The plaintiff's claim is dismissed.

Litigation costs shall be borne by the plaintiff.

Details of the disposition

A. The Plaintiff is a herb doctor who establishes and operates a “C convalescent Hospital” located in Gyeonggi-gu Group B (hereinafter “instant convalescent Hospital”).

B. On July 2014, the President of the National Health Insurance Service rendered a request for an on-site investigation to the Defendant by taking part in the search and seizure of the instant convalescent hospital conducted by the Gyeonggi Provincial Police Agency to verify the “violation of the standards for calculating the differential rate of hospitalization based on the level of securing human resources for nursing,”

C. On October 2014, the Gyeonggi Provincial Police Agency conducted search and seizure of the instant convalescent in relation to the “suspected suspicion that the Plaintiff provided approximately 1.3 km buildings located in the instant convalescent Hospital to patients as sick rooms and received medical care benefit costs unlawfully.”

In the above search and seizure, the office of the National Health Insurance Corporation Namyang-ju confirmed that the Plaintiff participated in the above search and seizure, and confirmed that “the Plaintiff leased 10 gate rooms without permission as to the above suspicions and applied for medical care benefit costs in the course of operating them as sick rooms,” and requested the Defendant to conduct on-site investigations of the instant convalescent hospital.

From March 16, 2015 to March 21, 2015, the Defendant conducted on-site investigations with respect to the instant convalescent hospital (from April 16, 2013 to May 2014, and from November 2014 to January 2015, the period of investigation thereafter was extended from April 2013 to January 2015).

(hereinafter “instant period” and “instant field investigation” E.

Based on the instant field investigation, on November 27, 2018, the Defendant issued a disposition to suspend qualification for the Plaintiff on the following grounds, subject to Article 66(1)7 of the former Medical Service Act (Amended by Act No. 14438, Dec. 20, 2016; hereinafter the same shall apply) and Article 4 of the former Rules on Administrative Dispositions Related to Medical Services (Amended by Ordinance of the Ministry of Health and Welfare No. 604, Dec. 20, 2018; hereinafter the same shall apply).

(hereinafter “instant disposition”). This case’s details of false claims do not exceed “the instant disposition.”