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(영문) 서울행정법원 2018.04.05 2017구합53996
요양급여비환수처분취소
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 doctor, the Plaintiff established and operated C Hospital in Bupyeong-si B (hereinafter “instant hospital”).

B. On September 22, 2015, the Defendant requested the instant hospital to conduct an on-site investigation for the period from October 2012 to March 2013, 2013, on the grounds that “the instant hospital is suspected to have filed an unfair claim for medical care benefit in violation of the human resources standards related to visual medical specialists while operating the computer-bed photographing equipment (hereinafter “CT”), and accordingly, requested the Ministry of Health and Welfare to conduct an on-site investigation.

C. The Defendant, the Ministry of Health and Welfare, and the Health and Welfare Review and Assessment Service conducted an on-site investigation on the instant hospital from February 22, 2016 to October 25, 2016 (hereinafter “on-site investigation”). During that process, the investigation period, which was 8 months (from November 24, 2012 to March 2013, from August 2015 to October 2015; hereinafter “the investigation period before extension”), was 15 months (from November 2013 to October 2015; hereinafter “the investigation period after extension”).

The Defendant and the Ministry of Health and Welfare determined that the Plaintiff received medical care benefit costs as follows upon the instant on-site investigation.

Claim for Violation of the Standards for Operating Special Medical Equipment: 140,009,56 won - From March 1, 2009 to April 2, 2013 in the case of D of the film medical specialist, and from April 3, 2013 to June 21, 2015 to take overall charge of, or supervise, the duties of the quality control of medical pictures, such as failing to work at the actually in the instant hospital, etc., without taking overall charge of, or supervising, the duties of the quality control of medical pictures, such as failing to work at the instant hospital, etc., even though he/she entered into a contract with the G of the Speaker of the Finematographic Image, and made a remote reading, and filed a claim for medical care benefit costs, such as CT equipment TR-C-180.

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