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(영문) 대법원 2017.07.11 2015두2864
과징금부과처분취소
Text

The appeal is dismissed.

The costs of appeal are assessed against the Plaintiff.

Reasons

The grounds of appeal are examined (to the extent of supplement in case of supplemental appellate briefs not timely filed).

1. Whether the guidelines for review by the Minister of Health and Welfare and the Health Insurance Review and Assessment Service are unconstitutional or unlawful;

A. Article 39(2) of the former National Health Insurance Act (amended by Act No. 11141, Dec. 31, 201) provides that “The standards for medical care benefits, such as the method, procedure, and scope of medical care benefits under paragraph (1) (hereinafter “medical care benefits”), shall be prescribed by Ordinance of the Ministry of Health and Welfare.”

According to its delegation, Article 5(1) of the Regulations on the Standards for Medical Care Benefits in National Health Insurance (hereinafter “Rules on Medical Care Benefits”) provides that “The medical care institution shall provide medical care benefits to policyholders, etc. according to the criteria and methods for medical care benefits in attached Table 1,” and subparagraph 1(c) of attached Table 1.

Subject to the provision that “medical care benefits shall be provided in an economically effective way,” the basic principle for the application of medical care benefits is set and Article 5(2) of the Regulations on Medical Care Benefits provides that “The detailed matters concerning the criteria and methods for the application of medical care benefits under the provisions of paragraph (1) and the criteria and methods for the application of medical care benefits for hemoto cell transplantation, shall be determined and announced by the Minister of Health and Welfare after hearing the opinions

Accordingly, the details on the criteria and method for applying the former medical care benefit (amended by Ministry of Health and Welfare No. 2007-3, Jan. 23, 2007, and announced by Ministry of Health and Welfare No. 201-144, Nov. 25, 201) established accordingly are as follows: (a) the type of “self-divating operation using self-help tape” among “self-divating treatment, surgery fees, etc.” in Chapter 9, “self-divating operation using self-help tape” is confirmed as a epidemology test (deficial pressure measurement and divating pressure test).

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