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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 medical corporation established and operated a C Hospital (hereinafter “instant hospital”) as a medical care institution in Ulsan-gu B, Ulsan-gu.
B. The head of the hospital of the instant hospital was issued a summary order of KRW 3 million on September 15, 2014 with respect to the preparation of medicine for the instant patients on the day when the pharmacist of the original pharmacy of the instant hospital does not attend the school from December 3, 2012 to October 14, 2013, on which he/she was issued a fine of KRW 3 million due to the same fraud as indicated in [Attachment 1] and the facts constituting a violation of the Pharmaceutical Affairs Act.
Ulsan District Court Decision 2014 High Court Decision 8764, October 16, 2014
On January 11, 2016 through an on-site investigation (hereinafter “on-site investigation”) from around January 15, 2016 to January 15, 2016, the Defendant ordered the Plaintiff to suspend business operations for 40 days pursuant to Article 98(1)1 of the National Health Insurance Act due to the following disposition, and to suspend business operations for 20 days pursuant to Article 28(1)1 of the Medical Care Assistance Act on October 10, 2018.
(hereinafter referred to as “the total suspension of each of the above suspension of business” is the case’s suspension of business.
2. Details of unfair amount calculation;
(a) Unfair amount: 127,637,530 won (medical care benefits), 18,212,130 won (medical care benefits) are expected to be collected by the National Health Insurance Corporation;
(b) Claim for medical expenses, etc. manufactured by an unqualified person - No person, other than pharmacists or herb pharmacists, pursuant to Articles 23(1) and 24(4) of the Pharmaceutical Affairs Act; and a pharmacist, if he/she dispenses drugs, shall provide patients with necessary guidance on taking medicine. However, although a pharmacist is required to provide necessary guidance on taking medicine due to leave, etc., a pharmacist is required to prepare medicines for all inpatients without the direction and supervision of a doctor and then a pharmacist is required to prepare medicines, etc. for all inpatients without any direction and supervision of a doctor;
3. Grounds related to the calculation details of administrative dispositions: Article 70 (1) [Attached Table 5] of the Enforcement Decree of the National Health Insurance Act.