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(영문) 광주고등법원 2017.07.20 2015누6872
요양급여비용 환수결정 취소 청구의 소
Text

1. Of the judgment of the first instance court, the part of the claim for revocation of the disposition rejecting the payment of medical care benefit costs as of September 17, 2014 shall be revoked, and such revocation shall be revoked.

Reasons

1. Basic facts

A. The Plaintiff’s establishment process 1) obtained permission from the Gwangju Metropolitan City Mayor on May 16, 2012, and was established for the purpose of establishing and operating medical institutions on May 21, 2012. B, from the time of the Plaintiff’s establishment to October 22, 2012, was employed as a director with the Plaintiff’s sole representation right, and thereafter was employed as the Plaintiff’s office. (2) At the time of the Plaintiff’s establishment, the Gold Health Co., Ltd. contributed to the Plaintiff a total amount of KRW 5,402,323,400,00 on the condition that the Plaintiff bears the secured debt of KRW 2.7 billion with the maximum debt amount secured by the said goods (debtor). The real estate and B donated KRW 500,500,000 in cash to the Plaintiff.

B. On June 7, 2012, the Plaintiff established a medical institution and operated an E oriental medical hospital with permission for establishment granted by C, a oriental medical doctor, on November 29, 2012, and closed the above hospital on November 29, 2012. 2) Furthermore, on June 7, 2012, the Plaintiff, who was operating the G convalescent hospital with permission for establishment granted by F, a doctor, transferred and operated the G convalescent hospital located in Gwangju Mine-gu, which was operated on June 7, 2012, filed a report on suspension of business on November 13, 2014.

(hereinafter referred to as “each of the instant hospitals” in total, of E oriental medical hospitals and G convalescent hospitals.

The Defendant’s disposition 1) on September 4, 2014, the Jeonnam Provincial Police Agency notified the Defendant to recover the full amount of medical expenses paid from the time the Plaintiff established each of the instant hospitals on the ground that the instant hospital was operated in the manner of law pursuant to B. (2) Upon receipt of such notification, the Defendant issued a disposition to refuse payment of KRW 313,71,30 of the medical care benefit cost on September 17, 2014; the disposition to refuse payment of KRW 10,186,107,940 of the medical care benefit cost on November 20, 2014; and the disposition to refuse payment of KRW 289,390,890 of the medical care benefit cost on December 16, 2014.

September 17, 2014

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