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1. Revocation of the first instance judgment.
2. The Defendant’s medical care benefit cost of KRW 15,648,120, which was paid to the Plaintiff on April 28, 2016.
Reasons
1. The following facts are either in dispute between the parties or in accordance with the purport of Gap evidence 1 to 7 (including the numbers when they are not specially indicated; hereinafter the same shall apply) and the whole pleadings, and there is no counter-proof.
From May 22, 2007, the Plaintiff is a person who opened and operates a C convalescent which is a medical care institution in Daegu Dong-gu.
B. The Plaintiff, at the time of the establishment of a Cvalescent, did not report the establishment and operation of meal service facilities to the competent authorities under Article 69(1) of the former Food Sanitation Act (amended by Act No. 8852, Feb. 29, 2008; hereinafter the same) while operating the meal service facilities from May 30, 2007 to January 15, 2018 after establishing the said hospital.
C. On April 28, 2016, the Defendant issued a disposition to recover the above medical care benefit costs against the Plaintiff pursuant to Article 52(1) of the National Health Insurance Act (amended by Act No. 8852, Feb. 29, 2008; hereinafter the same) on the ground that, among the medical care benefit costs paid to the Plaintiff, the amount of KRW 15,648,120 paid by a medical care institution, in addition to the number of regular dietitians and cooks, constitutes the insurance benefit cost that the Plaintiff received by deceit or other unlawful means.
(hereinafter “instant disposition”) D.
The Plaintiff dissatisfied with the instant disposition and filed an objection against the Defendant on June 9, 2016, but the objection was dismissed on July 21, 2016. Although the Plaintiff filed an appeal with the Health Insurance Dispute Mediation Committee, the appeal was dismissed on October 31, 2017.
2. The Plaintiff’s instant disposition should be revoked on the following grounds.
Only a meal facility that provides meals to at least 50 persons each time of misunderstanding the requirements for disposal, falls under “facilities providing meals” under Article 69(1) of the former Food Sanitation Act. The Plaintiff is from May 30, 2007 to May 30, 2018.