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(영문) 서울행정법원 2012.09.28 2012구합4432
자격정지처분취소
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. As a dentist, the Plaintiff established a “Cental clinic” (hereinafter “instant clinic”) as a medical care institution in Seocho-gu Seoul Metropolitan Government and performed medical treatment.

B. From January 25, 2010 to January 29, 2010, the Defendant conducted an on-site investigation (hereinafter “instant investigation”) on medical benefits and medical benefits for the period from November 1, 2008 to November 30, 2009, pursuant to Article 84(2) of the former National Health Insurance Act (amended by Act No. 8852, Feb. 29, 2008) with respect to the instant member.

C. The Defendant confirmed whether part of the patients were actually treated in the process of the above investigation, prepared a list of patients whose contents are inconsistent with the medical records and daily business reports of the instant Council members (hereinafter “receiving register”), and confirmed by the Plaintiff.

The plaintiff alleged that part of the above list is a patient who actually provided medical treatment, and that he did not impose his own charge on his family, relatives, and relatives, etc., and the defendant deleted the list of 17 students and 245 students, from the original list of patients.

On January 29, 2010, the Plaintiff’s husband D and the Plaintiff, who provided medical treatment with the Plaintiff, stated that they provided medical treatment to patients not admitted to the Plaintiff, and filed a false claim for medical care benefit costs in the medical record, and submitted to the Defendant with the signature and seal attached to the confirmation document (No. 2, No. 2, and No. 1; hereinafter “instant confirmation document”) accompanied by the list of patients claiming medical care benefit costs.

E. The Defendant: (a) on January 26, 2012, on the ground that the Plaintiff filed a false claim for medical care benefit costs; and (b) on December 31, 2009, amended by Act No. 9906, Dec. 31, 2009.

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