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(영문) 창원지방법원 2020.12.10 2020구합50674

업무정지처분취소

Text

1. The plaintiff's claim is dismissed.

2. The costs of lawsuit shall be borne by the Plaintiff.

Reasons

1. Details of disposition;

A. On February 22, 2016, the Plaintiff as a party has reported the establishment of the “C Senior Citizens’ Welfare Center” (hereinafter “instant center”) which is a senior citizens’ long-term care institution pursuant to Article 32 of the Long-Term Care Insurance Act and Article 24(1) of the Enforcement Rule of the same Act, and provided a visiting medical care benefit.

B. (1) The Defendant, upon receiving support from the National Health Insurance Corporation for survey personnel, conducted a field investigation on the current status, etc. of claims for expenses for long-term care benefits of the instant center between December 2, 2019 and October 2, 2019 (from July 2, 2018 to October 2019). (2) At the time of the field investigation, the number of beneficiaries of the visit medical care benefits of the instant center is 38 and 31 caregivers.

C. On February 24, 2020, the Defendant issued a disposition of suspending business and imposing a fine for negligence pursuant to Article 37 of the former Act on Long-Term Care Insurance for the Aged (amended by Act No. 17173, Mar. 1, 2020; hereinafter the same shall apply) and Article 29 of the former Enforcement Rule of the Long-Term Care Insurance for the Aged (amended by Ordinance of the Ministry of Health and Welfare No. 639, Jun. 12, 2019; hereinafter the same shall apply) on the ground that the Plaintiff claimed expenses for long-term care benefits against the Plaintiff by fraud or other improper means based on the results of the said on-site investigation.

(hereinafter “instant disposition”). In addition, the Defendant imposed an administrative fine of KRW 250,00 on the Plaintiff on the ground that the Plaintiff did not record and manage data on the provision of long-term care benefits.

Details of the violation in addition to inserting marks.

(a) 23,254,940 won by visiting the amount requested for unfair visits;

(b) Where a long-term care institution provides beneficiaries with long-term care benefits and claims expenses therefrom, details of violations (22,917,680 won) shall be calculated in accordance with the standards, such as the Decree on Long-Term Care Insurance for Long-Term Care and the Public Notice thereof (Notice of the Ministry of Health and Welfare No. 2018-130), and Articles 57 (Additional Disposition of Social Workers, etc. on Visiting Care and Social Workers, etc.) and 58 (Additional Amount