1. The Plaintiff’s claim in September 27, 2018, among the lawsuits against Defendant National Health Insurance Corporation, is sought by the warden.

Details of the disposition

The plaintiff is a doctor to operate the "C Council member" (hereinafter referred to as the "instant Council member") in the Jung-gu Seoul Special Metropolitan City B and the third floor.

On July 2016, the Defendant Minister of Health and Welfare (hereinafter “Defendant Minister”) conducted an on-site investigation as to whether the instant Council member’s claim for medical care benefit costs is appropriate (the period subject to investigation: from December 2014 to April 2016; hereinafter “instant on-site investigation”).

As a result of the instant on-site investigation, on July 19, 2018, Defendant Minister issued a disposition to suspend the business of 72 days (from February 25, 2019 to May 7, 2019) based on the “Article 98(1)1 of the National Health Insurance Act” to the Plaintiff on the following grounds:

(hereinafter referred to as the “instant disposition of business suspension”. Improper amount: 18,416,690 won: double claims for medical care benefit costs and unfair claims for medicine costs: 18,416,698 won; 18,416,698 won under attached Table 2 of Article 9(1) [Attachment 2] of the Regulations on the Standards for Medical Care Benefits in National Health Insurance; and even if the expenses were collected from persons who received non-benefits, the examination fees, etc. were claimed as medical care benefit costs (12,385,830 won); - The detailed calculation of the period of business suspension for the instant disposition of business suspension is as follows.

The Defendant National Health Insurance Corporation (hereinafter “Defendant Corporation”) on September 27, 2018, to recover KRW 12,385,830 based on the “Article 57 of the National Health Insurance Act” (hereinafter “instant restitution disposition”), and at the same time, to recover KRW 6,030,860 based on Article 750 of the Civil Act, the Defendant Health Insurance Corporation (hereinafter “Defendant Corporation”) on September 27, 2018, based on the “Article 57 of the National Health Insurance Act” (hereinafter “instant restitution disposition”); and at the same time, to recover KRW 12,385,830 based on the “instant restitution disposition”; and to recover KRW 6,030,860 based on Article 750 of the Civil Act.