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1. The part of the instant lawsuit seeking revocation of notification of confirmation of unjust enrichment shall be dismissed.
2. The Defendant on February 2, 2016.
Reasons
Details of the disposition
The Plaintiff is operating a B Hospital (hereinafter referred to as the “instant hospital”) in Youngnam Cancer-gun C.
On December 2, 2013, the Defendant conducted an on-site investigation with regard to the instant hospital by setting the period of investigation as the period from November to October 2013, 2010. As a result, the Plaintiff unduly claimed total of KRW 2,653,93,610 of the medical care costs in violation of the Medical Care Assistance Act, and accordingly, issued a notice of business suspension (hereinafter “instant disposition”) and confirmation of unjust enrichment (hereinafter “instant notice”) against the Plaintiff pursuant to Article 28(1)1 of the Enforcement Decree of the Medical Care Assistance Act (amended by Presidential Decree No. 27275, Jun. 28, 2016), Article 16-2 and [Attachment Table 2] of the Enforcement Decree of the Medical Care Assistance Act (amended by Presidential Decree No. 27275, Jun. 28, 2016).
The calculation details of the unfair amount and the period of suspension of business shall be as follows:
2. Details of unfair amount calculation;
(a) Unfair amount: 2,653,933,610 won;
(b) Claim for a violation of a standard for calculating a differential calculation of admission fees for the wrongful amount: 2,639,313,475 won - Standard for medical care fees and standard for applying a differential calculation system for mental health department and hospitalization fees based on the level of human resources secured by medical personnel, etc., including medical personnel, according to Chapter I of Chapter I of the General Standards.
3. According to the standards for the application of human resources of doctors in a differential system of mental health shall be based on mental health specialists and arts reported on the current status of human resources of medical care institutions, including medical personnel, on the notice of the current status of medical care institutions. They shall be excluded from those subject to calculation, and persons subject to part-time leave, persons subject to long-term paid leave for at least 16 days, etc., and persons subject to part-time leave or day-day leave for at least 3 days per week and at least 20 hours per week. However, they shall be recognized as 0.5 in cases of part-time or day-time leave for at least 20 hours per week, however, they shall be reported as full-time workers even if they actually worked at least
4. According to the standards for the application of the nursing personnel, the nursing personnel in the at-class system of mental health department shall be hospitalized in the department of mental health and the low-level hospital.