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(영문) 부산지방법원 2017.05.11 2016구합24626
장기요양급여비용 환수처분 무효확인 등
Text

1. On May 29, 2015, the Defendant violated the criteria for assignment of human resources and additional assignment of human resources against the Plaintiff.

Reasons

1. Details of the disposition;

A. On November 26, 2007, the Plaintiff was a juristic person established for the purpose of implementing social welfare programs, and operated with a construction permit granted to the Green Citizens Health Center (hereinafter “Medical Care Center in this case”).

B. From October 27, 2014 to October 30, 2014, the Defendant: (a) conducted an on-site investigation into the instant sanatorium; (b) deemed that the Plaintiff unfairly received expenses for long-term care in breach of the criteria for placement of human resources, etc. from February 1, 2011 to September 30, 2014; and (c) on May 29, 2015, the Defendant issued a disposition to recover KRW 77,152,800 for long-term care benefits to the Plaintiff pursuant to Article 43(1)3 of the Act on Long-Term Care Insurance for the Aged.

(1) Of the care workers registered for the sanatorium of this case in violation of the criteria for the placement of human resources and additional placement of human resources, the part concerning recovery disposition due to the violation of the criteria for the placement of human resources and the criteria for the placement of additional placement of human resources (hereinafter “instant disposition”). From July 2010 to April 2013, 201, B from November 1, 201 to November 201, and C from May 201 to April 201, 201. The Plaintiff, as shown in the attached Table 1, performed the duties of a cook without performing its unique duties as a care worker. The Plaintiff is amended by Ordinance of the Ministry of Health and Welfare No. 437 of Jan. 28, 2008; hereinafter the same shall apply.

[Attachment 4] of Article 22(1)(hereinafter “Revised Clause”)

(2) A public notice of expenses for long-term care benefits, etc. (No. 2010-19 of the Ministry of Health and Welfare’s notice, April 28, 2010; hereinafter “instant public notice”) is issued, even if the standards for placement of human resources for caregivers

2) Part III II. 2.2, without reducing the amount of 67,138,240 won, it received 67,138,240 won unfairly. 2) Part III of the instant notice of violation of the criteria for additional placement of human resources

I. 2.b.

If the cost of benefits is reduced in the current month due to other reasons, it is not applied to the premium, but the plaintiff has reduced long-term care benefits in violation of the criteria for placement of human resources for caregiver.

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