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(영문) 서울행정법원 2018.08.16 2017구합74153

장기요양급여비용 환수처분 취소청구등

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

2. The costs of lawsuit shall be borne by the Plaintiff.

Reasons

1. Details of the disposition;

A. On December 27, 2012, the Plaintiff established and operated the “Acheon-gu Care Center for the Aged” (hereinafter “instant Medical Care Center”) which is a long-term care institution under the Long-term Care Insurance for the Aged in the Seo-gu, Seo-gu, Seocheon-gu, Yan-gu, Seoul.

B. From March 14, 2016 to January 18, 2016, the Defendants conducted an on-site investigation of the instant medical care center (the period subject to the investigation: from February 1, 2013 to January 28, 2016; hereinafter “instant on-site investigation”) with respect to the instant medical care center, and as a result, determined that the Plaintiff unduly claimed and received the cost of long-term care benefits (= KRW 66,408,560, KRW 66,536,460, KRW 29,872,10) as follows.

A claim for violation of standards for placement of human resources (G16): 6,536,460 won - B caregiver C shall be from July 1, 2013 to July 23, 2013; B shall be from January 31, 2013 to May 9, 2013; B shall be from May 7, 2013 to June 30, 2013; B shall be from May 7, 2013 to June 28, 2013; B shall be registered as a caregiver and has actually worked as a caregiver; B shall be deemed to have actually worked as a caregiver during the period from May 2 to February 28, 2015; B shall be deemed to have actually worked as a caregiver during the period from January 31, 2013 to May 31, 2014; B shall be deemed to have actually worked as a caregiver, but it shall be deemed to have actually worked as a caregiver for the period from May 21, 2017

C. On April 28, 2017, Defendant Corporation notified Defendant Mayor of the results of the instant on-site investigation, and requested prompt commencement of the administrative disposition procedure against the Plaintiff.

Defendant Corporation on May 12, 2017, based on Article 43(1)3 of the Act on Long-Term Care Insurance for the Aged, based on the results of the instant field survey, KRW 96,408,560.