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(영문) 대구지방법원 경주지원 2014.02.07 2013고합66
특정경제범죄가중처벌등에관한법률위반(사기)등
Text

Defendant

A Imprisonment for three years, three years of imprisonment for Defendant B, and twenty thousand won of fine, and Defendant C for a fine of 9,000,000 won.

Reasons

Punishment of the crime

Defendant

B is the president of the J Medical Foundation established around April 2006, the L Hospital opened to K on or around February 20, 2008, the N Hospital opened to K on or around January 15, 2010, and the representative of the P Hospital opened to the P Hospital on or around October 201, which was opened to the P Hospital on or around October 201, and has overall control over the operation, accounting, patient management, and insurance claims of each of the above hospitals.

Defendant

A is a person who is working as the vice-chairperson of the above foundation from June 29, 2007 to October 2012 and has been in charge of personnel affairs, business and property management of each of the above hospitals, and quarterly reports and requests for review by the Health Insurance Review and Assessment Service.

Defendant

C is a person who has been engaged in the duties such as the discharge and management of patients, health care expenses management, quarterly reporting of the Health Insurance Review and Assessment Service, request for review, etc.

Defendant

D is a person who has been engaged in the affairs such as the discharge management of patients by the head of the above N Hospital, the management of medical care expenses, the quarterly report of the Health Insurance Review and Assessment Service, and the request for review.

Q is a person who has been engaged in the duties such as entry, discharge management, medical care expenses management, quarterly report of the Health Insurance Review and Assessment Service, and request for review by the head of the above P Hospital.

1. Defendants A and B’s violation of the Act on the Aggravated Punishment, etc. of Specific Economic Crimes (Fraud) and fraud are assessed by evaluating the nursing grade (average number of patients/average number of nursing personnel) in accordance with the standards for calculating the differential rate of hospitalization fees according to the level of securing human resources for nursing only with the materials submitted by the Health Insurance Review and Assessment Service, and, in the case of the in-patient food service, the amount of health insurance premium paid to the relevant hospital is differentiated according to the number of full-time personnel for dietitians and cooks according to each evaluation grade, and the number of inpatientss are abused to abuse the above evaluation method.

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