the National Health Insurance Act” on the following grounds:

(hereinafter referred to as the “instant disposition of business suspension”. Improper amount: 18,622,220 won: double claim for medical care benefit after non-care of the patient: 16,753,190 won; 16,753,190 won; 2. According to Article 9(1) [Attachment 2] of the Regulations on the Standards for Medical Care Benefits in National Health Insurance, the examination fees have been collected from the person who received the expenses as non-care; 368,720 won: 8,720 won as medical care benefit costs; 201: 1.30% of the medical care costs; 201; 1.30% of the medical care costs; 1.4% of the medical care costs; 30% of the medical care costs after consultation with the person in charge of treatment at his/her own request; 1.4% of the medical care costs after consultation with the patient or after consultation with the patient; 1.5% of the medical care costs;