요양급여비용환수결정취소 청구의 소
The appeal is dismissed.
The costs of appeal are assessed against the Plaintiff.
The grounds of appeal are examined.
1. Object of the disposition of unjust enrichment collection;
(a) If medical care benefits were paid at a medical institution that was not lawfully established in violation of Article 33 (2) of the Medical Service Act, the relevant medical institution does not constitute a medical care institution that can claim medical care benefits under the National Health Insurance Act, and thus the said medical care benefits cannot be included in the medical care benefits
(See Supreme Court Decision 2014Da229399 Decided May 29, 2015). B.
The lower court determined that the medical care benefit costs paid to a medical care institution established by a non-medical person in the name of a person qualified to establish a medical institution constitutes an object of disposition of unjust enrichment collection.
The judgment of the court below is based on the above legal principles, and there was no error by misapprehending the legal principles on the collection of unjust enrichment under the National Health Insurance Act
2. The lower court determined that the instant hospital was a medical institution established and operated on March 28, 2014 under the name of the Plaintiff, who was unable to establish a medical institution, on the grounds as indicated in its reasoning, by lending and establishing it in the name of the Association A (the original co-Plaintiff; hereinafter “Nonindicted A”).
The judgment below
Examining the reasoning in light of the record, the lower court did not err in its judgment by exceeding the bounds of the principle of free evaluation of evidence against logical and empirical rules.
3. Abuse of discretionary power;
A. Article 57(1) of the National Health Insurance Act provides that “The NHIS shall collect all or part of the amount equivalent to the insurance benefits or the insurance benefits costs from a person who has received the insurance benefits or a medical care institution that has received the insurance benefits by deceit or other unjust means,” which states that it is possible to collect them in part.
The above provision shall prevent the medical care institution from claiming the payment of expenses for benefits by improper means, thereby maintaining the desirable benefit system in finance for health insurance and medical benefits.