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(영문) 서울행정법원 2018.05.24 2017구합72256

부당이득금징수처분취소

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The plaintiff's claim is dismissed.

Litigation costs shall be borne by the plaintiff.

Reasons

1. Details and details of the disposition;

A. The Plaintiff is a medical corporation that establishes and operates the C convalescent Hospital (hereinafter “instant hospital”) in Ansan-si, Ansan-si.

B. From February 9, 2015 to February 13, 2015, the Minister of Health and Welfare conducted an on-site investigation of the instant hospital’s matters concerning medical care benefits and medical benefits (hereinafter “instant on-site investigation”) (from February 9, 2015 to February 13, 2015).

C. On May 2, 2017, the Minister of Health and Welfare issued a disposition suspending the business of 89 days for medical care institutions based on Article 98(1)1 of the former National Health Insurance Act (amended by Act No. 13985, Feb. 3, 2016; hereinafter the same) on the ground that “the Plaintiff was unfairly paid medical care benefit costs of KRW 180,441,170 in total from the Defendant by the following means:

(2) On the other hand, the Plaintiff: (a) the Plaintiff reported as a nursing staff member exclusively in charge of providing nursing services to in-patients even though it did not exclusively take charge of providing nursing services for in-patients as indicated in the same table (hereinafter “the instant table period”); (b) the grade of hospitalization fee system (hereinafter “in-house grade”) according to the level of securing nursing workforce in February 2, 2014 of the instant hospital from 8 to 1; (c) the class of nursing in March 3, 2014 from 7 to 1; and (d) the class of nursing in April 4, 2014 from 6 to 11 in the quarter from 3/4th quarter from 2014; and (b) the rate of the number of nurses in-house patients of the instant hospital from 3/4/4:1, 2014 to 25/4:111, respectively; and (d) the Defendant may not be paid from 2/14th quarter from 2014 to 2/14.