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(영문) 광주지방법원 2015.04.22 2014고단1419
사기등
Text

A defendant shall be punished by imprisonment for not less than eight months.

However, the execution of the above punishment shall be suspended for two years from the date this judgment becomes final and conclusive.

Reasons

Punishment of the crime

The Defendant is the representative director of a social welfare foundation G with “D”, a long-term care hospital in the Jeonnam Ma, and “F, a long-term care institution for home care in the Jeonnam-gun E, who is an affiliated agency, who exercises overall control over the overall affairs of the Defendant, such as the employment and management of employees, and the payment of benefits.

A long-term care institution shall provide education, training, etc. for physical activities and the maintenance and improvement of mental and physical functions with persons aged 65 or older or persons with sexual illness under 65 years of age who have difficulty in daily life on its own, for at least six months (hereinafter referred to as "facility benefits"), and a long-term care institution that has provided such benefits shall claim expenses for long-term care benefits to the National Health Insurance Corporation by entering the victim's long-term care insurance homepage by electronically entering the "management status" and "management status of employees" in connection with the website

Therefore, in claiming expenses for long-term care institutions, the employee's working hours is true, and the person in charge of the National Health Insurance Service should be paid after reducing a certain amount according to the ratio of vacancy caused by violation of the standards for placement of human resources.

However, the Defendant did not provide facility benefits, such as having employees work properly or take full charge of other duties, and did not meet the criteria for placement of human resources. However, the Defendant was willing to claim as if the expenses for long-term care benefits were met in order to prevent the decrease in the cost of long-term care benefits.

On August 2010, the Defendant: (a) was accused of the Defendant by claiming long-term care benefits in a false manner to the National Health Insurance Corporation, a victim, even though H, a caregiver, provided facility benefits for 320,00 hours (average 4 hours a month) around July 2010; and (b) was deceiving the victim by claiming long-term care benefits from the National Health Insurance Corporation (hereinafter “National Health Insurance Corporation”); and (c) such deception was made from the victim on August 2010.

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