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(영문) 서울중앙지방법원 2016.11.18 2016나15982
손해배상(기)
Text

1. The plaintiff's appeal and the plaintiff's claim added in the trial are all dismissed.

2. The costs of appeal and the costs of appeal shall be based on the trial.

Reasons

1. Facts of recognition;

A. The Plaintiff, B, and C (hereinafter referred to as the “Plaintiff, etc.”) as the Plaintiff’s father and doctor had operated the “Esan Madician” (hereinafter referred to as the “instant member”) in Silsi-si D.

B. The Ministry of Health and Welfare’s notice No. 2007-3 of the Ministry of Health and Welfare’s announcement, which was amended on January 23, 2007 and enforced on February 1, 2007, regarding the criteria and methods for the application of medical care benefits for the operation of a gold surgery (hereinafter “instant recognition criteria”) refers to the criteria for the recognition of the operation of a gold operation using artificial tapes (hereinafter “instant recognition criteria”).

On the other hand, the recognition criteria of the instant case were amended by the Ministry of Health and Welfare No. 2011-144, Nov. 25, 2011, as follows. The operation of the required amount using the artificial tape under the recognition criteria amended in 2011, are recognized as having been mainly mixed with the required amount of retension, which is determined as follows: (a) the principal amount of the required amount for retension, or the amount of the required amount for retension, is verified as a result of the epidemology test (the measurement of luminous pressure and the leakage pressure test); and (b) the required amount is less than 120ccH2O; and (c) other than the said recognition criteria, the treatment fees and the expenses for the materials for medical treatment, which are considered to have reduced the cost effectiveness and are more preventive than the treatment purpose (non-benefit benefits).

1. The surgical operation using artificial tapes shall be recognized in cases where it is necessary to conduct the surgical operation, since the main amount of pytension loss, gold, or pytension loss is confirmed as a result of the epidemology test: Provided, That a medical doctor in charge of diagnosis and treatment shall prepare a test report on the epidemology test by a doctor in charge of diagnosis and treatment including the following items and submit it along with the test report and related test report at the time of a request for medical care benefit:

2. In addition to the standards for recognition, all kinds of medical treatment costs (involuntary admission fees, narcotics and expenses for materials for medical treatment, etc.) are not medical care benefits (non-medical care benefits) as they fall short of the cost effectiveness and are deemed to be more preventive than those for treatment.

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