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(영문) 서울행정법원 2019.01.10 2018구합68384
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 each disposition;

A. As a doctor, the Plaintiff is establishing and operating “C Council member” (hereinafter “instant Council member”) which is a health care institution under the National Health Insurance Act on the Gyeonggi-gu Group B and the first floor.

B. Upon the request of the Defendant National Health Insurance Corporation (hereinafter “Defendant Corporation”) on an on-site investigation, the Minister of Health and Welfare (hereinafter “the Minister of Health and Welfare”) conducted the on-site investigation of the instant member from February 20, 2017 to May 22, 2016 (the period subject to the investigation: March 2015 to May 2016 and October 2016; hereinafter “the instant on-site investigation”).

As a result, the defendant Minister determined that the plaintiff was paid medical care benefit costs by unfairly claiming them as follows:

2. Details of unfair amount calculation;

(a) Unfair amount: 34,213,060 won;

(b) Claim for a violation of the standards for operating special medical equipment of unfair amounts: 30,306,526 - In the case of D, the difference between the total unfair amount to be collected and the unfair amount of the detailed amount of each personal charge, such as separate collection of special examination fees (3,60,000 won), separate collection of special examination fees (3,60,000 won), and separate collection of special examination fees (249,000 won), shall be the amount incurred in the course of treating national funds by comprehensively taking charge of, supervising, etc. the quality control of medical pictures, such as the performance of duties, such as failing to work at the actual time and failing to work at the meeting of the instant council member, etc., and making a report to non-exclusive personnel of this case, even though only reading operations were conducted at the outside of the instant council member.

C. On March 28, 2018, based on Article 98(1)1 of the National Health Insurance Act, Defendant Minister suspended the Plaintiff from medical care institutions for 69 days (from July 2, 2018 to September 8, 2018).

(hereinafter “instant disposition of business suspension”). Specific calculation details of the period of business suspension are as follows:

3. Grounds related to the details of administrative disposition calculation: Gu;

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