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(영문) 대구지방법원 2019.01.23 2018구합22090
요양급여비용환수처분취소
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 an oriental medical doctor, is opening and operating a “C,” a medical care institution as defined in the National Health Insurance Act, in B at the time of residence from March 9, 2004.

The plaintiff filed a false claim for the number of days of internal medicine: 14,777,315 won, as if some of the winners did not actually have to perform the internal medicine, claimed medical examination fees, etc. as medical care costs.

After medical examination and treatment outside a medical institution, the plaintiff 9,722,01 won claimed medical examination fees, etc. as medical care benefit costs even though some of the medical professionals received medical treatment from a inspection other than a medical care institution.

The plaintiff 1,826,189 won claimed medical examination fees, etc. as medical care benefit costs, even if some of the medical professionals did not wish to the medical care institution and received medical treatment by telephone, as if they directly wish to do so.

The plaintiff 3,151,292 filed a false claim for oriental medicine treatment fees: The plaintiff 3,151,292 filed a claim for oriental medicine treatment fees as medical care benefits costs as if he/she did not perform the oriental medicine treatment, such as oriental medicine treatment, by inserting a fire in the sub-sea complex, made the air scarbly by safing it, making the air scarbly saf and making it rare.

B. As a result of an on-site investigation conducted against the Plaintiff around October 2016, the Minister of Health and Welfare determined that the Plaintiff unduly claimed KRW 29,467,230 in total of the medical care benefit costs as follows to the Defendant from September 2013 to August 2016.

C. Accordingly, on October 13, 2017, the Defendant notified the Plaintiff that KRW 29,467,230 of the cost of health care benefit was recovered pursuant to Article 57(1) of the National Health Insurance Act on the ground that the Plaintiff received the cost of health care benefit by deceit or other unjust means.

(hereinafter “instant disposition”) D.

On December 29, 2017, the Plaintiff filed an objection against the instant disposition with the Defendant, but was dismissed on March 15, 2018.

【Ground of recognition】 There is no dispute;

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