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(영문) 서울행정법원 2018.09.20 2017구합77268
요양기관업무정지처분 취소 등
Text

A medical care institution that the Defendant rendered to the Plaintiff on August 2, 2017 and the Plaintiff on August 29, 2017.

Reasons

Details and details of the disposition

A. The Plaintiff is an oriental medical doctor who establishes and operates a Korean-style Medical Center C in Gyeong-gun, Gyeongnam-gun (hereinafter “Korean-style Medical Center”).

B. On April 2013, the National Health Insurance Corporation (hereinafter “the instant on-site verification”) requested the Defendant to conduct an on-site inspection of the instant Institute on the grounds that “after the implementation of moxibation art with respect to an unqualified member’s oral statement at the instant Institute, it was confirmed that the unfair claim for medical care benefit costs was confirmed after the implementation of the moxibation art” around May 22, 2013.

C. From April 13, 2015 to April 15, 2015, the Defendant conducted an on-site investigation (hereinafter “instant on-site investigation”) on the matters concerning the medical care benefits and medical benefits of the Plaintiff, setting the period of investigation as “36 months from March 2012 to February 2015” (hereinafter “instant period”).

On August 2, 2017, the Defendant rendered a disposition to suspend the business of 72 days’ health care institutions pursuant to Article 98(1)1 of the former National Health Insurance Act (amended by Act No. 13985, Feb. 3, 2016; hereinafter the same) on the ground that “the Plaintiff, upon having some of the winners who are not qualified as medical personnel for the instant period, allowed them to make an oral statement, and then demanded the National Health Insurance Corporation to pay KRW 75,959,460 on the aggregate of the health care benefit costs in the oral-indirect-Indirect-Indirect-Indirect-Indirect-Indirect-Informed Districts, and received the payment by deceit or other unlawful means, and rendered a disposition to suspend the business of the Plaintiff on August 29, 2017, based on Article 28(1)1 of the Medical Care Assistance Act, on the ground that he/she had the Plaintiff bear the costs of medical care benefits of KRW 7,005,620.

hereinafter "each disposition of this case" and "the grounds for the disposition of this case" are "the grounds for the disposition of this case".

) [In the absence of a dispute over the basis for recognition, entry in Gap evidence 1, 2, and Eul evidence 6, pleading.

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