Earticle

초록

영어

Article 347 of criminal law provides the act of deceiving another, thereby taking property or obtaining pecuniary advantage from another. On the other hand, the concepts of fraud and abuse are confused upon interpretation since the definition in National Healthcare Insurance Law is unclear, and it affects closely to the administrative measures such as surcharge levy by the period of inspection, therefore, the disputes continue in the forms of formal objection, administrative ruling and administrative litigation. This study aims to look over the legal problems on application of criminal fraud toward the abuse of ‘Paid Medical Expenses(Article 57, Sections 1 and 4 of the National Health Insurance Act)’. The main issues are concept of abuse(Article 57, Sections 1 and 4 of the National Health Insurance Act), the problems of Directions of Health-Welfare Ministry on aspect of ‘Nullum crimen sine lege’ Principles, the proper sentencing guidelines of fraud.

목차

I. 서론
 II. 허위청구와 사기죄 적용상의 쟁점
  1. 사기죄의 구성요건 개관
  2. 국민건강보험법 제57조와 사기죄의 구성요건
  3. 장관 고시에 의한 사기죄 성부
  4. 사기죄의 미수와 기수
  5. 사기죄의 죄수와 이득액
 III. 사기죄의 양형에 있어서의 쟁점
  1. 보험사기에 있어서 적정 양형의 의의
  2. 보험사기 판결례의 분석
  3. 선고형량의 분석
  4. 허위청구행위의 양형에 대한 평가
 IV. 결론
 참고문헌
 ABSTRACT

키워드

사기죄 허위청구 요양급여비용 건강보험 국민건강보험법 부정청구 양형 Fraud Abuse Health care fraud National health insurance law Paid Medical Expenses

저자

• 황만성 [ Hwang, Manseong | 원광대학교 법학전문대학원 부교수, 법학박사 ]
• 이정엽 [ 서울북부지방법원 판사 ] 지정토론문

참고문헌

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