beta
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. The Plaintiff is operating a “C”, which is a long-term care institution that provides home care benefits in Gangseo-gu Seoul Metropolitan Government (hereinafter “instant medical care institution”).
B. As a result of the instant on-site investigation (the period subject to investigation: from June to November of the same year; hereinafter “instant on-site investigation”) conducted on the instant medical care institution from January 25, 2016 to January 28, 2016, the Defendant and Gangseo-gu Office determined that the Plaintiff unjustly received KRW 19,484,410 for home care benefit costs in violation of the former notification (wholly amended by the Ministry of Health and Welfare’s notification No. 2015-202, Nov. 25, 2015; hereinafter the same) on the criteria for the provision of long-term care benefits and the methods for calculating expenses for home care benefits.
C. On March 25, 2016, based on the results of the instant on the Plaintiff’s on-site investigation, the Defendant rendered a disposition to recover expenses for long-term care benefits of KRW 11,478,220 (hereinafter “instant disposition”) to the Plaintiff based on Article 43(1)3 of the former Long-Term Care Insurance Act (amended by Act No. 13647, Dec. 29, 2015; hereinafter the same) as follows.
Although the amount of recovery decision on the violation period between April 2015 and November 2015, the caregiver, who was the beneficiary of D, was actually provided with family care services to D in fact, he/she claimed expenses for benefits as if he/she provided the beneficiary F (hereinafter referred to as "grounds for Disposition 1") 8,652,210 won from April 2015 to November 2015 (excluding April 8, 2019) G caregiver did not provide visiting care services to H and I (hereinafter referred to as "grounds for Disposition 2") but he/she claimed expenses for benefits as if he/she provided the services (hereinafter referred to as "grounds for Disposition 3"), even if he/she did not provide visiting care services to K, L, M, N, and I, it claimed expenses for benefits as if he/she provided the services (hereinafter referred to as "grounds for Disposition 2,826,010 won recovered in total"), 11,278,200 won.
D. The Plaintiff’s objection thereto on June 22, 2016.