부당발급된 처방전에 의한 의료기관의 약제비반환의무-서울행정법원 2004.6.1 2003구합20449 사건을 중심으로-

Abstract

The judgment is very significant since it is the first decision of the court addressing that in spite of mistaken prescriptions, it is legally unwarranted that doctors reimburse the National Health Insurance Corporation for medicine cost paid to pharmacies. This meaningful decision makes it clear that the long-standing administrative practice of reimbursement by medical institutions so far is improper. Moreover, the judgment is important on account of its ruling that the Article 52 ① of the National Health Insurance Act applied to this case is not in accordance with the civil law principle, “Restoration of Unjust Enrichment”. In short, the judgment admits that inappropriate customs prevailing in the government's medical administration should be remedied. However, the court just indicates that the present reimbursement system is not reasonable, and does not go further on concrete methods to reform the system. Therefore, it is necessary to review fundamental problems such as who should reimburse for costs incurred by misjudged prescriptions. In the near future, in addition to the confirmation of the court on unjustified precedents, it is essential to explore theoretical and legislative scrutiny with regard to objects and ranges of reimbursement..