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(영문) 대전지방법원 2017.03.30 2016구합104561
업무정지등처분취소
Text

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

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

Reasons

1. Details of the disposition;

A. On March 2015, the Defendant discovered that the Plaintiff received KRW 13,540,530 as the claim for medical care benefit (in the case of a partial completion of medical care, the medical examination and treatment fees, etc. after visiting a community center or home, other than a medical care institution), and ② the false claim for the number of days of internal medical care (in the case of a partial completion of medical care, the medical examination fees, and treatment fees, etc. are deemed to have been provided as medical care benefit costs) as a result of an on-site investigation conducted by the Plaintiff in the name of “C” in Yangyang-gun, Gangwon-do (hereinafter “instant oriental medical institution”).

B. Based on the above detection, on June 28, 2016, the Minister of Health and Welfare issued a disposition of 102 days of business suspension of health care institutions (from October 31, 2016 to February 9, 2017) pursuant to Article 98(1)1 of the National Health Insurance Act; and the Defendant National Health Insurance Corporation issued a disposition of recovering KRW 27,502,280 on August 31, 2016 pursuant to Article 57 of the National Health Insurance Act.

(hereinafter referred to as “each of the dispositions of this case”). Specific calculation details of each of the dispositions of this case are as follows.

Unit: 152,692,620,620 27,502, 280, 200, 207 280, 207 102/102 / [Grounds for Recognition] of the absence of dispute, Gap evidence 2, 4 (including Serial number; hereinafter the same shall apply), Eul evidence 1, 2, Eul evidence 1, 1, 2, 1, and 1, and the purport of the whole pleadings, as a whole, of the costs of health care benefit (from March 2014 to January 11, 2015) of the total amount of costs of health care benefit for the period of investigation.

2. Whether each of the dispositions of this case is legitimate

A. The plaintiff's gist of the plaintiff's assertion is that the plaintiff mainly provided medical treatment within one Council member of this case, and that the plaintiff provided medical treatment at the community hall or at the residents' home.

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