진료비삭감처분등취소
The appeal is dismissed.
The costs of appeal are assessed against the defendant.
The grounds of appeal are examined.
1. As to the misapprehension of legal principles as to the scope of voluntary non-benefit medical treatment, the lower court determined that the part of KRW 23,214,240 among the items related to the benefits in the attached Table 1 of the lower judgment (hereinafter “attached Table”) constituted voluntary non-benefit medical treatment on the same grounds as the reasons stated in the “grounds for personal burden” in the attached Tables 2 and 3 of the lower judgment.
Examining the records in accordance with the relevant legal principles, the lower court’s aforementioned determination is justifiable.
There is no error of law by omitting judgment or by misapprehending the legal principles on the scope of voluntary non-payment treatments.
2. (1) With respect to the misapprehension of legal principles as to exceptional permissible requirements for voluntary non-benefit medical treatment, etc., based on the purport of the national health insurance system, when examining the whole system of the National Health Insurance statutes, such as the subject of, standards for, and procedures for, medical treatment benefits, legal principles concerning non-benefit medical treatment, etc. based on the purport of the national health insurance system, health care institutions shall provide health care benefits to subscribers, etc. in accordance with the standards and procedures prescribed in statutes, in principle, unless the so-called legal non-benefit medical treatment that is excluded from the subject of health care benefits under Article 39(3) of the former National Health Insurance Act (amended by Act No. 9932, Jan. 18, 2010; hereinafter the same shall apply)
Therefore, the excessive charges that the defendant should confirm and notify under Article 43-2 (1) and (2) of the former National Health Insurance Act should be borne by the medical care institution by providing the insured, etc. with medical care benefits in accordance with the standard and procedure prescribed by the law in relation to the criteria for recognition of medical care benefits.