logobeta
본 영문본은 리걸엔진의 AI 번역 엔진으로 번역되었습니다. 수정이 필요한 부분이 있는 경우 피드백 부탁드립니다.
텍스트 조절
arrow
arrow
(영문) 서울고등법원 2015.05.15 2012누25196
업무정지처분취소
Text

1. Revocation of a judgment of the first instance;

2. An institution providing medical benefits that the Defendant rendered against the Plaintiff on July 9, 2008 shall be subject to suspension of business.

Reasons

1. Details of the disposition;

A. The Plaintiff, as a social welfare foundation for the purpose of implementing social welfare programs under the Social Welfare Act, established and operated C Hospital, which is an institution providing medical benefits under the National Health Insurance Act (hereinafter “instant hospital”).

B. From June 25, 2007 to July 4, 2007, the Defendant conducted an on-site investigation on the overall amount of the health insurance benefits and medical benefits (hereinafter “instant on-site investigation”) with respect to the instant hospital from September 23, 2005 to April 30, 2007 with the period subject to the investigation from September 23, 2005 to April 30, 2007: (a) discovered that the instant hospital claims for the medical benefits costs worth KRW 753,106,020 (hereinafter “the instant unfair amount”) by fraudulent and other unjust means as indicated below, as follows:

(The difference between the gross amount and the amount of unfair practices by details is generated in the course of a single-use treatment of national funds. The summary of the sequence 1 is that some of the persons who have filed a claim for evaluative treatment, such as evaluative development therapy, functional electrical therapy therapy, functional stimulation therapy, work therapy, ioncurcary therapy, etc., were conducted without implementing evaluative evaluative treatment, and 37,875,915, which were not used in the event of a false claim for evaluative evaluative method, and drug management fees, were charged to some of the persons who have filed a claim for evaluative treatment without taking 16,897,012 evaluative treatment, evaluative treatment, evaluative treatment, evaluative treatment, evaluative treatment, evaluative treatment, evaluative treatment, and evalucopic therapy.

arrow