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(영문) 대전지방법원 2020.10.29 2019구합106766
부당금액징수처분무효확인 청구의 소
Text

The plaintiff's claim is dismissed.

Litigation costs shall be borne by the plaintiff.

Reasons

1. Details of the disposition;

A. The Plaintiff is an intention to operate the “C Council member” (hereinafter “C Council member”) from December 10, 2010 to Gyeongnam-gun, public official, and official (hereinafter “C Council member”).

B. On February 28, 2013, the National Health Insurance Corporation: (a) conducted on-site verification as to whether the instant medical care benefit costs were claimed by the National Health Insurance Corporation (hereinafter “the instant on-site verification”); and (b) requested the Defendant to conduct on-site investigations with respect to the instant Council members on April 2, 2013.

C. Accordingly, the defendant 2015

4. From the 13th to the 15th day of the same month, the instant member conducted an on-site investigation (the period subject to investigation: from March 2012 to February 2013, and from December 2014 to February 2015, hereinafter “instant on-site investigation”). D.

As a result of the instant on-site investigation, on September 21, 2017, the Defendant rendered a disposition to suspend the business of the Plaintiff for 115 days (from March 26, 2018 to July 18, 2018) (hereinafter “instant disposition”) as follows pursuant to Article 98(1)1 of the National Health Insurance Act.

2. Details of unfair amount calculation;

(a) Unfair amount: 143,358,880 won;

(b) Claims for medicine expenses, etc. that have been prepared by an unqualified person for detailed calculation: 143,358,880 won - A person other than pharmacists or herb pharmacists pursuant to Articles 23 (1) and 24 (4) of the Pharmaceutical Affairs Act shall not prepare medicines, and a pharmacist shall, if he/she prepares medicines, require a patient to give necessary guidance on taking medicines, but a pharmacist shall require a general employee D who is disqualified to prepare medicines, etc. as medical care benefit costs after having a general employee D who is disqualified prepare the medicines.

3. Grounds related to the calculation of administrative dispositions: Article 70(1) [Attachment Table 5] of the Enforcement Decree of the National Health Insurance Act; the standard calculation details of business suspension and imposition of penalty surcharges; the total amount of costs of health care benefit for the period subject to review (from March 2, 2012 to February 2, 2013; from February 2, 2014 to February 2, 2015; 15) calculated by applying the average of the total amount of costs of health care benefit for the period subject to review to review; 367,451,540 won; 143,358,80 won; 9,557,258 won; 39.01%; 175 days; - the total amount of costs of health care benefit for the period subject to review and determination under the provision of administrative dispositions;

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