Earticle

초록

영어

The National Health Insurance Corporation has been retrieving from health care providers the payments made to them by insured patients as a result of the health care providers’ arbitrary denial of coverage under the National Health Insurance, and has been disbursing such retrieved monies back to the patients, pursuant to Article 57, Sections 1 and 4 of the National Health Insurance Act. However, such practice is an application of the law that lacks legal exactitude. Another problem with such practice is that there is no legal provision under any laws or notices that expressly prohibits arbitrary denial of coverage. A legislative solution, therefore, is called for to address these issues.

목차

I. 문제의 제기
 II. 건보법 제57조 제1항과 제4항의 적용요건과 그 법적 성질
  1. 유사한 내용의 법률들과 대조하는 방법론의 시도
  2. 건보법 제57조 제1항과 제4항의 적용요건
  3. 건보법 제57조 제1항고 제4항의 법적 성질
 III. 건보법 제57조 제4항의 적용범위 및 건보공단의 징수청구권의 법적 성질
  1. 건보법 제57조 제4항의 적용범위
  2. 건보법 제57조 제4항에서 정한 건보공단의 징수청구권의 법적 성질
 IV. 임의비급여의 유형과 건보법 제57조 제1항과 제4항의 적용가능성 여부
  1. 임의비급여의 유형
  2. 임의비급여의 유형에 따른 건보법 제57조 제1항과 제4항의 적용가능성 여부
 V. 임의비급여와 건보법 제57조에 대한 대법원 전원합의체 판결 검토
 VI. 마침말
 참고문헌
 ABSTRACT

키워드

임의비급여 부당이득금 징수 부정한 방법 부당한 방법 요양급여기준 강행규정 Arbitrary Denial of Coverage Collection oh Unjust Enrichment unlawful means improper means Criteria for medical care benefits compulsory provisions

저자

• 송명호 [ Myung-Ho, Song | 법무법인 서정 변호사 ]

참고문헌

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