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(영문) 서울행정법원 2018.08.30 2017구합52689
요양급여비용 등 지급청구의 소
Text

1. The Plaintiff:

A. The Defendant National Health Insurance Corporation shall pay 89,198,289 won and 88,720,459 won among them.

Reasons

1. Basic facts

A. On July 1, 2009, the Plaintiff operated the instant hospital, which is a medical care institution under the National Health Insurance Act, as an institution providing medical care under the Medical Care Assistance Act, after obtaining permission to establish a medical institution with respect to the “C convalescent hospital” located in Bupyeong-gu Seoul Special Metropolitan City B and 1-8 (hereinafter “instant hospital”).

B. On October 27, 2016, the chief of the Military Police Station notified the Defendant Agency of the following investigation results (hereinafter “instant investigation results”).

The Plaintiff and D’s violation of the Medical Service Act - The Plaintiff and D had the nominal owner of the instant hospital as the Plaintiff, divide the revenues from the sales of the hospital into 470% and 30%, and conspired to operate the instant hospital together.

Accordingly, on May 1, 2013, D transferred the name of the founder and the name of the hospital building, land, etc. to the Plaintiff, left the Plaintiff as the head of the hospital, and had the Plaintiff work as the head of the instant hospital with 70% of the revenues of the instant hospital. Since then, D worked as the head of the instant hospital, he/she opened the “E Hospital” on November 19, 2015 while working as the head of the instant hospital, and on May 1, 2013, the Plaintiff received 30% of the revenues of KRW 120-18 million from D and the sales of the instant hospital from D while working as the head of the instant hospital.

- Medical personnel under the Medical Service Act shall not establish and operate two or more medical institutions under any pretext.

D In spite of the establishment of “E Hospital”, the Plaintiff, the head of the instant hospital, was reported in the form of a draft, with the monthly salary of KRW 18 million, and was involved in the adjustment of employees’ benefits and the management of facilities, etc., and was divided into KRW 70% of the operating earnings and losses of the hospital and Plaintiff 30% of the total amount, and was actually operating the “E Hospital,” and the Plaintiff and D, who conspired with the Plaintiff to operate the instant hospital at least two medical institutions.

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