The appeal is dismissed.

The grounds of appeal are examined.

Articles 33(2) and 87(1)2 of the Medical Service Act prohibit a person, who is not qualified to establish a medical institution, from establishing a medical institution by limiting his/her qualification to a doctor, an oriental medical doctor, etc., and imposes criminal punishment on such person in violation of such prohibition. This is to prevent in advance the risk of national health that may occur in the event of establishing a medical institution for the purpose of establishing sound medical order and for profit-making by strictly limiting the qualification to establish a medical institution to a medical person who has expertise in the qualification for

(see Supreme Court Decision 2009Do2629, Oct. 27, 2011). Moreover, Article 42(1)1 of the National Health Insurance Act limits one of the health care institutions that can provide health care benefit to “medical institutions established under the Medical Service Act”.

Therefore, if medical care benefits such as medical treatment of patients at a medical institution which was not lawfully established, in violation of Article 33(2) of the Medical Service Act, were provided, the pertinent medical institution does not constitute a medical care institution that can claim medical care benefits under the National Health Insurance Act, and thus,

(See Supreme Court Decision 201Du21669 Decided January 27, 2012, and Supreme Court Decision 2012Da72384 Decided May 14, 2015). Therefore, as if a medical institution established by a non-medical person is a medical care institution legally established under the Medical Service Act, claiming the payment of medical care benefit costs to the National Health Insurance Corporation would cause the National Health Insurance Corporation to make a mistake in the decision-making on the payment of medical care benefit costs, thereby constituting deception in fraud, and if the medical care benefit costs are paid from the National Health Insurance Corporation by such deception, fraud is established.

In such cases, non-medical persons who are the founders of such medical institutions shall be themselves.