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(영문) 서울고등법원 2014.10.31 2013누31099
과징금부과처분취소
Text

1.The judgment of the first instance shall be modified as follows:

The Minister of Health and Welfare against the Plaintiff on August 4, 201.

Reasons

1. Details of the disposition;

A. Establishment of D and the establishment of B hospital, E hospital, and C hospital (1) on August 14, 1992, the Plaintiff established D medical corporations for the purpose of establishing and operating medical institutions (hereinafter “D”).

(2) On May 26, 1994, Gyeongnam-do opened a hospital B (hereinafter “B hospital”) with the Plaintiff’s founder as a result of donation of land from D and Plaintiff, and entrusted its management to D.

(3) Around April 26, 1996, D opened an E Hospital with the Plaintiff’s founder as the immediate next side of the B Hospital.

(4) On July 12, 200, Gyeongnam-do opened a C Hospital (hereinafter “C Hospital”) with the Plaintiff’s founder as it received donations from D and the Plaintiff, and entrusted its management to D.

B. As a result of an on-site investigation conducted by the Ministry of Health and Welfare on-site investigation with respect to B hospitals and C hospitals from November 9, 2009 to September 14, 2009, the Minister of Health and Welfare determined that the above hospitals filed a false claim for medical care benefit costs and medical care costs as follows during the period from July 1, 2008 to September 30, 2009 (total 15 months).

Illegal amount of violation - Claim for medical care benefit costs for patients hospitalized in other medical institutions (E hospital) - Claim for violation of the Mental Care Benefit Calculation Standard of 53,280,560 won 168,58,580 won for patients hospitalized in B hospital (E hospital) - The work and entertainment method may be calculated when a full-time expert (mental nurse, social worker, etc.) was conducted under the diagnosis and instruction of a psychiatrist. However, from July 208 to February 2009 without a diagnosis by a psychiatrist and without a diagnosis by a psychiatrist, the number of hospitalization per day is 36,24,76 won 51,571,792 won in total, 89,525,36 won in total, 220,530,5372 won in violation of the medical care benefit costs - The medical care institution uses the medical care benefit benefit costs claim procedure without resorting to the medical care benefit claim procedure.

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