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(영문) 부산지방법원 2020.10.22 2019구합21550
요양급여비용 지급보류처분취소
Text

1. The instant lawsuit shall be dismissed.

2. The costs of the lawsuit are assessed against the defendant.

Reasons

1. Details of the disposition;

A. On December 30, 2011, the Plaintiff is a medical corporation established and operated for the purpose of establishing and operating a medical institution, etc., and each of the medical corporations established and operated “C convalescent Hospital” in Busan, the “D convalescent Hospital” in Busan, the “D convalescent Hospital” in F, and the “B convalescent Hospital” in Busan, Dongdong-gu, Busan (hereinafter collectively referred to as the “instant hospital”).

B. On April 1, 2019, the Busan Regional Police Agency investigated the Plaintiff’s operation of the instant hospital upon the Defendant’s request for investigation, and established and operated the instant hospital under the name of the Plaintiff, after establishing a non-profit corporation, which did not meet the formal requirements by falsely preparing meeting minutes, etc. of the board of directors, etc., even though H and I was not qualified to establish a medical institution, and then acquired medical care benefits, etc. from the Defendant from the Defendant in the process, and sent them to the Busan District Prosecutors’ Office as prosecution opinions on the violation of the Medical Service Act and the charges of fraud. On April 4, 2019, the notice of the result of the instant disposition (violation of Article 33(2) of the Medical Service Act) (hereinafter “instant notice”).

E Institutions are confirmed to have violated Article 33(2) of the Medical Service Act or Article 20(1) of the Pharmaceutical Affairs Act (violation of the standards for the establishment of medical institutions and pharmacies), and they cannot claim medical care benefit costs because they are not medical care institutions provided for in Article 42(1) of the National Health Insurance Act.

(Non-existence of Right to Claim Medical Care Benefit Costs). Accordingly, the Corporation notifies the suspension of the payment of medical care benefit costs until it confirms that it is a medical care institution prescribed by law.

The details of the deferment of the payment of medical care benefit costs, the amount of withholding the payment to the person who established the name of the medical care institution, the medical care benefit costs, the expected payment after the disposition of withholding the payment after the disposition of withholding the payment after the Busan So-called Busan in Busan in the Cvalescent, and the cost of medical care benefits for which the payment was deferred after the disposition of withholding the payment after the disposition of withholding the payment after the disposition of withholding the payment, and the cost of medical care benefits

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