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(영문) 대법원 2018.04.26 2018도2166
특정경제범죄가중처벌등에관한법률위반(사기)등
Text

The appeal is dismissed.

Reasons

The grounds of appeal are examined.

1. As to the first ground for appeal, the lower court: (a) in collusion with F to establish a medical institution prohibited by the Medical Service Act by establishing a J delegate under the name of F, although it was sufficiently possible for the Defendant, who is not a medical personnel, to be aware of the fact that there is no substance as an incorporated foundation B established by the joint Defendant F of the first instance trial, not a medical personnel.

The decision was determined.

In light of the relevant legal principles and records, the lower court did not err by misapprehending the legal doctrine regarding the degree of proof of facts charged, or by exceeding the bounds of free evaluation of evidence against logical and empirical rules.

2. On the second ground of appeal, in violation of Article 33(2) of the Medical Service Act, if a medical institution provided medical care benefits, such as medical treatment for patients at a lawfully established medical institution, the relevant medical institution does not constitute a medical care institution that is entitled to claim medical care benefits costs under the National Health Insurance Act, and thus is not entitled to lawful payment of care benefits (see, e.g., Supreme Court Decisions 2011Du21669, Jan. 27, 2012; 2012Da72384, May 14, 2015). Therefore, if a non-medical institution established under the Medical Service Act was a medical care institution, claiming medical care benefits costs to the National Health Insurance Corporation would cause error in the decision-making on the payment of medical care benefits, and thus, it constitutes fraud if the National Health Insurance Corporation received medical care benefits from the National Health Insurance Corporation due to such deception, the lower court is recognized as one of the medical care institutions established under the National Health Insurance Service Act.

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