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1. The plaintiff's claim is dismissed.
2. The costs of lawsuit shall be borne by the Plaintiff.
Reasons
1. Details of the disposition;
A. On April 30, 2003, the Plaintiff, as a doctor, established the “Canwon,” which is a medical care benefit institution under the National Health Insurance Act (hereinafter “instant member”), in Daegu-gu, Daegu-gu, and entered into a partnership agreement with the network D (Death on September 18, 2017) on June 1, 2003, and operated the instant member jointly with the network D from around 13th of the same month.
B. On July 17, 2013, the National Health Insurance Corporation made on-site verifications with respect to the instant member (hereinafter “on-site verification”), and as a result, deemed that it is probable that the Plaintiff could have unduly claimed and received medical care benefit costs related to visual therapy (e.g., food, d, etc.), and requested the Defendant to conduct on-site investigations.
C. From April 13, 2015 to February 2, 2015, the Defendant conducted an on-site investigation on the instant member from April 13, 2015 (hereinafter “ instant on-site investigation”) and extended the investigation period for the previous 13 months (from March 2012 to December 2012, and from December 2014 to February 2015) to 36 months (from March 2012 to February 2015).
As a result of the instant on-site investigation, the Defendant determined that the Plaintiff received the payment from the National Health Insurance Corporation by unfairly claiming or claiming the cost of health care benefit of KRW 34,317,010 against the winners of KRW 1,070 as follows.
Dual claims for medical care benefit costs and unfair claims for medicine costs: 34,317,016 won - 34,317,016 won - 13,308,000 won - 23,308,950 won for medical care benefit costs, even though the costs were collected from the winners as non-benefits, even though the costs were collected as non-benefits - also 11,008,066 won for the issuance of medical care benefits for the primary prescription and for the unreasonable claim for pharmacy medication costs (11,08,066 won)
E. The Defendant issued a prior notice on August 23, 2016 to the Plaintiff on August 2, 2017 after undergoing the prior notice procedure.