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(영문) 광주지방법원 2015.08.27 2014구합1901
장기요양급여비용환수처분취소
Text

1. All of the plaintiff's claims are dismissed.

2. The costs of lawsuit shall be borne by the Plaintiff.

Reasons

1. Details of the disposition;

A. The Plaintiff is a legal entity established to carry out welfare projects for the elderly, and is operating Cmedical Care Center located in Seoyang-gun B (hereinafter “instant Medical Care Center”).

B. From September 23, 2014 to September 26, 2014, the Defendant issued an on-site investigation with respect to the instant medical care center from around October 2010 to around July 2014, and discovered that the Plaintiff claimed expenses for long-term care benefits by violating the guidelines for the placement of human resources for the instant medical care center, additional placement guidelines for human resources, and promotional incentives, and received the expenses by fraudulent or other illegal means; and then, the Plaintiff “to recover expenses for long-term care benefits paid excessively due to the wrongful error claim pursuant to Article 43 of the Long-Term Care Insurance Act (or cash notice)” under the following circumstances, the Defendant issued a disposition to recover expenses for long-term care benefits (hereinafter “instant disposition”) and the instant disposition to recover the expenses for long-term care benefits (hereinafter “the instant disposition”) under each of the instant items 36,452,640 won and each of the instant long-term care benefits (hereinafter “the instant disposition”).

1) The ground for disposition No. 1 of the instant case (violation of criteria for reduction of placement of human resources) was that the Plaintiff: (a) from February 2, 2014 to July 2014, the Plaintiff did not exclusively engage in laundry work of the Medical Care Center; and (b) even though the Medical Care Center E, while taking exclusive charge of cooking work of the Medical Care Center, was in violation of the criteria for the placement of human resources by reporting as if D and E had performed the duties of care workers for at least 60 hours a month, the Plaintiff filed a claim for expenses for benefits without reducing the expenses for benefits according to the standards for calculation of expenses for benefits; (c) the ground for disposition No. 2 of the instant case was the ground for disposition.

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