Text
1. The plaintiff's claims against the defendants are all dismissed.
2. All the costs of lawsuit are assessed against the Plaintiff.
Reasons
. Claim for Violation: 53,791,044 won - The details of the health insurance act’s health care benefit and the list of non-benefit points, and the equivalent value points in the health insurance act’s list of benefits and non-benefit points, and the professional rehabilitation treatment fees pursuant to Part II Section 3 of Part III of Part I, the specialized rehabilitation treatment fees cannot be calculated in the absence of the patient due to the following work types and vacations, but the medical specialist cannot calculate the specialized rehabilitation treatment fees in the absence of the patient due to the absence of the patient: The medical specialist calculates the specialized rehabilitation treatment fees and claims for calculation of differential calculation standards of hospitalization fees in the D E-C long-term care hospital: 21,79,210 won - The list of health insurance act’s benefits and non-benefit points in Part III of the benefits and the calculation guidelines [calculated guidelines];
4. (e);
According to the differential hospitalization system based on the level of nursing personnel, the hospitalization fee differential nursing system should be calculated according to the average number of patients at the immediately preceding quarter, but it shall be reported differently from the fact that the nursing personnel actually worked, and the difference between the total unfair amount and the detailed amount by the claim for medical care benefit.
D. Specific details of calculation of penalty surcharge of this case are as follows.
The amount of penalty surcharges of 6,919,302,890 won 48,687,070 won 2,318,431 won 20.70% 20.151,165,180 won 20.70% of the total amount of costs of health care benefit for the investigation period (from August 2015 to April 21, 2017) subject to reduction of the total amount of costs of health care benefit for the total amount of reduction.
E. On March 19, 2019, Defendant National Health Insurance Corporation (hereinafter “Defendant Corporation”) issued a disposition to recover medical care benefit costs of KRW 75,561,940 on the basis of “Article 57 of the National Health Insurance Act” (hereinafter “instant disposition to recover medical care benefit costs”).
F. On March 25, 2019, the Defendant Young-si Market (hereinafter “Defendant Market”) issued a disposition to recover medical care costs of KRW 7,644,490 on the basis of Article 23 of the Medical Care Assistance Act with respect to the Plaintiff on the grounds as follows.