1. The plaintiff's lawsuit against the defendant National Health Insurance Corporation shall be dismissed;

2. The plaintiff's defendant Minister of Health and Welfare.

Details of the disposition

The Plaintiff is a herb doctor who has established and operates “C Hanwon” (hereinafter “instant Council member”) in the Daegu-gu Jin-gun B and the second floor.

Defendant Corporation established the unfair confirmation period from January 2014 to December 2014, 2015, and conducted on-site verification as to whether the instant member’s claim for medical care benefit costs is appropriate.

(hereinafter “On-site verification.” The Defendant Minister conducted an on-site investigation by setting the investigation period from November 2013 to March 2015, and from November 201 to January 2016, 2016, upon request for on-site investigation by Defendant Corporation. The Defendant Minister conducted an on-site investigation by setting the total of 20 months from March 2013 to January 2016.

(2) On June 4, 2018, based on the “Article 98(1)1 of the National Health Insurance Act”, the Defendant Minister suspended the business of a medical care institution for the following reasons.

(hereinafter referred to as “instant disposition of business suspension”): False claim for the number of days within KRW 40,720,110: KRW 40,720,110; KRW 40,720,110; and KRW 40,720,110; and KRW 40,720,110; and KRW 40,000, although there was no fact that medical treatment was not actually performed, the medical records were recorded in the medical records;

On August 28, 2018, Defendant Corporation rendered a disposition to recover medical care benefit costs of KRW 40,692,360 on August 28, 2018, based on the “Article 57 of the National Health Insurance Act” in accordance with Article 57 of the National Health Insurance Act, for the following reasons: (a) the average of the total amount of costs of health care benefit for the investigation period (from November 2013 to November 2015 to January 2016; and (b) the average of the unfair amount per month during the period of suspension of business 185,25,251,200 won; (c) the period of suspension of business; (d) the average of the unfair amount per month; and (d) the amount of costs of health care benefit of KRW 40,

(hereinafter “instant restitution disposition”). On August 30, 2018, Defendant Corporation sent the instant restitution disposition to the Plaintiff by registered mail, and the Plaintiff was served the said registered mail on September 3, 2018.

On August 22, 2018, the Plaintiff raised objection against the Minister of Justice to the Central Administrative Appeals Commission.