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(영문) 수원지방법원 2018.09.11 2016구합64327
요양급여환수결정취소
Text

1. The Defendant’s disposition of restitution of KRW 2,690,177,870, which the Plaintiff rendered on May 10, 2016, shall be revoked.

2...

Reasons

1. Details of the disposition;

A. The Plaintiff is a medical consumer cooperative for the purpose of establishing and operating common facilities necessary for medical activities, and established and operated the B oriental medical hospital, C Chinese medicine clinic, and D medical care institution under the National Health Insurance Act (hereinafter “each of the instant medical institutions”).

B. On April 15, 2016, the Defendant: (a) opened each of the instant medical institutions in violation of Article 33(2) of the Medical Service Act; and (b) notified the scheduled recovery of the medical care benefit cost on the ground that the Plaintiff wrongfully claimed the health insurance benefit cost.

The amount to be recovered and the period to be recovered shall be KRW 683,266,430 (from March 27, 2012 to February 29, 2016), KRW 928,90,560 (from February 6, 2011 to February 26, 201), and KRW 364,197,830 (from June 25, 2013 to February 22, 2016).

C. On May 10, 2016, the Defendant notified the Plaintiff of the decision to recover medical care benefit costs of KRW 2,690,177,870 in total.

(B) The disposition of this case (hereinafter referred to as the “disposition of this case”). Each entry in Gap’s 3 and 4 evidence (including each number), and the purport of the whole pleadings, as a whole, shall be: (a) the fact that there is no dispute; (b) there is no dispute; (c) each entry in Gap’s 3 and 4 evidence (including each number); and (d) the purport of the whole pleadings.

2. Whether the instant disposition is lawful

A. The Plaintiff’s assertion is unlawful since the Plaintiff did not establish and operate a medical institution in violation of Article 33(2) of the Medical Service Act, and there is no ground for disposition.

B. The entry in the relevant statutes (attached Form 1) is as follows.

C. 1) The Plaintiff’s representative E established the Plaintiff in violation of Article 33(2) of the Medical Service Act, and established and operated the E-owned hospital in the form of the Plaintiff’s affiliated medical institution (hereinafter “the instant medical institution”) (the charge of violating the Medical Service Act, and the facts of “the instant medical institution” are as follows: (a) each of the instant medical institutions falls under the “office-general hospital operated by an individual” operated by the individual; and (b) each of the instant medical institutions is legally

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