과징금 부과처분 및 요양급여비용 환수처분 취소 등
1. The plaintiff's lawsuit against the defendant National Health Insurance Corporation shall be dismissed;
2. The plaintiff's defendant Minister of Health and Welfare.
1. Details of the disposition;
A. The Plaintiff established and operated an Esan Women’s Medical Care Institution (hereinafter “instant Council member”) under the National Health Insurance Act, which is a health care institution under the National Health Insurance Act, B and 6th C through D in e.g., the Plaintiff.
2. Details of unfair amount calculation;
(a) Unfair amount: 63,907,130 won;
B. In the event that medical care benefits under Article 41(1) of the National Health Insurance Act are provided in excess of the cost of calculating the unjust amount - the cost of providing medical care benefits under Article 44 of the same Act and Article 19(1) of the Enforcement Decree of the same Act, some of the winners are required to accurately calculate and collect the cost to be borne by themselves pursuant to Article 44 of the same Act and Article 19(1) of the same Act. However, a part of the number of winners is administered in excess of the permit of the Ministry of Food and Drug Safety (hereinafter referred to as “the instant injection”), and a separate collection of 65,000 won per time for treatment subject to non-payment (hereinafter referred to as “the ground for Disposition 1”), with the cost of double claim 11,907,130 won per time after the treatment subject to medical care benefits (hereinafter referred to as “the ground for Disposition 1”). Article 9(1) [Attachment 2] of the Regulations on the Standards of Medical Care Benefits for National Health Insurance Benefits
B. On August 2016, the Defendant Minister of Health and Welfare (hereinafter “Defendant Minister”) conducted an on-site investigation with respect to the instant member (the period subject to investigation: from July 2013 to August 2015; from April 2016 to June 2016; hereinafter “instant on-site investigation”) and determined as follows.
2,481,46,690 won 63,907,130 won 2,203,694 won 2.57% 40% 2.57% 40% 25,628,520 won for the period of suspension of business from July 2013 to August 2015, 2016; from April 2016 to June 29, 2016)
C. The defendant Minister shall conclude the instant on-site investigations and the defendant.