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(영문) 춘천지방법원 2020.04.21 2018구합50404
요양급여비용환수고지처분취소 등
Text

1. The plaintiffs' claims are dismissed.

2. The costs of lawsuit are assessed against the plaintiffs.

Reasons

1. Details of the disposition;

A. Plaintiff A consumer cooperative (hereinafter “Plaintiff cooperative”) is an operator and an operator under the name of “A consumer cooperative C member” and “C Council member,” and Plaintiff B is an actual operator of “C Council member,” the chief director of the Plaintiff cooperative, who is not a doctor.

B. On June 8, 2016, the Defendant rendered a disposition to withhold the payment of medical care benefit costs against C Council members on the following grounds:

(hereinafter referred to as “instant disposition suspending payment.” Relevant grounds - Seoul Central Police Station investigation-2773 ( May 30, 2016) - “Notification of Results of Handling Cases, such as Violation of the Consumer Cooperatives Act” - Article 47-2 of the National Health Insurance Act and Article 22-2 of the Enforcement Decree of the National Health Insurance Act - Article 22-1950 ( May 31, 2016) of the Insurance Department-1950 (Notice of Estimated Payment of Medical Care Benefit Costs) are confirmed to have violated Article 33(2) of the Medical Service Act as a result of investigation by an investigative agency, and is not a medical care institution under Article 42(1) of the National Health Insurance Act. In such cases,

(Non-existence of the right to claim medical care benefits) Accordingly, the Corporation will notify the details currently withheld and the deferment of payment of the medical care benefit cost claimed in the future until it is confirmed that your source is a medical care institution provided by law.

Name of Health Care Institution: C Councilor

(b) Date of the measure at which payment is deferred: May 31, 2016;

Details currently withheld: None.

C. On July 4, 2016, the Defendant notified the Plaintiff Union of the determination on the recovery of medical care benefit costs as follows pursuant to Article 57(1) of the National Health Insurance Act:

(hereinafter “instant restitution disposition”). Relevant grounds - Seoul Eunpyeong Police Station investigation-2773 ( May 30, 2016) and notification of the result of the case handling, such as violation of the Consumer Cooperatives Act” - Article 57(1) of the National Health Insurance Act is notified by the Eunpyeong Police Station of the results of the investigation into the violation of the Consumer Cooperatives Act (case No. 2016-600), and Article 57(1) of the National Health Insurance Act.

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