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(영문) 서울행정법원 2019.05.16 2018구합78121
요양급여비용 환수처분 취소
Text

1. All of the plaintiffs' claims are dismissed.

2. The costs of lawsuit are assessed against the plaintiffs.

Reasons

1. Details of the disposition;

A. On July 6, 2017, the Commissioner of the Do Police Agency: (a) around January 2016, the Plaintiff A, who is not eligible to establish a medical institution under the Medical Service Act, paid money to the Defendant as remuneration, etc.; and (b) the Plaintiff B, in the name of the Plaintiff B, opened and operated the instant hospital in North-gu C (hereinafter “instant hospital”). Furthermore, even though the instant hospital was established in violation of the Medical Service Act, the Plaintiffs et al. were not entitled to claim medical care benefit due to its establishment in violation of the Medical Service Act; (c) by deceiving the Defendant as if the instant hospital was a medical institution established normally in accordance with the Medical Service Act and the procedures from April 7, 2016 to September 28, 2016, the Commissioner of the Do Police Agency received KRW 1,919,604,660 from the Defendant as the name of the medical care benefit, etc.; and (d) sent the written opinion of prosecution as to the criminal facts, such as violation of the Medical Service Act,

B. On August 11, 2017, based on the police’s investigation result, the Defendant notified the Plaintiffs of the restitution decision, based on Article 57(1) and (2)1 of the National Health Insurance Act, on the ground that the instant hospital, which was a medical institution established in violation of Article 33(2) of the Medical Service Act, was unable to receive medical care benefits under the National Health Insurance Act, even if it was provided with medical care benefits, and was unfairly claimed and paid, the Defendant received such benefits.

(2) On March 14, 2016 through October 17, 2016 through July 7, 2017, the founder of each of the instant dispositions (hereinafter referred to as “each of the instant dispositions”) / [the list]: Plaintiff B’s office: Plaintiff A2,129,872, 250, 694, 160, 8202, 8202, 824, 03,070, 070, 03,070;

C. The Plaintiffs were indicted on July 26, 2017 due to the violation of the Medical Service Act and the violation of the Act on the Aggravated Punishment, etc. of Specific Economic Crimes (Fraud), and the wooden Branch of the Gwangju District Court on January 11, 2018.

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