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1. The plaintiff's claims against the defendants are all dismissed.
2. The costs of lawsuit shall be borne by the Plaintiff.
Reasons
1. Details of each disposition;
A. The Plaintiff, as a doctor from February 21, 2006, established and operated a “Csan medical care institution” (hereinafter “instant member”), which is a health care institution under the National Health Insurance Act, in Namyang-si, Namyang-si.
B. On January 22, 2014, the Defendant National Health Insurance Corporation (hereinafter “Defendant Corporation”) received a report from the Defendant Corporation on the following: (a) the instant Council member was recommended to conduct a health examination, which was free of charge from the Plaintiff, and was exempt from personal charges (limited to the required field examination, hereinafter “the required field examination”); and (b) the Plaintiff became aware of the claim for health care benefit from the Defendant Corporation by reporting a detailed statement of medical expenses.
After conducting on-site verification with respect to the instant member, the Defendant Corporation requested the Minister of Health and Welfare (hereinafter “Defendant Minister”) to conduct on-site investigations with respect to the instant member on June 3, 2014.
C. From October 19, 2015 to December 21, 2015, Defendant Minister conducted an on-site investigation (the period subject to investigation: the period from July 19, 2013 to June 2, 2015 to June 8, 2015; hereinafter “instant on-site investigation”) on the instant member, and determined that the Plaintiff was unfairly claimed and paid medical care benefit costs as follows.
2. Details of unfair amount calculation;
(a) Unfair amount: 42,460,590 won;
B. After examining and treating the details of calculation of the unfair amount, the claim for medical care benefit costs: 42,460,590 won - The difference between the total unfair amount and the unfair amount by detailed details of the medical care benefit cost, according to Article 9(1) [Attachment 2] of the former Regulations on the Standards for Medical Care Benefits in National Health Insurance (amended by Ordinance of the Ministry of Health and Welfare No. 431, Aug. 4, 2016; hereinafter “former Regulations on Medical Care Benefits”).