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(영문) 서울행정법원 2019.01.17 2018구합71984
요양급여비용 지급보류처분 취소
Text

Of the instant lawsuit, the Defendant’s notification against the Plaintiff on July 16, 2018 is revoked.

Reasons

1. Details and details of the disposition;

A. The Plaintiff is a cooperative B established on June 11, 2015 pursuant to the Consumer Cooperatives Act, and is opening and operating a “D Council member” (hereinafter “instant Council member”), which is a medical institution, on the full-time C and 4th floor in the previous city in the previous city.

B. On July 9, 2018, the Defendant was notified of the following results of the investigation regarding the violation of the Medical Service Act to E and F who is the representative of the Plaintiff and his/her spouse, and the violation of the Act on the Aggravated Punishment, etc. of Specific Economic Crimes (Fraud).

Main contents: As a result of the investigation on the case requested to be investigated by the your agency, the suspect E and F are recognized as a violation of the Medical Service Act and the Act on the Aggravated Punishment, etc. of Specific Economic Crimes (Fraud).

The suspect F of the suspected suspicion is a non-medical person, who actually operates the instant member, and the suspect E is a non-medical person, the president of the instant member.

The suspects were recruited to establish and operate a medical institution (one-person office hospital) by lending the name of the G Association in violation of the purpose of the non-profit corporation.

No person, other than doctors, herb doctors, dentists, midwifes, the State or local governments, medical corporations, nonprofit corporations, quasi-governmental institutions, etc., may establish medical institutions for criminal suspects in violation of the Medical Service Act.

Nevertheless, the suspects established the instant member as of August 24, 2015.

Therefore, it employed a doctor H, etc. for profit-making purposes of individuals, families, not the self-reliance, self-reliance, and self-government operation of members and local residents, and allowed patients to conduct medical treatment until July 13, 2017.

B. If a medical institution is established even if a suspect is not a doctor in violation of the Medical Service Act against the Act on the Aggravated Punishment, etc. of Specific Economic Crimes (Fraud), a medical care benefit or medical care cost shall be claimed against the defendant

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