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1. The Defendant’s disposition of suspending the business of a medical care institution for 50-day against the Plaintiff on January 25, 2018 shall be revoked.
2...
Reasons
Details and details of the disposition
A. As a doctor, the Plaintiff is establishing and operating a “C Council member” in Yeongdeungpo-gu Seoul Metropolitan Government (hereinafter “instant Council member”).
B. The Defendant conducted an on-site investigation as to whether the period subject to the investigation was determined as “from February 2014 to June 2015” and “from January 2016 to March 2016, the Defendant conducted an on-site investigation as to whether the instant member’s claim for medical care benefits was made or not.”
(C) On the basis of the results of the above on-site investigation, the Defendant: (a) on the basis of the results of the above on-site investigation, “the Plaintiff unfairly charged KRW 21,513,050,050 for the insurer (National Health Insurance Corporation) as indicated below.
“On January 25, 2018, based on Article 98(1)1 of the National Health Insurance Act (hereinafter “instant disposition”). The details of calculation of unfair amount (hereinafter “instant grounds for disposition”) are as follows: (1),950,020 won after non-benefit treatment; (2) double claim for medical care benefit; (3) even if the relevant expenses were to be collected to a person who was at his/her own desire, the examination fees, etc. are collected; (3) double claim for medical care benefit after health examinations: 1,950,020 won; (4), 18,604,324 won - Although the relevant expenses were claimed to the National Health Insurance Corporation after health examinations; and (3) the method of calculating the medical care fees on the day when the examination was conducted in violation of 962,30 won; and (4) the method of calculating the medical care fees on the day when the examination was conducted in violation of the medical examination guidelines and the method of calculating the medical care fees on the day; and (4) the method of calculating the medical examination fees on the day;