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(영문) 대전지방법원 천안지원 2016.04.14 2015고단1858

사기등

Text

Defendant

A Imprisonment for 10 months, Defendant B's medical consumer cooperatives shall be punished by a fine of 5,00,000 won.

(b).

Reasons

Punishment of the crime

1. Defendant A

(a) No person, other than doctors, herb doctors, dentists, etc. who violate the Medical Service Act, shall establish a medical institution;

Although the Defendant is not a medical person such as a doctor, he/she is willing to establish a medical institution with the authorization of the establishment of a consumer life cooperative by unlawful means, such as registering its members in the form and paying their contributions, etc. On October 15, 2012, the Defendant obtained the authorization of the cooperative for medical life from the Chungcheongnam-do branch office around October 15, 2012, and established and operated a medical institution under the name of “B Medical Life Cooperative E member” in ASEAN-si, Asan-si on April 29, 2013.

(b) No medical institution which has not been established lawfully in violation of the Medical Service Act may claim expenses for medical care benefits in the course of national health insurance;

Nevertheless, from May 2013 to October 2014, the Defendant, as described in the foregoing paragraph, provided that the Defendant employed patients F who were doctors at the above B Medical Life Cooperatives E member established in violation of the Medical Service Act, as described in the foregoing paragraph, and provided medical treatment. The Defendant received KRW 231,627,150,150, in total, the amount of the medical care benefit payment from May 13, 2013 to October 2014, by claiming the cost of medical care benefits to the Victim Health Insurance Corporation and receiving KRW 3,415,630, around May 13, 2013 from the Victim Corporation who believed to be true.

2. Defendant B was a non-profit corporation established for the purpose of establishing and operating medical institutions. Defendant B, a representative of the Defendant, committed a violation as set forth in Article 1(a).

Summary of Evidence

1. Defendants’ respective legal statements

1. A protocol concerning the examination of each police officer against the defendant or G;

1. Each police statement made with respect to H, I, J, K, and L;

1. Requesting an investigation of medical care institutions to file unfair claims (in violation of standards for medical cooperation-establishment);

1. Current status and inspection report of the medical institution;

1. Application of the Acts and subordinate statutes for investigation reporting;

1. Relevant legal provisions concerning criminal facts;

A. Defendant A: Medical Service Act.

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