2019 Highest 1449 Fraud, Medical Service Violation

A

Kim Jong-hee (Public prosecution) and misappropriations (public trial)

Law Firm B, Attorney C, D

August 21, 2019

A defendant shall be punished by imprisonment for one year.

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

Criminal facts

1. Violation of the Medical Service Act;

The defendant is the president of the "G Council member" located in Kimhae-si, the building E and F, and the medical personnel.

No medical person shall prepare a false medical examination and treatment record.

Nevertheless, even though the Defendant did not provide H at the above G Council around January 8, 2016, the Defendant prepared a false statement, such as the statement that he provided H in the medical records of H, including the statement that he provided the medical records of H, as indicated in the annexed crime list (1) from June 2, 2014 to December 31, 2016, by stating that he provided the medical treatment of 204 patients as a patient in the medical records despite having not provided the medical treatment as a patient.

2. Fraud;

Around February 15, 2016, the Defendant: (a) filed a claim for medical care benefits for patients with the National Health Insurance Corporation on or around January 8, 2016; (b) provided false medical records as if H actually received medical care; and (c) accordingly, filed a claim for medical care benefits with the National Health Insurance Corporation for the payment of 22,200 won with the victim; and (d) informed the victim from March 14, 2014 to January 23, 2017, by deceiving the victim from 6,326 times in total to 153,383,912 won as medical care benefits for 207 patients; and (b) received property from the victim by deceiving the victim. Accordingly, the Defendant received property from the victim.

Summary of Evidence

1. Defendant's legal statement;

1. The police statement of I, J, K, L, M, N,O, P, Q, and R;

1. A written accusation;

1. Each medical record and each written certificate of payment of medical expenses;

1. Status of individual entry or departure;

1. The investigation report (S and currency), the investigation report (H and currency), the investigation report (H and currency), the investigation report, the investigation report (V and currency), the investigation report, the investigation report (W and currency), the investigation report, the investigation report (Y and currency), the investigation report (AA and currency), the investigation report (AB and currency), the investigation report (AA and currency), the investigation report, the investigation report (AA and currency currency), the investigation report (AAC and currency), the investigation report, the investigation report (AA and currency currency), the investigation report, the investigation report (AF and currency), the investigation report (AF and currency), the investigation report (AH and currency), the investigation report, the investigation report (AH and currency currency), the investigation report, the investigation report (AJ and currency currency), the investigation report, the investigation report (AL and currency currency), the investigation report, the investigation report (O and currency currency), the investigation report, the investigation report, the investigation report, the investigation report, the criminal investigation report and the investigation report, the criminal investigation report, the statement and currency and currency report, the investigation report, the investigation report, the criminal investigation report, the statement, the statement, the statement and currency currency and currency currency call call (A and the statement, the investigation report.

Application of Statutes

1. Article applicable to criminal facts;

Subparagraph 1 of Article 88 and Article 22(3) of the Medical Service Act (a false preparation of a medical record), Article 347(1) of the Criminal Act (Fraud) of the Criminal Act, selection of each imprisonment penalty

1. Aggravation for concurrent crimes;

Articles 37 (former part), 38 (1) 2, and 50 of the Criminal Act

1. Suspension of execution;

The grounds for sentencing under Article 62(1) of the Criminal Act are as follows: (a) comprehensively taking into account various sentencing conditions, such as the Defendant’s age, character and conduct, the details and circumstances of the instant crime, and the circumstances after the crime, the sentence as ordered.

○ Unfavorable Circumstances: Medical records are falsely prepared as if a number of patients who did not actually receive medical treatment over a long-term period were treated, and accordingly, the method of committing the instant crime is not good, and the degree of violation of the professional ethics and duty as a doctor is heavier.

The amount of fraud exceeds 150 million won.

The circumstances favorable to ○: The Defendant recognized each of the instant crimes and did not repeat the same mistake. The National Health Insurance Corporation took measures to recover damage to the victim of money that is more than twice the amount of defraudedation. Some of the circumstances may be taken into account in relation to the prescription and treatment for some patients. The Defendant has no record of criminal punishment prior to the instant case.

Judges Ho Sung-ho