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(영문) 서울고등법원 2013.12.18 2011누32210
과다본인부담금확인처분등취소
Text

1. The part against the defendant among the judgment of the court of first instance is revoked, and the plaintiff's claim on this part is dismissed.

2...

Reasons

1. Details of disposition;

A. A and B (hereinafter “the instant winners”) requested the confirmation of the patient’s self-paid charges to the Plaintiff hospital after receiving medical treatment from the Plaintiff hospital as blood diseases, such as acute dystrophal typosis, and paid the patient’s own charges to the Plaintiff hospital.

At around 2010, they requested the Defendant to verify whether the Plaintiff hospital is eligible for the cost of personal care.

B. As a result of the examination, the Defendant issued a disposition to confirm that part of the costs of the examination, treatment, medicine, or materials for medical treatment, which the Plaintiff hospital received from the instant patients, constitutes excessive personal charges, and at the same time, issued a disposition to refund the amount to the winners (hereinafter “instant disposition”).

C. The type of unfair collection of excessive principal charges, which the Plaintiff hospital received from the instant recipient, is the type of unfair collection of excessive principal charges as follows.

① The portion of the cost of health care benefit to be claimed by the Plaintiff hospital for the remaining National Health Insurance Corporation, which is anticipated to be reduced in light of the past review cases, in which the Plaintiff hospital collected the cost of health care benefit to be claimed from the winners in the form of non-benefit medical care benefit, based on the medical care benefit standard. ② The cost of materials, equipment, etc. for medical treatment is already included in the cost of health care benefit in the medical care benefit standard, and thus, it cannot be separately calculated.

D. The Plaintiff’s hospital was reduced upon the Plaintiff’s filing of objection.

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