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(영문) 대전지방법원 2019.11.07 2018구합104374
과징금부과처분취소
Text

1. The plaintiffs' claims are dismissed.

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

Reasons

1. Details of the disposition;

A. The Plaintiffs are willing to jointly operate the D Hospital located in Seojin-gu Seoul Special Metropolitan City (hereinafter “instant hospital”).

B. On April 11, 2018, the Defendant imposed a penalty surcharge of KRW 38,440,230 on the Plaintiffs based on Article 99(1) of the National Health Insurance Act on the following grounds:

(hereinafter referred to as “first Disposition”). 2. The details of the wrongful amount calculation;

(a) Unfair amount: 12,813,410 won or more; or

12,813,410 won in violation of the standard for calculation of the differential rate of hospitalization fees in a long-term care hospital; list of health insurance benefit and non-paid benefit; and list of benefit points in a long-term care hospital under Part III of the relative value points of the benefits (calculated guidelines)

4. (e);

According to the differential rate system of hospitalization based on the level of nursing personnel, the grade of differential nursing for the immediately preceding quarter shall be calculated on the average number of patients (number of patients to be the number of nursing personnel). In accordance with the standards of differential application of hospitalization fees for convalescent hospitals according to the level of securing nursing personnel prescribed in Article 2009-214 announced by the Ministry of Health and Welfare, nursing personnel shall be recognized as nursing personnel in cases of nurses exclusively in charge of nursing for inpatients and assistant nurses to assist in nursing services for them. However, in fact as follows, although they do not take full charge of nursing for inpatients, they shall be reported to have taken full charge of nursing services for inpatients even if they did not take full charge of nursing services for inpatients, they shall be reported to have taken full charge of nursing services for inpatients, and medical care expenses for the first quarter class 2 of 2014 shall be claimed as class 1 - The type of occupation, the details of service period reported and confirmed on the details of name (resident registration number) E. (F. on October 16, 2014.

3. Grounds related to calculation details of administrative disposition: The total amount of medical care benefit costs subject to investigation of the standard calculation details for the disposition of suspension of business and imposition of penalty surcharges under Article 70(1) [Attachment Table 5] of the Enforcement Decree of the National Health Insurance Act (from January 1, 2014 to June 6, 2014; from March 2016 to May 9, 2016).

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