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1. On August 2, 2017, the Minister of Health and Welfare imposes a penalty surcharge of KRW 95,719,010 on the Plaintiffs.
Reasons
1. Details of the disposition;
A. The Plaintiffs jointly establish and operate the D Hospital in Dobong-gu Seoul Metropolitan Government (hereinafter “instant hospital”).
B. Upon receiving the information from the Anti-Corruption and Civil Rights Commission on September 2015, the Defendant National Health Insurance Corporation confirmed the forgery of the nurse license certificate of nurse E employed at the instant hospital, and conducted an on-site investigation to the Minister of Health and Welfare based on Article 57(1) of the former National Health Insurance Act (amended by Act No. 13985, Feb. 3, 2016; hereinafter the same shall apply) on the ground that the Plaintiff unfairly claimed KRW 45,696,160 for medical care benefit costs in violation of the “standards for calculating the differential rate of hospital admission fees for convalescent hospitals based on the level of securing human resources for nursing” from January 2012 to June 2012, 2012.
C. In February 2016, the Defendant and the Minister of Health and Welfare conducted an on-site investigation into the instant hospital by setting the period subject to investigation as “from November 2012 to September 2013 and from August 2015 to October 2015”.
As a result of the above on-site investigation, the Plaintiffs unfairly claimed KRW 63,812,670 of the medical care benefit costs in violation of the “based standards for calculating the differential rate system of hospitalization fees in a long-term care hospital according to the level of nursing personnel in accordance with the level of nursing personnel in a long-term care hospital according to the method of reporting the nursing class from Grade 4 to Grade 3 in April 3, 2012, including the nursing personnel in exclusive charge of nursing for the in-patient in E, even though the Plaintiffs were disqualified persons E, to class E, from July 201 to September 2013.
For this reason, the plaintiffs, and ① Defendant Minister of Health and Welfare on August 2, 2017, Articles 99 and 98 of the former National Health Insurance Act.