1. The defendant's appeal is dismissed.

2. The costs of appeal shall be borne by the Defendant.

Purport of claim and appeal

purport.

1. Facts of recognition;

A. The Defendant is a doctor who operated a B convalescent hospital, which is a health insurance medical care institution, from October 27, 2009 to December 21, 2013.

B. From September 3, 2013 to September 30, 2013, the Defendant issued a medical care benefit standard (Notice of the Minister of Health and Welfare) in violation of the medical care benefit standard as indicated in the attached Table (Notice of the Minister of Health and Welfare) and accordingly, the relevant patient received the medicine after receiving the medical care benefit. The total amount is KRW 262,670.

[Ground of recognition] Facts without dispute, entry of Gap evidence Nos. 10 to 18, purport of the whole pleadings

2. Determination as to the cause of action

A. Article 41 of the National Health Insurance Act provides that health insurance policyholders and their dependents shall provide health care benefit, and the scope of health care benefit for medicine is determined and publicly notified by the Minister of Health and Welfare.

Since a prescription outside of the medical care benefits standards cannot be included in the medical care benefits amount, regardless of any case, the medical care institution shall not use it as the medical care benefits amount and issue a prescription.

Nevertheless, if a medical care institution issues a prescription with an out-of-the-counter prescription that deviates from the medical care benefit standard as a medical care benefit subject, even if the prescription is intended to fulfill the best medical care obligation for patients, and cannot be viewed as an unlawful act against the subscriber, etc., it constitutes an act causing loss to the insurer to pay medical care benefit costs for diagnosis and treatment not the medical care benefit subject. In order to realize the obligation of the State to protect the health of the people under the Constitution, it constitutes an act detrimental to the national health insurance system or order that has formed the insurance finance based on the social insurance principle, and thus, constitutes an unlawful act under Article 750

(see, e.g., Supreme Court Decision 2013Da66911, Feb. 27, 2014). Defendant from September 3, 2013 to September 30, 2013.