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(영문) 서울행정법원 2020.12.17 2020구합56476
업무정지처분취소
Text

All of the plaintiff's claims are dismissed.

Litigation costs shall be borne by the plaintiff.

Reasons

1. Details of the disposition;

A. The Plaintiff’s status is an out-of-the-door medical specialist who establishes and operates a hospital specialized in treatment, such as kneeeing, in Gangseo-gu Seoul Metropolitan Government (hereinafter “instant hospital”).

B. Around July 2016, the director of the National Health Insurance Corporation (the Director of the National Health Insurance Corporation) on-site investigation conducted on-site investigation conducted on-site verification of the instant hospital, and requested the Defendant to conduct an on-site investigation on the instant hospital around February 2017.

Accordingly, the Defendant conducted an on-site investigation with the period of investigation of the instant hospital as “36 months from November 2013 to October 2016”.

As a result of the above investigation, with respect to the “unfair claims by medical care institutions” of the instant hospital, the Defendant confirmed that: (a) the instant hospital violated the standards for calculating the differential rate of hospitalization; (b) KRW 6,511,352; and (c) three violations, including the violation of the standards for operating special medical equipment; and (b) the claim for medical care benefit costs of KRW 176,989,370, total sum of KRW 27,69,370.

In relation to the "unfair claim by the medical care institution" of the hospital of this case, the medical care institution of this case confirmed the improper claim for medical care costs amounting to 6,57,700 won in total, including (1), 3,102,20 won in violation of the standards for calculating the differential rate of hospitalization, (2), 2,048,888 won in violation of the standards for operating special medical equipment and (3), 1,429,888 won in violation of the standards for operating special medical care equipment and the claim for medical care costs amounting to 6,57,70 won in total, and the detailed details are as follows.

(2) If there is a difference between the sum of the improper sum of the total sum and the detailed sum by each item of the contract, the difference between the sum of the improper sum by each item of the contract has occurred. This does not affect the judgment on the legality of the disposition due to the difference caused by the difference between the difference between the amount and the improper sum of the unfair sum by each item of the contract. (1) The claim for the calculation of the differential rate of the admission fee (hereinafter referred to as the "claim for the

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