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(영문) 서울행정법원 2016.06.23 2015구합7883
장기요양급여비용환수처분취소
Text

1. The plaintiff's claim is dismissed.

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

Reasons

1. Details and details of the disposition;

A. The Plaintiff operates a long-term care institution that provides home care benefits among long-term care benefits in the trade name of “C” from February 1, 2014.

(hereinafter “instant medical care institution”). (b)

From April 20, 2015 to April 24, 2015, the Defendant and the head of Gangnam-gu: (a) conducted a field investigation on the details of long-term care benefits from February 2014 to February 2015 of the instant medical care institution (hereinafter “instant investigation”); (b) as a result, the Defendant and the head of Gangnam-gu determined that the Defendant claimed expenses for long-term care benefits to the Defendant and received them by increasing the number of days or times of providing home care benefits to 17 persons, such as beneficiaries D; and (c) by increasing the number of times of providing home care benefits to 7 persons, such as beneficiaries D, etc.

(The specific content is the same as the description in the evidence Nos. 1 and 2).

On June 26, 2015, the Defendant issued a notice to the Plaintiff to recover the total amount of KRW 14,750,060 of the expenses for long-term care benefits paid excessively due to the Plaintiff’s wrongful error claim pursuant to Article 43 of the Long-Term Care Insurance Act for the Aged.

On June 20, 2016, the Defendant revoked ex officio the disposition of “the recovery of expenses for long-term care benefits in relation to beneficiaries B” on June 20, 2016.

[This case’s disposition of restitution of expenses for long-term care benefits (i.e., KRW 14,750,060 - KRW 39,090) remaining after ex officio revocation as above] / [The grounds for recognition] / The fact that there is no dispute, Gap’s evidence 1, 2, Eul’s evidence 1, and Eul’s evidence 2, the purport of the whole pleadings, and the purport of the whole pleadings.

2. The gist of the Plaintiff’s assertion was that the Plaintiff claimed and received expenses for long-term care benefits to the Defendant by fraud or other improper means.

Therefore, the instant disposition is unlawful.

3. On the following grounds, the instant disposition is lawful. A.

It is as shown in the attached Form of the relevant statutes.

B. The relevant legal doctrine is false or fraudulent as provided by Article 43(1)3 of the Long-Term Care Act.

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