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(영문) 의정부지방법원 2019.07.18 2017구합12617
업무정지 처분 취소 청구의 소
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. From December 3, 2013, the Plaintiff established and operated Cmedical Care Center (the name of the first facilities of the Party was changed to that of the D Medical Care Center; hereinafter “instant medical care institution”) in Namyang-si, Namyang-si (hereinafter “instant medical care institution”).

B. The Defendant and the National Health Insurance Corporation conducted a field investigation on the instant health care institution from December 19, 2016 to December 22, 2016.

(Period subject to Investigation: From April 2014 to October 2016; hereinafter “instant on-site investigation”). From January 2, 2015 to April 31, 2015, E registered as an assistant nurse was limited to the duties of caregiver from January 2, 2015 to March 31, 2015, and filed a false claim for expenses for benefits by reporting as if he/she had worked as an assistant nurse even if he/she did not actually work as an assistant nurse.

Even if there is an additional placement of human resources in the relevant month to which the calculation of reduction is applied due to a violation of the criteria for placement of human resources in violation of the criteria for placement of additional placement of human resources of KRW 37,803,00,000, the additional placement of human resources was added due to the placement of a cook during the period during which the reduction is applied due to a vacancy, as above.

926,920 Won 38,729,920

C. On April 14, 2017 based on the results of the instant on-site investigation, the National Health Insurance Corporation rendered a disposition to recover KRW 38,729,920,00 based on Article 43 of the former Act on Long-Term Care Insurance for the Aged (amended by Act No. 13647, Dec. 29, 2015; hereinafter the same) on the ground that the Plaintiff unduly claimed and received expenses for long-term care benefits by violating the criteria for placement of human resources and additional placement standards as follows:

(hereinafter “instant restitution disposition”) D.

On May 17, 2017, the Defendant, on the ground that the Plaintiff unduly claimed expenses for long-term care benefits as above, Article 37(1)4 of the former Act on Long-Term Care Insurance for the Aged.

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