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(영문) 서울행정법원 2018.11.08 2018구합54767
부당이득금환수처분취소
Text

The plaintiff's claim is dismissed.

Litigation costs shall be borne by the plaintiff.

Reasons

1. Details and details of the disposition;

A. The Plaintiff is an intention to establish and operate a convalescent hospital C (hereinafter “instant convalescent hospital”) in Ansan-si B.

B. On May 12, 2014, the Minister of Health and Welfare conducted an on-site investigation (hereinafter “on-site investigation”) on the medical care benefits matters of the instant convalescent hospital by setting the period subject to investigation as “from September 2010 to October 2012” (hereinafter “instant on-site investigation”).

C. On January 19, 2018 based on the results of the instant on-site investigation, the Defendant rendered a disposition to recover the above medical care benefit costs to the Plaintiff based on Article 57(1) of the National Health Insurance Act, on the ground that “the Plaintiff was paid medical care benefit costs (the difference between the total amount and the disposition cause is generated in the course of treating the fractional amount of national funds) in total by deceit or other unlawful means as indicated in the grounds for disposition, as follows:

(hereinafter referred to as “instant disposition”). The grounds for disposition are as follows: (a) the nurse D who worked in the instant convalescent hospital in violation of the standards for calculating differential hospitalization fees in the convalescent hospital; (b) the nurse D worked in the instant convalescent hospital from April 1, 2010 to May 31, 201; (c) the nurse E worked for 24 hours a week from April 1, 2010 to July 10, 201; and (d) the nurse E did not work in the instant convalescent hospital at a differential convalescent hospital based on the standards for calculating differential hospitalization fees in the convalescent hospital (hereinafter referred to as “Graded hospitalization system”); (d) the Plaintiff is unable to calculate the number of nursing personnel in the instant convalescent hospital as 3 hours from April 1, 2010 to September 30, 2011; and (e) the Plaintiff is required to provide differential nursing service at the rate of 30-day nursing personnel in the instant convalescent hospital.

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