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(영문) 서울행정법원 2015.12.03 2015구합62613
업무정지처분취소
Text

1. The plaintiff's claims against the defendants are all dismissed.

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

Reasons

Details of the disposition

On November 25, 2005, the Plaintiff is an oriental medical doctor established and operated a “C” (hereinafter “instant member”).

From July 9, 2012 to April 13, 2012, the Defendants conducted on-site investigations against the instant member on the details of medical treatment from May 1, 2009 to April 31, 2012.

(2) On March 2, 2015, the Defendant Minister of Health and Welfare rendered a disposition to suspend the business of a medical care institution for 120 days pursuant to Article 98(1)1 of the National Health Insurance Act (hereinafter “instant disposition”). On June 3, 2015, Defendant National Health Insurance Corporation rendered a disposition to recover medical care benefit costs of KRW 100,205,80 pursuant to Article 57(1) of the same Act (i.e., ①9,692,040 won ② ② KRW 372,780, KRW 140,980) on the ground of the same disposition against the Plaintiff on March 2, 2015.

(2) If a traffic accident patient D, etc., who is a patient of KRW 9,692,040, received medical care benefit expenses as if he/she received medical care expenses (hereinafter “reasons for Disposition 1”) as if he/she received medical care due to his/her failure to do so even after he/she received a false claim for the number of days of internal origin 9,692,040 (hereinafter “the ground for Disposition 1”), the medical care benefit expenses for double claim 372,780, after the medical care for non-payment, was provided for non-payment for non-payment (hereinafter “the ground for Disposition 2”), and the medical care benefit expenses were collected as if he/she received medical care expenses as a “comfort” disease (hereinafter “the ground for Disposition 2”). (3) After the medical care for the patient under the Guarantee of Automobile Accident Compensation Act, the traffic accident patient of KRW 140,980, was paid as an automobile insurance, and received the medical care expenses as if he/she received it.

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