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(영문) 대법원 2019.05.30 2016두56370
요양급여비용환수처분취소
Text

The appeal is dismissed.

Plaintiff

The application for participation by the Intervenor X and Y shall be dismissed.

The costs of appeal are assessed against Plaintiff.

Reasons

1. Judgment on the grounds of appeal

A. (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 disease and injury, prevention, diagnosis, and rehabilitation, for childbirth and death, and for improvement of health (Article 1). The National Health Insurance Act provides that the health care benefits for the disease, etc. of the insured and their dependents, including medical examination, the provision of medicines and materials for medical treatment, treatment surgery, and other medical treatment, shall be provided (Article 41(1)), and the National Health Insurance Corporation shall pay the expenses for the health care benefits provided by health care institutions, including “medical institutions

(1) Articles 42(1) and 47(1) of the Medical Service Act provides for the purpose of protecting and improving the health of the people by providing for matters necessary for national medical fees so that all citizens can benefit from high-quality medical treatment (Article 1), and the Medical Service Act limits the establishment of a medical institution only to a medical doctor, dentist, oriental medical doctor, or midwife (hereinafter “medical person”) (Article 33(2)1). On the other hand, medical personnel are prohibited from opening and operating two or more medical institutions (the main sentence of Article 33(8); hereinafter “the prohibition of double establishment”); medical personnel are prohibited from opening and operating a medical institution under the name of another medical person.

(Article 4(2) and 33(8) main text of the Medical Service Act provides a penal provision for a person who has been employed not only by a person who established a medical institution but also by a person who is not eligible to establish a medical institution (Article 90) in the case of violation of Article 33(2) of the Medical Service Act.

Unlike this, in the case of violation of Article 33(8), the penal provisions for medical persons who established and operated two or more medical institutions are regulated.

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