The appeal is dismissed.

The costs of appeal are assessed against the defendant.

The grounds of appeal are examined.

1. As to the grounds of appeal Nos. 1 and 2, Articles 33(2), 66(1)2, and 87(1)2 of the former Medical Service Act (amended by Act No. 9906, Dec. 31, 2009; hereinafter “former Medical Service Act”) limit the qualifications of a person who established a medical institution to intent, etc. Meanwhile, if a person employed by a person who is unable to establish a medical institution and performed medical practice, a person who is not qualified to establish a medical institution is strictly prohibited from establishing a medical institution, such as determining the qualifications for license, and by providing criminal punishment for violations, thereby contributing to protecting and promoting national health based on the appropriateness of medical care.

In addition, Article 40(1) of the former National Health Insurance Act (amended by Act No. 11141, Dec. 31, 201; hereinafter “former National Health Insurance Act”) provides that medical care benefits shall be provided by “medical institutions established under the Medical Service Act”.

Therefore, if medical care benefits were paid at a medical institution that was not lawfully established in violation of Article 33(2) of the former Medical Service Act, the pertinent medical institution does not constitute a medical care institution that can claim medical care benefits under the former National Health Insurance Act, and the above medical care benefits cannot be included in the medical care benefits amount

(See Supreme Court Decision 201Du21669 Decided January 27, 2012 (see, e.g., Supreme Court Decision 2011Du21669). In cases where a person who is not eligible to establish a medical institution employs a medical doctor, thereby establishing a medical institution, and let his/her employees conduct medical treatment, and then claims for medical care benefit costs not included in the medical care benefits amount to the Plaintiff, which is paid by the insurer, the Plaintiff, is an act causing damage to the Plaintiff, which is the insurer, to the payment of medical care benefit costs