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(영문) 서울고등법원 2019.05.22 2018누69303

장기요양급여비용환수처분취소청구불복

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1. All appeals filed by the plaintiffs are dismissed.

2. The costs of appeal are assessed against the Plaintiffs.

The purport of the claim and appeal is the purport of the appeal.

Reasons

1. The reasoning of the judgment of the court of first instance, such as accepting the judgment of the court of first instance, is as follows 2. The relevant part of the judgment of the court of first instance is modified as stated in the reasoning of the judgment of the court of first instance (excluding the part pertaining to the fifth conclusion) except to supplement or add the judgment as stated in the following 3. Thus, it is acceptable as it is in accordance with Article 8(2) of the Administrative Litigation Act and Article

2. A modification to “I for the first instance trial witness I for the second instance trial and the witness K for this court” for the first instance court’s correction to “I for the second instance trial” with “12 and 14 Evidence”.

3. Supplement and addition of judgments;

A. The plaintiffs asserts as follows.

The manager of a medical care institution, such as the plaintiffs, cannot easily find whether a caregiver is negligent in performing his/her duties of visit care, and even if the time for providing visit care benefits was reduced to the defendant, this would result in his/her neglect or deviation from the work of an individual caregiver under his/her control, and the Plaintiffs did not have any economic motive for the purpose of pecuniary profit or economic motive.

Therefore, the instant disposition should be revoked in an unlawful manner.

"Where a long-term care institution claims and receives facility benefits by fraud or other improper means" under Article 43 (1) 3 of the Act on Long-Term Care Insurance for Long-Term Care, means that the institution is not required to submit false data to receive expenses for long-term care benefits or actively conceals the fact, but includes all acts of claiming and receiving expenses for long-term care benefits even though it is not eligible to receive such expenses pursuant to relevant

(See Supreme Court Decision 2008Du3975 delivered on July 10, 2008, regarding similar clauses, Article 52(1) of the National Health Insurance Act. Therefore, even if the Plaintiffs provided visit care services to the beneficiary G, the time when the Plaintiffs requested the Defendant.