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(영문) 부산지방법원 2016.05.19 2015고정4042

사기등

Text

Defendant shall be punished by a fine of two million won.

If the defendant does not pay the above fine, KRW 100,000.

Reasons

Punishment of the crime

The defendant is a herb doctor operating D Hanwon in Busan Dong-gu C.

1. Around December 10, 2010, the Defendant entered the medical record department and the electronic set of the medical record department as if he/she provided live treatment, which is an item claiming health insurance benefits, to E, in a false manner, even though the Defendant provided live oriental medicine treatment at the above D Medical Center around December 10, 2010. Around that time, the Defendant claimed reimbursement of health insurance benefits benefits to the Health Insurance Review Evaluation Institute based on the medical record record prepared falsely, and was granted KRW 14,490 from the National Health Insurance Corporation as the expenses for health care benefits by the victimized person.

The Defendant, from August 1, 2010 to June 30, 2013, received KRW 2,677,530,00 from the National Health Insurance Review Board, by deceiving a person in charge of review of the Health Insurance Review Board as if he/she provided medical treatment of 115 persons, including E, over 199 times in the same manner as indicated in the attached list of crimes, and received KRW 2,67,530,00 from the National Health Insurance Corporation as medical care benefits.

Accordingly, the defendant was given property by deceiving the victim.

2. Around December 10, 2010, the Defendant violated the Medical Service Act, as an oriental medical doctor, drafted a false medical record register and an electronic set of the medical record register of the above E and the electronic set, as if the Defendant provided her treatment for non-only oriental medicine treatment, which is a health insurance benefit item, to E at the above D’s medical clinic.

The Defendant, from August 1, 2010 to June 30, 2013, prepared a false record of medical treatment for 115 persons, including E, in the same manner as indicated in the list of offenses in attached Form 1, on a total of 199 occasions, from around August 1, 2010.

Summary of Evidence

1. Partial statement of the defendant;

1. Each police statement made to F, G, and H;

1. A petition and an improper list of petitioners for medical expenses subject to non-payment;

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

1. Relevant legal provisions of the Criminal Act, Article 347(1) of the Criminal Act, Articles 88 and 22(3) of the Medical Service Act, and selection of fines for a crime;

1. Article 37 of the Aggravation of Concurrent Crimes Act.