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(영문) 춘천지방법원 2021.02.09 2019구합51657
요양급여비용 지급보류 처분 취소의 소
Text

1. The instant lawsuit shall be dismissed.

2. The costs of the lawsuit are assessed against the defendant.

Reasons

1. Details of the disposition;

A. The Plaintiff, a non-profit medical corporation established on August 24, 2015, established and operated a hospital, a medical institution, pursuant to Article 33 of the Medical Service Act.

B. On July 5, 2019, the Defendant confirmed that the Plaintiff’s hospital B operated by the Plaintiff violated Article 33(2) of the Medical Service Act (violation of the standards for the establishment of a medical institution), and notified that it was scheduled to withhold the payment of expenses for medical care benefits on the ground that it does not constitute a medical care institution prescribed in Article 42(1) of the National Health Insurance Act (non-existence of the right to claim expenses for medical care benefits). On July 15, 2019, the Defendant issued a disposition to withhold the payment of expenses for medical care benefits on the foregoing ground (hereinafter “instant disposition”). [Grounds for recognition] The Defendant did not dispute over the absence of dispute, Party A’s evidence Nos. 1, 2, and Party B evidence Nos. 1, 2, and 2, and the purport of the entire pleadings

2. The parties' assertion and the indication of relevant regulations;

A. On July 5, 2019, the Defendant’s assertion 1) did not state, in any respect, that the Plaintiff’s hospital B operated by the Plaintiff violated Article 33(2) of the Medical Service Act. Thus, the Defendant’s failure to undergo lawful prior notification procedures is illegal.

2) The Plaintiff established and operated a hospital B after its establishment, and there was no profit accrued from the corporation’s establishment, and there was no loss from the corporation’s profit generated therefrom. Thus, the results of the operation of the hospital B belonged to non-medical personnel other than the Plaintiff corporation

shall not be deemed to exist.

The Plaintiff did not violate Article 33(2) of the Medical Service Act, and thus, the instant disposition is unlawful on the ground that there is no ground for disposition.

B. Since the defendant's defense prior to the merits had already cancelled the decision on the unfair profit (other money to be collected) that the defendant had already been decided to cancel the payment deferment and to recover the payment deferment, the lawsuit of this case is subordinate to the law.

(c)

The indication of the relevant regulations shall be as shown in the attached Form.

3. If the determination of an administrative disposition is revoked, such disposition shall lose its effect and shall be subject to any non-existent administrative disposition.

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