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(영문) 서울행정법원 2019.07.18 2018구합83055
장기요양급여비용 환수처분 취소
Text

1. The plaintiff's claim is dismissed.

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

Reasons

1. Circumstances and details of the disposition;

A. The Plaintiff is a person who is operating the “C Care Center” in Ansan-si B (hereinafter “instant long-term care institution”).

B. On May 2018, the Defendant conducted an on-site investigation as to whether the claim for expenses for long-term care benefits of the instant long-term care institution is appropriate, along with the Ansan market.

(hereinafter “instant on-site investigation”). C.

On October 18, 2018, the Defendant issued to the Plaintiff a disposition to recover expenses for long-term care benefits of KRW 189,537,750 based on the “Article 43 of the Long-Term Care Insurance for the Aged” on the following grounds:

(1) Pursuant to Article 23 of the Enforcement Rule of the Act on Long-Term Care Insurance for the Aged (Notice of the Ministry of Health and Welfare No. 2014-97), a long-term care agency that has violated the criteria for placement of human resources shall have facilities and human resources pursuant to Article 23 of the Enforcement Rule of the Act on Long-Term Care Insurance for the Aged, and pursuant to Chapter IV Section 4 (Guidelines for Calculation of Additional Benefits) of the Public Notice of Standards for Provision of Long-Term Care Benefits (Notice of the Ministry of Health and Welfare No. 2014-97), among human resources reported to the head of the competent Si/Gun/Gu, the number of employees to calculate additional or reduced expenses for benefits

D From May 1, 2015 to April 30, 2018, the instant long-term care institution violated the criteria for placement of human resources prescribed by relevant regulations by registering as a social worker, even though it had worked for less than the standard monthly working hours, and E had worked for less than 10 hours a month from August 17, 2015 to April 30, 2018.

In addition, when the criteria for placement of human resources are violated, the expenses for the relevant monthly allowance shall be reduced according to the ratio of human resources vacancies for all recipients during the violation period.

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