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(영문) 서울행정법원 2019.04.04 2016구합85682
요양급여비용환수고지처분취소 청구의 소
Text

1. All of the plaintiffs' claims are dismissed.

2. The costs of lawsuit are assessed against the plaintiffs.

Reasons

1. The details of the disposition [Violation of the Medical Service Act]: (a) around November 2012, C, who is not qualified as a medical personnel, had the mind to open E-government points on the 11st floor of the building D, the government from around November 2012; (b) around that time, the Plaintiff B and the Plaintiff A, a doctor, are in charge of overall preparation for the establishment of the above hospital, including employment of employees; (c) Plaintiff B, a hospital marketing, attraction of patients, and the overall operation of the hospital; and (d) Plaintiff B, a doctor, planned to establish the hospital under its own name and take charge of patient treatment.

Accordingly, around April 2, 2013, the Plaintiffs conspired to establish E Council members under the name of Plaintiff A in the same place.

[Fraud] The establishment and operation of a medical institution under the name of a medical person who is qualified as a medical institution by investing necessary funds, such as funds for the establishment of a medical institution, expenses for the operation of facilities, etc., and the establishment and operation of a medical institution under the name of the medical institution cannot be considered as a medical institution established under the Medical Service Act, so in the

Nevertheless, the Plaintiffs, C, from April 2013 to September 15, 2015, requested an examination by submitting the statement of medical care benefit costs to the Health Insurance Review and Assessment Service, after treating patients according to the public offering such as the above item, and received a total of KRW 184,834,370 from the Defendant who believed the result of the examination to be true.

On March 23, 2016, the prosecutor of the District Public Prosecutor's Office indicted the Plaintiffs under the name of a violation of the Medical Service Act and a crime of fraud against the following facts charged (hereinafter referred to as "violation, etc. of the Medical Service Act").

(No. 1, No. 2)

In relation to the instant violation of the Medical Service Act, the Defendant’s medical care benefit cost on May 25, 2016 on the ground that the Plaintiffs violated the establishment standards under Article 57 of the National Health Insurance Act.

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