요양기관 업무정지처분 등의 취소
1. All of the plaintiff's claims are dismissed.
2. The costs of lawsuit shall be borne by the Plaintiff.
Details of the disposition
The Plaintiff, as an oriental medical doctor, is establishing and operating the “Chanwon”, which is a medical care institution under the National Health Insurance Act (hereinafter “instant member”).
From February 13, 2017 to February 15, 2017, the Defendant Minister of Health and Welfare (hereinafter “Defendant Minister”) conducted an on-site investigation as to whether the instant member’s claim for medical care benefit costs was appropriate (the period subject to investigation: January 1, 2014 to December 31, 2016; hereinafter “instant on-site investigation”).
On September 18, 2018, based on the results of the instant on-site investigation, the Defendant filed a false claim for the disposition of business suspension of 78 days’ health care institutions (hereinafter “instant disposition of business suspension”) based on Article 98(1)1 of the former National Health Insurance Act (amended by Act No. 14557, Feb. 8, 2017; hereinafter the same) for the following disposition with the Plaintiff on September 18, 2018 (hereinafter “instant disposition of business suspension”), - KRW 42,237,340 in the case of certain multiple persons, the medicine expenses, etc. shall be claimed as health care benefit costs even if they were invested in the actual amount of the Korean medicine
The calculation details of the period for which the instant business suspension is suspended on 78 days, 1,173,259 won, 10.54% of the total amount of costs of health care benefit (from January 2014 to December 2016, 36 months) for the total amount of unfair monthly unfair amounts, shall be as specified in the table below, for the period for which the instant business suspension is suspended on 1,173,259%.
On November 20, 2018, Defendant National Health Insurance Corporation (hereinafter “Defendant Corporation”) rendered a disposition to recover medical care benefit costs of KRW 42,237,340 based on Article 57(1) of the former National Health Insurance Act as grounds for the same disposition as the instant disposition of business suspension to the Plaintiff.
(2) Each of the dispositions of this case is legitimate. (3) Each of the dispositions of this case, including the disposition of this case and the disposition of this case (hereinafter referred to as "each of the dispositions of this case"). (4), there is no dispute about the grounds for recognition, Gap evidence Nos. 1, 4, 5, 7, and 8, Eul evidence Nos. 1, 1, and Eul evidence No. 1.