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(영문) 서울고등법원(춘천) 2020.06.15 2019누1123
요양급여비용삭감처분 등 취소
Text

1. Revocation of the first instance judgment.

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

3. The total cost of the lawsuit.

Reasons

1. Details of the disposition;

2.The indication of the relevant regulations;

3. The reasoning of the judgment of the court on this part of this part of the summary of hospitalization fees in a convalescent is the same as that of the judgment of the court of first instance. Therefore, it is acceptable to accept this as it is in accordance with Article 8(2) of the Administrative Litigation Act and the main sentence of

4. Determination

A. The purport of the Plaintiff’s assertion is that, in the event that a convalescent institution has failed to submit a written notice of the current calculation period of hospitalization fees, the highest grade shall be given during one quarter in calculating medical care benefit costs and hospital fees, which are medical care benefit costs.

As a result, the costs of medical care benefits and medical care benefits that the plaintiff can receive should be reduced by 50% compared to the basic grade that did not add or reduce the amount in the fixed amount of hospitalization fees in a convalescent hospital. Accordingly, the reduction review decision and the notice of recovery decision were made.

However, there is no procedure for the Defendants to confirm the class of a convalescent which is actually satisfied by the convalescent, and the period for submission and the Defendants did not request the convalescent, and even if the convalescent is actively explained, there is no way to provide a procedural method. Nevertheless, regardless of the actual status of the supply and demand of human resources in a convalescent hospital, the provisions of this case, which provide that 50% of expenses shall be reduced uniformly compared to the basic class, are in violation of the constitutional principles and the principle of proportionality as the general principles of administrative law, and where the submission period of relevant materials is excessive, the provision of this case violates the principle of equality, which is a fundamental right in the Constitution, and violates the principle of equality, which is the general principles of administrative law.

Therefore, the review decision and notice of recovery decision of this case based on the provision of this case, which is unconstitutional, should be revoked.

B. The instant provision is against the principle of proportionality.

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