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(영문) 서울행정법원 2017.04.06 2016구합59133
장기요양급여비용 환수결정처분 취소
Text

The plaintiff's claim is dismissed.

Litigation costs shall be borne by the plaintiff.

Reasons

1. Circumstances and details of the disposition;

A. From April 29, 2013, the Plaintiff is the representative of the “C Center” (hereinafter “instant Center”) that provides home care services during home care benefits as welfare facilities for the aged under the Welfare of Older Persons Act from Pyeongtaek-si B and the sixth floor.

B. From January 12, 2015 to January 15, 2015, the Defendant conducted an on-site investigation on the details of benefits between April 2013 and November 2014 of the instant center. On September 21, 2015, the Defendant rendered a decision to recover the aggregate of KRW 51,554,30 of the cost of long-term care benefits 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 ground that the Plaintiff paid excessive expenses for long-term care benefits to the Plaintiff (hereinafter “the initial disposition”).

The specific reasons for this disposition are as follows:

1) Although the beneficiary D, after the non-provision of the services, received accommodation for 24 hours from E Medical Care Center (hereinafter “instant medical care center”) to August 2014, the Plaintiff did not use the weekly care service at the instant center, the Plaintiff claimed KRW 1,725,910 to the Defendant, as if D had received the weekly care benefit costs at the instant center, and received the payment from the Defendant (hereinafter “instant claim after the instant non-provision of the services”); (ii) the beneficiary F, during the period from December 2, 2013 to October 201, 2014, excluding some of the beneficiaries’ period from September 2, 2014 to October 201, 2014; and (iii) the Plaintiff used the beneficiary’s respective expenses for long-term care benefits to the Defendant during the period from April 1, 2013 to October 14, 2014 to the beneficiary’s respective expenses for accommodation, and each of the instant beneficiaries’ expenses for the period from the beneficiary’ respective beneficiaries’ respective period of the instant medical care benefits to the Plaintiff and the first.

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