beta
(영문) 대법원 2012.12.27 2010두27394

부당이득금환수처분취소

Text

The judgment below

Among them, the remainder except for unjust enrichment collection of selective medical fees is reversed, and this part is reversed.

Reasons

The grounds of appeal are examined.

1. As to the misapprehension of legal principles as to the legality of medical treatment different from the standard for medical care benefits or the standard for calculation of expenses for medical treatment (which is not the medical treatment without payment)

(a) first outlines laws and regulations governing medical benefits;

1) Article 36(3) of the Constitution declares the State’s duty to protect the health of all citizens, and Article 36(3) of the former Medical Care Assistance Act (amended by Act No. 8036, Oct. 4, 2006)

(a) The same shall apply;

A) The purpose of the former Medical Care Assistance Act was to contribute to the improvement of national health and the promotion of social welfare by providing medical benefits to those who have difficulties in living (Article 1(2)). According to the former Medical Care Assistance Act, all medical institutions established under the Medical Service Act, all pharmacies registered under the Pharmaceutical Affairs Act, etc., as an institution providing medical benefits, shall provide medical benefits to those who are entitled to medical benefits, such as “beneficiary under the National Basic Living Security Act” on behalf of the head of Si/Gun

(Articles 3, 5, and 9(1) and (3) of the Medical Care Assistance Act. Medical care benefits refer to diagnosis, examination, provision of medicine and materials for medical treatment, surgery, other treatment, preventive rehabilitation, hospitalization, etc. conducted by beneficiaries of medical care for disease, injury, childbirth, etc., and the former Medical Care Assistance Act delegates the authority to determine standards for medical care, such as methods, procedures, and scope

(Article 7(1) and (2) of the former Enforcement Rule of the Medical Care Assistance Act (amended by Ordinance of the Ministry of Health and Welfare No. 390, Mar. 27, 2007)

(a) The same shall apply;

(ii) Article 5(2) and (3) of the Regulations on the Standards for Medical Care Benefits under National Health Insurance and the attached Table 1 [excluding subparagraph 2(b)] (excluding subparagraph 2(b)].

The provisions of the former Regulations on the Standards for Medical Care Benefits under National Health Insurance (Article 6) are prescribed (Article 6), and the Ordinance of the Ministry of Health and Welfare on December 29, 2006.