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(영문) 서울행정법원 2018.04.05 2017구합68646
장기요양급여비용환수결정 취소
Text

1. The plaintiff's claim is dismissed.

2. The costs of lawsuit shall be borne by the Plaintiff.

Reasons

1. Details of the disposition;

A. The Plaintiff operates C, a long-term care institution under the Act on Long-Term Care Insurance for the Aged and the Welfare of Older Persons Act (hereinafter “instant medical care institution”).

B. The Defendant conducted an on-site investigation with respect to the instant medical care institution from May 17, 2016 to the 20th of the same month, and on September 19, 2016, issued a disposition to recover the amount pursuant to Article 43 of the former Act on Long-Term Care Insurance for the Aged (amended by Act No. 13647, Dec. 29, 2015; hereinafter “instant disposition”) on the ground that the Plaintiff unduly claimed and received KRW 114,870,820 in total expenses for long-term care due to the violation of excess of the prescribed number of employees, the standards for placement of human resources, subscription to liability insurance, and the criteria for additional placement of human resources (hereinafter “instant disposition”).

The details of the reasons for the violation of the Medical Care Institution: (a) although a person admitted to an institution for long-term care whose maximum number exceeds the standard amount to be recovered, including all persons other than the grade, the instant medical care institution shall report the details of the violation, from December 1, 2015 to May 16, 2016; (b) during the period from March 1, 2016 to April 14, 2016; and (c) during the period from October 22, 2015 to October 25, 2015; (d) during the period from October 25, 2015 to 10.6% of the total number of those admitted to the relevant medical care institution (1.6% of the total number of those admitted to the institution for long-term care, 20% of the total number of those admitted to the institution for long-term care; and (d) during the period from 20 days to 20% of the number of those admitted to the institution for long-term care; (hereinafter referred to 16.6%);

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