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(영문) 서울고등법원 2015.12.23 2015누54973
요양급여비용 환수처분취소
Text

1. The plaintiff's appeal is dismissed.

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

The purport of the claim and appeal is the purport of the appeal.

Reasons

1. The reasoning of the judgment of the court of first instance, which cited the judgment of the court of first instance, is as follows, with the exception of adding the judgment below to the plaintiff's assertion.

Therefore, it is accepted in accordance with Article 8 (2) of the Administrative Litigation Act and Article 420 of the Civil Procedure Act.

[Additional Decision] ① The Plaintiff asserts that Article 57(2) of the National Health Insurance Act, which is the basis for the instant disposition, applies to the case where unjust enrichment occurred after the enforcement of Article 57(2) of the National Health Insurance Act pursuant to Article 2 of the Addenda (amended by Act No. 11787, May 22, 2013) and Article 57(2) of the National Health Insurance Act (amended by Act No. 11787, May 22, 2013). In the instant case, the instant unjust enrichment occurred prior to that, and the Plaintiff cannot be deemed to have lent a license by continuously performing medical acts at the instant hospital. Accordingly, the Plaintiff’s act cannot be applied to

However, during the first instance trial, the Defendant changed the applicable law of the instant disposition to Article 57(1) of the National Health Insurance Act, and as if the first instance court properly rendered such determination, it constitutes a case where the Defendant changed only the applicable law within the scope recognized as identical to the underlying factual basis of the disposition, and thus lawful.

Therefore, this part of the Plaintiff’s assertion based on the premise that the underlying law of the instant disposition is Article 57(2) of the National Health Insurance Act is without merit.

② The Plaintiff asserts that the instant hospital cannot be a medical care institution under the National Health Insurance Act because it was not established lawfully under the Medical Service Act, and thus cannot be the subject of the disposition of recovery of medical care benefit costs.

However, Article 57 (1) of the National Health Insurance Act shall be equivalent to the insurance benefits or expenses for insurance benefits to a person who has received insurance benefits or a medical care institution that has received insurance benefits costs by deceit or other unjust means.

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