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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 December 3, 2007, the Plaintiff was a medical corporation established on March 15, 2002, and established and operated C convalescent (hereinafter “instant hospital”) which is a medical care institution that is a medical care institution.
B. On July 19, 2018, the Defendant rendered a disposition of suspending business operations for 40 days under Article 98(1)1 of the National Health Insurance Act on the ground that the Plaintiff filed a false report on the level of nursing manpower security based on the list of health insurance benefit costs and the relative point of relative value of benefits (hereinafter referred to as “class of nursing”) with the Plaintiff, on the ground that the Plaintiff reported differently from the facts, as follows, the Defendant rendered a disposition of suspending business operations for 20 days under Article 28(1)1 of the Medical Care Assistance Act on August 21, 2018.
(hereinafter referred to as the “instant suspension disposition”) ... The instant hospital in the status of the medical care institution
2. Details of unfair amount calculation;
(a) Unfair amount: 29,627,860 won (medical care benefits), 5,56,040 won (medical care benefits) shall be expected to be collected by the National Health Insurance Corporation;
(b) Details of detailed calculation of unfair amount: Request for violation of differential calculation standards for hospitalization fees in a convalescent hospital; list of health insurance acts and the benefit point table; and the list of benefit points in a convalescent hospital of Part III, relative value points and calculation guidelines.
4. (e);
According to the differential hospitalization system based on the level of nursing personnel, the grade of nursing fees for the immediately preceding quarter shall be calculated according to the average number of nursing personnel (expenses of the number of nursing personnel for the patient) in the immediately preceding quarter, who are engaged in nursing services for the average number of patients for the immediately preceding quarter. In accordance with the standards related to differential application of hospitalization fees for convalescent hospitals according to the level of security of nursing personnel in the convalescent hospital No. 2009-214 notified by the Ministry of Health and Welfare, nursing personnel shall be recognized as nursing personnel in the case of nurses exclusively in charge of nursing services for inpatients, but it shall be reported differently from the fact of actual service as follows, and it shall be reported differently from the fact of actual service, and it shall be reported in the quarter