1. The plaintiff's claim is dismissed.

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

1. Details of the disposition;

A. The Plaintiff is a person who operates the “C Hospital” (hereinafter “instant hospital”), which is a health care institution under the National Health Insurance Act, in the Gu and America City B.

The defendant is a corporation established under Article 62 of the National Health Insurance Act in order to examine medical care benefit costs and evaluate the appropriateness of medical care benefits.

B. From July 5, 2013, the Plaintiff filed a request for an examination of KRW 1,876,740 of the medical care benefit cost of the instant patient on January 1, 2014, on the premise that the classification of the instant patient based on the patient’s patient’s identification table and the relative value of benefits (Notice No. 2013-192 of the Ministry of Health and Welfare; hereinafter “instant notification”) constitutes the medical height, on the basis that the instant patient’s classification based on the patient identification table constitutes the medical height.

C. On March 14, 2014, the Defendant evaluated the instant patient as the physical skills low-level group for the following reasons, and notified the Plaintiff of the examination and conciliation to adjust the costs of health care benefit to KRW 1,344,780 by reducing the cost of health care benefit to KRW 531,960 on January 2014 (hereinafter “instant disposition”).

Although the fixed amount of hospitalization in a convalescent hospital includes all the medical expenses that are administered to the patient, it has been confirmed that the other hospital prescribed the major medicines or regularly conducted the medical examination. Accordingly, as a result of the examination of the disease, the period of hospitalization, the patient evaluation table, and the details of the other hospital during the period of hospitalization, the examination and adjustment should be made to the physically low-income group which is the standard of admission to the sanatorium in accordance with the guidelines for calculating the medical care benefit standard.

The Plaintiff appealed and filed an objection on April 14, 2014, but the Defendant dismissed it on June 2, 2014.

The plaintiff filed an administrative appeal, but the Central Administrative Appeals Commission dismissed the plaintiff's claim on March 17, 2015.