Supreme Court: "Recovery of Medical Benefits from Doctors in Office-Managed Hospitals is Unjust... Degree of Involvement Must Be Considered"

[Asia Economy Reporter Kim Hyung-min] The Supreme Court has ruled that it is unfair to order a doctor employed at a so-called 'Samu-jang Byeongwon' (office manager hospital) to refund all medical care benefits that the hospital wrongfully received.

The Supreme Court's First Division (Presiding Justice Kwon Soon-il) announced on the 9th that it overturned the lower court's ruling, which dismissed doctor A's appeal against the National Health Insurance Service's order to recover medical care benefit costs, and remanded the case to the Seoul High Court.

The court stated, "The registered founder (who lent their name to the Samu-jang Byeongwon) only receives compensation for labor provided and does not participate in the establishment or operation of the hospital, nor is they entitled to the profits or losses from the medical institution's operation," concluding that A's responsibility for the improperly paid medical care benefits is limited.

It further ruled, "Collecting the full amount of medical care benefit costs from the registered founder of a medical institution without considering the circumstances can be regarded as an abuse or excess of discretion unless there are special circumstances."

A worked at a 'Samu-jang Byeongwon' established by a non-medical professional from May 2005 to February 2007. A Samu-jang Byeongwon is an illegal institution operated under the name of a medical professional or nonprofit corporation but established by someone not qualified to open a medical institution under the Medical Service Act.

In September 2013, the National Health Insurance Service ordered A to refund 5.1 billion KRW in medical care benefit costs paid during the employment period, citing that A performed medical acts at an illegal institution.

A argued that the medical care benefits would have been paid even if patients received treatment at other hospitals, so the Service did not suffer any loss.

Additionally, A filed a lawsuit to cancel the order, claiming that the 5.1 billion KRW refund could lead to personal bankruptcy and that the order constituted an abuse or excess of discretion.

The first and second trials dismissed A's claims.

This content was produced with the assistance of AI translation services.