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TITLE ¡¼Syllabus of Latest Opinion¡½ Supreme Court Decision 2021Du58202 Decided May 30, 2024 ¡¼Claim for Revocation of Disapproval Disposition of Health Care Benefits and Medical Benefits¡½ [full Text]
Summary
¡¼Main Issue and Holding¡½ In a case where: a disposition for the suspension of qualification was imposed on Party B in accordance with Article 66(1)7 of the Medical Service Act on the grounds that Party B made a claim for medical expenses by fraud while Party A and others, medical personnel, and Party B, established and were operating a medical institution; nevertheless, Party A and others, who jointly established the medical institution, while Party B was still the joint founder of the medical institution, performed medical practices and claimed a review of the costs of health care benefits and medical benefits; and the Health Insurance Review and Assessment Service returned the request for the review to the above medical institution on the grounds that the above medical institution is not entitled to claim health care benefit expenses and medical benefit expenses during the period for suspension of qualification of Party B, the case holding that the above medical institution cannot provide medical services pursuant to Article 66(3) of the Medical Service Act during the period for suspension of qualification of Party B and thus does not correspond to a medical care institution or medical benefit institution that may claim health care benefit expenses and medical benefit expenses under the National Health Insurance Act and the Medical Benefit Act
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