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(영문) 대법원 2019.05.30 2016두62481
요양급여비용환수처분 취소 등
Text

The appeal is dismissed.

Plaintiff

The application for intervention by the supplementary intervenor and the defendant's supplementary intervenor shall be dismissed.

Reasons

1. The grounds of appeal are examined (to the extent of supplement in case of supplemental appellate briefs not timely filed).

1) The National Health Insurance Act was enacted for the purpose of contributing to the improvement of national health and the promotion of social security by providing citizens with insurance benefits for the prevention, diagnosis, medical treatment, and rehabilitation of diseases and injury, for childbirth, death, and improvement of health (Article 1). Under Article 41(1) of the Act, the National Health Insurance Act provides health care benefits for medical examinations, the provision of medicine and materials for medical treatment, treatment, surgery, and other treatment (Article 41(1) of the Act), and the National Health Insurance Corporation shall ensure that the expenses for health care benefits provided by health care institutions, including “medical institutions established under the Medical Service Act” are paid by the National Health Insurance Corporation (Articles 42(1)1 and 47(1) of the Act; and the National Health Insurance Corporation may collect all or part of the amount equivalent to the expenses for the insurance benefits from the national health care institutions that have received the insurance benefits in the form of “influencies or other unfair means” (Article 57(1) of the Act). The Medical Service Act provides for matters necessary for citizens’ medical fees so that all citizens enjoy high-quality health benefits (Article 1).

(1) Article 33(2)1 of the Act provides that a medical institution may be established (Article 33(2)1); medical personnel shall not establish and operate two or more medical institutions (the main text of Article 33(8)); and medical personnel shall not establish or operate a medical institution under the name of another medical personnel (Article 4(2) and the main text of Article 33(8)).

(2) As such, the National Health Insurance Act provides medical care benefits suitable for the treatment of diseases.

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