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(영문) 서울행정법원 2019.12.05 2019구합54061
업무정지처분취소
Text

1. The plaintiff's claims against the defendants are all dismissed.

2. The costs of lawsuit shall be borne by the Plaintiff.

Reasons

1. Details of the disposition;

A. The Plaintiff is a medical specialist in the regular external medicine, and in the literature-si B, a medical care institution under the National Health Insurance Act established and operated the “C Hospital” (hereinafter “instant hospital”) which is a medical care institution under the Medical Care Assistance Act.

【Improper Claim for Medical Care Benefit Costs】

2. Details of unfair amount calculation;

(a) Unfair amount: 162,067,230 won;

B. According to the criteria for recognition of installation and operation of special medical equipment under Article 3(1) [Attachment 1] of the Medical Service Act, more than one medical specialist in the non-speed image engineering as a personnel operating the Computerization group’s operating personnel. The medical specialist in the film department performs the overall control and supervision of the quality control of medical equipment of special medical care equipment, the cinematographic quality assessment, and the clinical image reading, while the medical specialist in the film department did not perform the duties of controlling or supervising the quality control of medical equipment from May 2015 to December 2016, 2016, such as failing to work at the hospital of this case. In addition, the medical specialist in the film department did not perform the duties of controlling or supervising the quality control of medical equipment of this case as a whole, including failing to work at the hospital of this case, and concluded an unfair medical care benefit claim for the medical care benefit cost of this case (hereinafter “unfair medical care benefit claim”).

2. Details of unfair amount calculation;

(a) Unfair amount: 26,018,630 won;

(b) Claim 26,018,630 won for a violation of the Guidelines for Operating Special Medical Equipment and Facilities - Grounds for the Unfair Claims for Medical Care Benefit Costs.

B. From March 13, 2017 to March 17, 2017, the Defendant Minister of Health and Welfare (hereinafter “Defendant Minister”) shall conduct on-site investigations and investigations with respect to the instant hospital from March 13, 2017 to March 17, 2017: Total from May 2015 to December 2016.

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