logobeta
본 영문본은 리걸엔진의 AI 번역 엔진으로 번역되었습니다. 수정이 필요한 부분이 있는 경우 피드백 부탁드립니다.
텍스트 조절
arrow
arrow
(영문) 광주지방법원 2015.11.12 2014구합12017
장기요양급여비용환수결정취소
Text

1. The plaintiff's claim is dismissed.

2. The costs of lawsuit shall be borne by the Plaintiff.

Reasons

1. Details of the disposition;

A. The Plaintiff is operating a long-term care institution (hereinafter “instant medical care institution”) with the trade name “C” in the Jeonsung-gun, Jeonsung-gun.

B. As a result of an on-site investigation conducted with respect to the instant medical care center from June 17, 2014 to June 20, 2014, the head of the Si/Gun/Gu to recover expenses for long-term care benefits, the Plaintiff’s operation of the instant medical care center from July 17, 2013 to May 20, 2014; however, the Plaintiff was found to have received expenses for long-term care benefits by fraudulent or other illegal means by claiming expenses for long-term care benefits without a reduction, but the Plaintiff was found to have received expenses for long-term care benefits by claiming expenses for long-term care benefits without a reduction, and then the Plaintiff was entitled to recover expenses for long-term care benefits paid excessive due to an illegal error (or cash notice) by deducting the expenses for long-term care benefits paid to the Plaintiff by an electronic offset at the time of paying the expenses for long-term care benefits during the next period, on the following grounds (hereinafter “instant disposition”).

1) On August 3, 2013, and August 4, 2013, the Plaintiff in violation of the standard number of outpatients filed a claim for one-day average number without claiming the number of outpatients, even though the beneficiary D, E, and F, on November 23, 2013. (2) On July 2013, 2013, the Plaintiff should have placed five caregivers at the instant medical care center. G, H reported as a caregiver, and H reported as a caregiver, who did not perform the duties of care, and reported as a caregiver that performed the duties of care for more than 160 hours at the instant medical care center, and, in the case of J, the Plaintiff actually worked for less than 6 hours a day and 40,000 hours a JJ served for less than 160 hours a day and violated the standard number of caregivers based on the criteria for the calculation.

arrow