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(영문) 의정부지방법원 2021.02.15 2019구단6190
업무정지처분취소
Text

1. The plaintiff's claim is dismissed.

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

Reasons

1. Details of disposition;

A. Establishment and operation of a “D Senior Welfare Center” (hereinafter “instant center”) designated as a long-term medical care institution in the Namyang-si, Namyang-si, Seoul, and as a long-term medical care institution under subparagraph C, on November 11, 2011.

B. On-site investigations conducted by the National Health Insurance Corporation (hereinafter “Corporation”) and the Defendant’s Center (from February 25, 2019)

2. 1) The target period: From January 1, 2016 to June 30, 2016; from September 30, 2018 to December 31, 2018; (ii) the violation of the guidelines for the placement of human resources (amount 2,012,390 won per additional claim) were employed for some of the months from September 11, 2018 to November; (iii) the additional working hours were reported to provide the services of 176 hours from September 136 to 176 hours per month (the base period for each actual working hours = the additional working hours = 35 hours/136 hours per September; (iv) the additional working hours from October 147 to December 154; and (v) the additional working hours from September 200 to December 18, 200 to December 31.

C. On June 14, 2019, the instant disposition authority rendered a redemption decision on May 9, 2019 regarding the above long-term care benefit costs (=2,012,390 won in violation of the standards for placement of human resources + KRW 3,692,270 in violation of the guidelines for addition of additional placement of human resources). The Defendant followed the hearing procedure.

6. 14. 50 days (from July 15, 2019) on the ground that the Plaintiff filed an unjust claim of KRW 5,704,660 for expenses incurred in providing benefits by fraud or other improper means (the annual average of KRW 4.47% per additional claim, and KRW 570,466).

9.2. To effect that the disposition of business suspension is taken; and

D. On the other hand, the Plaintiff.

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