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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. From July 16, 2007, the Plaintiff operated C Hospital in Kimhae-si B (hereinafter “instant hospital”).
The differential nursing rating of hospitalization fees based on the level of security of nursing personnel in a convalescent in violation of the standards for calculation of medical care benefit costs, hospitalization fees, and differential calculation of medical care benefit costs, shall be calculated according to the average number of nursing personnel ( nurses and nursing assistants) of the immediately preceding quarter immediately preceding year exclusively in charge of nursing for inpatientss.
However, since the assistant nurse D worked as a management director from October 1, 2009 to November 30, 2009, and the assistant nurse E was in charge of administrative affairs in the original department, from January 1, 2010 to April 6, 2010, in charge of buying goods in the original department, etc., they were not exclusively in charge of nursing services for inpatients, but they reported them as nursing personnel and claimed the medical care benefit costs and expenses unfairly, such as claiming the first quarter of April 2009 as class 2, and the second quarter nursing class 4 of February 2010 as class 3.
43,831,940 Won 10,257,600
B. From October 4, 2011 to October 8, 2011, the Defendant conducted an on-site investigation of the medical records of the instant hospital (hereinafter “instant on-site investigation”) and determined that the Plaintiff unduly claimed medical care benefit costs and medical care costs as follows.
C. Accordingly, the Defendant imposed a penalty surcharge of KRW 219,159,700 on the Plaintiff on October 22, 2012, pursuant to Articles 85(1)1 and 85-2(1) of the former National Health Insurance Act (Amended by Act No. 11141, Dec. 31, 2011; hereinafter the same) and Article 28(1)1 and 29(1) of the former Medical Care Assistance Act (Amended by Act No. 11878, Jun. 12, 2013; hereinafter the same) on each of the penalty surcharges of KRW 51,28,000, pursuant to Articles 29(1) of the former Medical Care Assistance Act (Amended by Act No. 11878, Jun. 12, 2013); and
(hereinafter “each of the instant penalty surcharges”). The details of calculation of each of the instant penalty surcharges are as follows.
A review of the investigation period.