beta
Text
1. On May 4, 2016, the Defendant rendered a decision to recover expenses for long-term care benefits of KRW 4,751,810 and KRW 11,272,730, respectively, to the Plaintiff.
Reasons
1. Details of the disposition;
A. From July 1, 2008, the Plaintiff had three caregivers from Seoul Special Metropolitan City, Gwanak-gu, 102 Dong 804, and operated C Care Center, a long-term care institution under the Long-Term Care Insurance Act (hereinafter “instant medical care center”).
B. The Defendant, jointly with the head of Gwanak-gu Office from February 1, 2016 to the fourth day of the same month, conducted a field investigation (the period subject to investigation: July 1, 2015 to December 2015; hereinafter “instant field investigation”) on the details of long-term care benefits provided by the instant medical center, and as a result, determined that the Plaintiff was unfairly claimed and paid expenses for long-term care benefits as follows.
Specific details - 4,751,810 won: Long-term care benefits provided to E and F from January 2014 to December 2015, and care benefits provided to G from September 2014 to January 2015, and from August 2015 to August 2015; and even though long-term care benefits provided to I from September 2014 to December 2015 to December 2015, it was claimed to increase the service hours (hereinafter referred to as "reasons for instant disposition"): 4,751,810 won: from July 2015 to December 2015 to December 2015; and
C. On May 4, 2016, the Defendant decided to recover KRW 4,751,810 and KRW 11,272,730, out of the expenses for long-term care benefits already paid to the Plaintiff pursuant to Article 43 of the former Long-Term Care Insurance Act (amended by Act No. 13647, Dec. 29, 2015; hereinafter the same) on the grounds of the instant disposition, and notified the Plaintiff on the same day.
(hereinafter “each disposition of this case”) D.
The head of Gwanak-gu Office on June 23, 2016, based on Article 37 (1) 4 of the former Act on Long-Term Care Insurance for the Aged of the Plaintiff on June 23, 2016, on the grounds that the Plaintiff unduly claimed KRW 4,751,810 during the above investigation period, as follows: