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(영문) 서울행정법원 2014.10.23 2014구합4900
과징금부과처분취소
Text

1. The Defendant imposed the penalty surcharge of KRW 482,978,850 on Plaintiff B on December 31, 2013, and the penalty surcharge of KRW 240,693 on February 11, 2014.

Reasons

1. Details of the disposition;

A. On April 12, 2007, Plaintiff A opened and operated the “Dvalescent Hospital” located in G (hereinafter “instant hospital”) and opened the instant hospital jointly with Plaintiff B from July 27, 201 to July 30, 2012, and closed the instant hospital on September 24, 2012.

B. On December 31, 2013, the Defendant issued a penalty surcharge of KRW 482,978,850 (hereinafter “instant first disposition”) to the Plaintiffs on the ground that “Plaintiff A, in violation of Articles 41, 44, 45, 46, and 47 of the National Health Insurance Act, Articles 19, and 21 of the Enforcement Decree of the same Act, Articles 13, 16, and 19 of the Enforcement Rule of the same Act, “Rules on the Standards for Medical Care Benefits under National Health Insurance,” and other provisions on the calculation of medical care benefit costs,” and that “the insurer, policyholder, and his/her dependent unfairly claimed medical care benefit costs” (hereinafter “instant first disposition”).

The calculation details of the unfair amount on which the above disposition was based shall be as follows:

1. Unfair amount: 190,019,030 won;

2. The payment of differential hospitalization fees according to the standard of determining the detailed calculation of the unfair amount of hospitalization fees, claim 113,377,768 won - The payment of differential hospitalization fees according to the standard of securing human resources for doctors shall be made according to the list of the benefits for the act of health insurance, the list of the benefits for the act of long-term care hospitals of Part III, the relative value points and the calculation

Pursuant to the foregoing, the average number of beds and the number of patients in the relevant medical care institution shall be calculated in accordance with the number of medical doctors employed full-time in the relevant medical care institution (the number of beds and the number of patients). However, doctors E shall report full-time, even if he/she did not actually work from October 19, 2009 to June 1, 2010, and shall request grades 2 of the first quarter and second quarter of 2010 (68,886,730 won) to first grade (68,86,730 won), and the average number of beds shall be calculated based on the number of the operating beds if the number of beds exceeds the number of the reported beds, but from June 200 to December 2, 209.

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