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(영문) 서울행정법원 2020.01.16 2019구합55057
요양기관업무정지처분 취소청구의 소
Text

1. All of the plaintiff's claims are dismissed.

2. The costs of lawsuit shall be borne by the Plaintiff.

Reasons

1. Details of the disposition;

A. The Plaintiff is an intention to establish and operate the “D Councilor” (hereinafter “instant Councilor”) under the building B and C in Gyeyang-gu, Yangyang-gu, Yangyang-gu.

B. On January 2016, the Defendant National Health Insurance Corporation (hereinafter “Defendant Corporation”) requested the instant member’s on-site investigation to the effect that “the Plaintiff performed medical treatment at a place other than the instant member from December 2014 to May 2015,” and that “the Plaintiff unduly claimed medical care benefits after performing medical treatment at a place other than the instant member.”

C. Around August 2016, Defendant Minister conducted an on-site investigation (hereinafter “instant on-site investigation”) with regard to all the matters regarding medical care benefits of the instant Council members by setting the period for investigation as “from December 2014 to May 2015, and from April 2016 to June 2016” (hereinafter “instant on-site investigation”).

On November 26, 2018, in accordance with the instant on-site investigation, the Defendant issued a disposition to the Plaintiff to unfairly charge the Plaintiff KRW 3,826,610 of the medical care benefit cost as follows: (a) based on Article 98(1)1 of the National Health Insurance Act, to suspend the operation of a medical care institution for 56 days (hereinafter referred to as “the instant disposition to suspend operation of a medical care institution”); (b) medical care benefit claim after treatment outside a medical care institution; (c) medical care benefit claim in accordance with Article 42(1) of the National Health Insurance Act; and (d) may be provided at a medical institution established under the Medical Service Act; (e) however, in the case of a certain number of persons, he/she directly visits and treats any of the members located in the same building; and (e) the method of calculating the period of business suspension in the instant case’s disposition to suspend operation is as listed below [Attachment 1] [Attachment 1]. The total amount of the medical care benefit cost for the investigation period;

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