A defendant shall be punished by imprisonment for not less than eight months.

except that the execution of the above punishment shall be suspended for two years from the date this judgment becomes final and conclusive.

Punishment of the crime

The Defendant is a doctor who operates a “D Council member” in Gangseo-si C and 2.

The Defendant entered false medical records into the Health Insurance Review and Assessment Service System (hereinafter “HICA System”) as if the Defendant provided medical treatment to patients, even on the date of non-medical examination and treatment, and tried to claim health insurance benefit costs (hereinafter “health benefit costs”) and basic cost of receiving health benefits (hereinafter “medical benefit costs”) to the National Health Insurance Corporation and the Medical Care Assistance Agency (competent local governments).

Around February 1, 2011, the Defendant: (a) had not provided medical treatment around January 3, 201 to E, an internal patient, at the above D’s meeting operated by the Defendant; (b) notwithstanding that there was no fact that the Defendant provided medical treatment around January 3, 201, the Defendant, as if provided medical treatment on the above date, requested medical benefits expenses by inputting the details of medical treatment into the HIMA system; (c) from that time until January 2, 2014, by deceiving the Health Insurance Review and Assessment Service by claiming medical benefits expenses based on false medical treatment records for a total of 1,036 items; (d) received medical benefits expenses of KRW 9,61,120 from the Gangseo-si of the victim; and (e) by deceiving the Health Insurance Review and Assessment Service from February 1, 2011 to January 2, 2014, based on false medical treatment records for a total of 5,716 items, and received medical benefits expenses from the National Health Insurance Service.

The Defendant, by deceiving the Health Insurance Review and Assessment Service as above, received an amount equivalent to KRW 57,056,70,000 from the victim Gangseo-si and the National Health Insurance Corporation, and the State out of the amount of indirect subsidies equivalent to KRW 7,688,896 from Gangnam-si by means of fraudulent application.