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(영문) 서울행정법원 2015.03.19 2014구합65776
업무정지명령 등 취소
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 is operating “C” (hereinafter “instant medical care institution”) as a long-term care institution under Article 31 of the Long-term Care Insurance Act for Long-Term Care Insurance in Geumcheon-gu Seoul (hereinafter “Medical Care Insurance Act”).

B. The Defendants conducted a field investigation on the details of long-term care benefits from March 15, 2011 to February 2014 of the instant medical care institution (hereinafter “instant field investigation”) from March 15, 2014 to February 21, 2014, and determined that according to the details on the criteria for calculating expenses for long-term care benefits (Public Health Insurance Notice No. 201-157 of the National Health Insurance Corporation; hereinafter “instant public notice”), the Defendants shall reduce the Corporation’s charges if the monthly working hours of employees are less than 160 hours, while the Plaintiff’s assistant nurse D working five times a week from 09:0 to 15:00, while the monthly working hours are less than 160 hours, it was reported that five times a week working from 09:0 to 18:00 and received medical care benefits by reporting that the monthly working hours are more than 160 hours.

C. On July 24, 2014, the head of Geumcheon-gu Seoul Metropolitan Government rendered a disposition to suspend the business of 142 days (from September 1, 2014 to January 20, 2015) pursuant to Article 37(1)4 of the Medical Care and Insurance Act on the ground that “the Plaintiff unduly claimed medical care benefit costs in violation of the instant public notice,” and the Defendant National Health Insurance Corporation (hereinafter “Defendant Corporation”) rendered a disposition to recover KRW 189,186,010 for expenses for long-term care benefits pursuant to Article 43(1)3 of the Medical Care and Insurance Act on the ground that “the Plaintiff unduly claimed medical care benefit costs in violation of the instant public notice.”

(hereinafter referred to as “instant disposition” in total with the above disposition of suspension of business and the disposition of recovery of the penalty, / [based on recognition] without dispute, entry in Gap’s 1, 2, Eul’s 1, 2, Eul’s 6, Eul’s 1, and Eul’s 1, and the purport of the whole pleadings

2. Whether the instant disposition is lawful.

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