logobeta
본 영문본은 리걸엔진의 AI 번역 엔진으로 번역되었습니다. 수정이 필요한 부분이 있는 경우 피드백 부탁드립니다.
텍스트 조절
arrow
arrow
(영문) 서울행정법원 2017.03.30 2015구합61399
요양급여비용지급보류처분취소
Text

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. The Plaintiff, as a doctor, is the name of the opening of C/C convalescent Hospital located in G/S (hereinafter “instant hospital”).

B. On March 23, 2015, the Commissioner of the Gyeongnam-do Police Agency notified the Defendant of the investigation results containing the following (hereinafter “instant investigation results notification”).

Criminal facts

Despite the fact that the Plaintiff and Nonparty D’s joint criminal conduct - the violation of the Medical Service Act is not a medical personnel, the Plaintiff and Nonparty D opened and operated the instant hospital in the name of the Plaintiff in collusion with the Plaintiff to newly establish the instant hospital by changing the founder of the instant hospital from Nonparty E to the Plaintiff. From October 1, 2013 to July 17, 2014, the instant hospital was illegally established and operated in the name of the Plaintiff.

- The violation of the Act on the Aggravated Punishment, etc. of Specific Economic Crimes (Fraud) and D, even if a non-medical person claims medical expenses when establishing a hospital, were aware that the medical expenses cannot be paid to the Defendant under the name of the Plaintiff, and acquired a total of KRW 2,167,576,350 from October 2013 to July 2014 by receiving the payment from the Defendant.

C. On April 6, 2015, the Defendant notified the Plaintiff of the instant investigation results that the Plaintiff violated Article 33(2) of the Medical Service Act, and notified the Plaintiff of the postponement of payment of medical care benefit costs in KRW 11,272,560 based on Article 47-2 of the National Health Insurance Act and Article 22-2 of the Enforcement Decree of the same Act.

(hereinafter “Disposition in this case”). 【No dispute exists, Gap evidence Nos. 1, Eul evidence Nos. 1 and 2, and the purport of the whole pleadings

2. Whether the instant disposition is lawful

A. The Plaintiff’s assertion 1) The ground for withholding the payment of medical care benefit costs under Article 47-2(1) of the National Health Insurance Act (hereinafter “instant legal provision”) is that “a case of confirming a violation of Article 33(2) of the Medical Service Act of a medical care institution as a result of investigation by an investigative agency” is confirmed to be a violation of Article 33(2) of the Medical Service Act by prosecution by a prosecutor.

arrow