In cases where an institution providing medical benefits submits relevant documents containing false information in custody at the time of receipt of an order to submit documents under Article 32 (2) of the former Medical Care Assistance Act, whether it constitutes a violation of an order or a false report under Article 28 (1) 2 of the same Act (negative)

In light of the language and text of Article 28(1)2 of the former Medical Care Assistance Act (amended by Act No. 8114 of Dec. 28, 2006) and Article 32(2) of the same Act concerning an order to submit documents related to medical benefits, such as the provision of medical treatment and medicine, and the principle of strict interpretation of the penal regulations, if an institution providing medical benefits submits the relevant documents under custody at the time when it was ordered by the Minister of Health and Welfare to submit documents pursuant to Article 32(2) of the Medical Care Assistance Act, even if the documents were to contain false information, it does not constitute “when it violates an order under Article 32(2) or makes a false report” under Article 28(1)2 of the same Act.

Articles 28(1)2 (see current Article 28(1)3) and 32(2) of the former Medical Care Assistance Act (Amended by Act No. 8114, Dec. 28, 2006);

Plaintiff (Attorney Jeon Soo-hee et al., Counsel for the plaintiff-appellant)

The Minister of Health and Welfare (Law Firm Namsan, Attorneys Jin-jin et al., Counsel for the defendant-appellant)

Seoul High Court Decision 2006Nu7951 Delivered on December 15, 2006

The appeal is dismissed. The costs of appeal are assessed against the defendant.

The grounds of appeal are examined.

Article 28(1)2 of the former Medical Care Assistance Act (amended by Act No. 8114, Dec. 28, 2006; hereinafter “Medical Care Assistance Act”) provides that when an institution providing medical benefits violates an order issued under Article 32(2) or makes a false report, the Minister of Health and Welfare may order the institution providing medical benefits to suspend its business for a fixed period not exceeding one year. Article 32(2) provides that the Minister of Health and Welfare may order the institution providing medical benefits to submit a report or relevant documents on medical benefits, such as the payment of medical treatment and medicine, etc. In light of the literal content and the principle of strict interpretation of the statutory provision, if the institution providing medical benefits submits the relevant documents kept in custody by the Minister of Health and Welfare after receiving an order to submit documents under Article 32(2) of the Medical Care Assistance Act from the Minister of Health and Welfare, even if the document was false, it does not constitute a violation of an order issued under Article 28(1)2 of the Medical Care Assistance Act or a false report under Article 32(2).

In the same purport, the court below is justified in revoking the business suspension of the defendant on the ground that the plaintiff's above act constitutes an unlawful act, since it does not constitute "a violation of an order under Article 32 (2) or a false report" under Article 28 (1) 2 of the Medical Care Assistance Act, since it does not constitute "when it violates an order under Article 32 (2) or makes a false report" while the plaintiff filed a claim for unfair medical care costs with the beneficiary or the head of a Gun, etc. for the payment of unfair medical care costs by entering false matters concerning medical treatment in the medical records or the personal charge ledger. There is no error in the misapprehension of legal principles as to the scope of application under Article 28 (1) 2 of the Medical Care Assistance Act

Therefore, the appeal is dismissed, and the costs of appeal are assessed against the losing party. It is so decided as per Disposition by the assent of all participating Justices.

Justices Kim Nung-hwan (Presiding Justice)