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(영문) 대구지방법원 2017.04.14 2016구합20281
요양급여비용지급보류처분취소
Text

1. The plaintiff's claim is dismissed.

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

Reasons

1. Details of the disposition;

A. 1) The Plaintiff is a medical corporation established for the purpose of establishing and operating a medical institution. 2) On February 4, 2009, the Gyeongbuk-do Governor established a medical corporation to establish and operate the medical corporation. On February 19, 2009, the Plaintiff granted permission for opening the B convalescent hospital (hereinafter “the instant convalescent hospital”).

B. On April 7, 2015, the Defendant, on the ground that the instant convalescent hospital was a medical institution established under the name of the Plaintiff, a medical corporation, who is not a doctor, and C, not a medical corporation. On April 7, 2015, the head of the Daegu District Prosecutors’ Office, on January 12, 2016, notified C of the charge that “The head of the Daegu District Prosecutors’ Office, on January 12, 2016, established the instant convalescent hospital, which is a medical institution, by lending the Plaintiff’s name to the Defendant.”

C. Grounds related to the instant disposition

(a) Article 47-2 of the National Health Insurance Act and Article 22-2 of the Enforcement Decree thereof;

B. As a result of the investigation by a judicial agency about the case subject to the violation of the Medical Service Act (Case No. 5677, 2015) of the Daegu District Public Prosecutor’s Office, the instant convalescent hospital is found to have violated Article 33(2) of the Medical Service Act, and does not constitute a medical care institution under Article 42(1) of the National Health Insurance Act. As such, the details of withholding the payment of medical care benefit until it is confirmed to be a medical care institution under the Act: 173,932,920 won: the Defendant notified the Plaintiff on January 13, 2016 that the payment of medical care benefit cost would be deferred on the ground of Article 47-2 of the National Health Insurance Act; and on January 25, 2016, the Defendant notified the Plaintiff that the payment of medical care benefit would be deferred (hereinafter “instant disposition”).

【Unsatisfied facts, Gap evidence 1 through 5 (including each number; hereinafter the same shall apply), and Eul evidence 1 through 4 respectively.

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