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(영문) 서울행정법원 2021.03.18 2020구합90094
의사면허자격정지처분취소
Text

The plaintiff's claim is dismissed.

Litigation costs shall be borne by the plaintiff.

Reasons

1. Details of the disposition;

A. The Plaintiff acquired a dentist’s license, and opened and operated a medical institution under the trade name of “C dental clinic” (hereinafter “instant clinic”) on the Jung-gu Incheon Metropolitan City’s B and 3 floors.

B. On July 15, 2020, the Plaintiff was issued a summary order of KRW 5 million due to the following facts constituting a crime of fraud by the Incheon District Court Decision 2020 high-level 2002, which became final and conclusive August 29, 2020.

Despite the absence of the fact that Sugjin D applied to D on May 12, 2014 and May 14, 2014, the Plaintiff: (a) entered false information in the treatment register as if he/she provided D on the pertinent day; (b) filed a false claim for medical examination fees and treatment materials for the medical care benefit cost with the disease “finite awareness of a quality”; and (c) filed a false claim for KRW 1,625 for the cost of medical care benefits until May 8, 2017; and (d) received a false claim for KRW 51,267,305 in total from the National Health Insurance Corporation; and (b) acquired the same amount by fraud.

(c)

In this regard, on October 5, 2020, the Defendant: (a) on the ground that the Plaintiff constituted “a case of forging relevant documents or claiming medical expenses by fraudulent or other unlawful means; (b)” Article 66(1)7 of the former Medical Service Act (Amended by Act No. 16375, Apr. 23, 2019; hereinafter the same shall apply); and (c) the former Rules on Administrative Dispositions Concerning Medical Services (Amended by Ordinance of the Ministry of Health and Welfare No. 587, Aug. 17, 2018; hereinafter the same shall apply) [Attachment] of the criteria for administrative disposition

1. Common standards:

(a)(iii)(b) and

2. Individual standards:

A. 38) Pursuant to the disposition of suspending the qualification of dentists for eight months (from April 3, 2021 to December 2, 2021) (hereinafter “instant disposition”). D.

Detailed calculation specifications based on the Defendant’s disposition of the instant case are as follows.

The total amount of false claims in calculation of the amount of false claims shall be the number of days in which false claims are filed, and shall be 18,452,213 won after medical treatment eligible for false claims, such as treatment for the number of days in which false claims are filed, which shall be 51,267,090 won 23,852,780 won, 8,213 won.

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