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(영문) 서울행정법원 2017.12.07 2016구합84009
요양기관 명단공표 처분 취소
Text

1. The plaintiff's claim is dismissed.

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

Reasons

1. Details of the disposition;

A. The Plaintiff, as a doctor, has established and operated Cental clinic B in Ansan-gu, Ansan-si (hereinafter “instant clinic”).

B. On October 29, 2013, the Defendant conducted a field investigation (the period subject to the investigation: from September 1, 2010 to August 31, 2013; hereinafter “instant field investigation”) on the instant member, and determined that the Plaintiff committed the following acts, such as claiming for medical care benefit costs:

1. Dual claim (excluding medical benefits) after non-benefit medical treatment (hereinafter “instant disposition”), Article 9 of the Regulations on the Standards for Medical Care Benefits for National Health Insurance; Part 3 of Part 1 of the Health Insurance Benefit List and the relative value of benefits (Notice of the Ministry of Health and Welfare) of Part 3 of the Act No. 3 of the Ministry of Health and Welfare: (a) the medical examination fees and other medical care benefit costs (excluding medical benefits), even if the medical examination fees and other medical care benefit costs were collected from the relevant medical person as full-time non-benefit treatment fees; (b) the medical examination fees and other medical care benefit costs, i.e., Japanese shock treatment; and (c) the multiple re

2. Excessive collection of charges for the person himself/herself (excluding medical care benefits) - The person who performs the removal of malicious rocks subject to medical care benefits and the excessive collection of charges 10,724,850 won;

3. Claim for medical care benefit (including medical care benefits) after photographing a radiation-emitting device not performed in a regular inspection - If it is intended to install and operate a radiation-emitting device for diagnosis, it shall be reported to the head of the relevant Si/Gun/Gu and used after undergoing an inspection on a three-year basis, but it shall be used after filing a report on radiation equipment from September 1, 201 to August 4, 201, and the amount of medical care benefit 4,859,224 won as medical care benefit costs without filing a report

C. On August 23, 2016, the Defendant rendered a disposition to suspend business for 102 days (from January 9, 2017 to April 20, 2017) based on Article 98(1)1 of the National Health Insurance Act on the ground of the result of the instant on-site investigation to the Plaintiff.

The calculation details shall be as follows:

The total amount of costs of health care benefit for the investigation period.

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