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(영문) 서울행정법원 2016.10.06 2015구합70133
요양급여비 환수결정처분취소
Text

1. The plaintiff's claim is dismissed.

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

Reasons

1. Details of the disposition;

A. From December 18, 2007 to August 31, 2014, the Plaintiff is a person who established and operated a C convalescent Hospital B in his/her name, Seodaemun-gu Seoul (hereinafter “instant hospital”).

1. Establishment of a C convalescent hospital by Defendant D and Defendant A;

A. The Defendants in violation of the Medical Service Act jointly invested in the establishment of the “E Hospital” in Seodaemun-gu Seoul Metropolitan Government, after completing employment of human resources and the establishment of medical facilities, etc., and employed Defendant D as the president of the establishment of the medical institution to take charge of various management. After changing the name of the said hospital to “C convalescent hospital”, Defendant A’s appointment as the president of the establishment of the said hospital, and the Defendants conspired to operate the C

On December 18, 2007, the Defendants agreed to divide the profits of the hospital into KRW 11,00,000,000 per month in the above C convalescent. From the time when the Defendants reported the establishment of the name of the “C convalescent” in the name of Defendant A to the Seodaemun-gu Public Health Center using the said E Hospital’s employees and medical facilities, Defendant A provided medical treatment to patients and took charge of the management of the medical field until August 31, 2014. Defendant D took charge of all kinds of management, including administrative affairs, employment of employees, fund raising, cash receipt and disbursement, and attraction of patients.

Accordingly, Defendant A and Defendant D, not medical personnel, conspired to establish a medical institution.

B. From December 18, 2007 to August 31, 2014, the Defendants in violation of the Act on the Aggravated Punishment, etc. of Specific Economic Crimes (Fraud) in the above C convalescent established in collusion with Defendant A and Defendant D, who is not a founder of the medical institution, such as the above paragraph (a), requested Defendant A to submit the statement of medical care benefit costs to the Health Insurance Review and Assessment Service after treating patients, and request the examination by Defendant A and his salary doctors. Upon receiving notice of the results of the examination, the said C convalescent was established under the Medical Service Act from the National Health Insurance Corporation.

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