요양급여비용채무와 손해배상채권의 상계 - 「국민건강보험법」 제52조 제1항에 따른 요양급여비용의 환수와 요양급여비용채권의 상계를 중심으로 -

Abstract

Since the separation of pharmacy and clinic. up to May 2007, had been inspected, if a medical off-prescription, that a doctor belonged a medical institution have issued to his patient, is wrote out to exceed the range of authorized criterion, by the Health Insurance Review Agency to prevent hospitals from using unnecessary medicine. And as a violation of the authorized criterion, exceeds the portion of the medical care expenses are restituted as a unfair profits. But the Supreme Court ruled that were invalid, as follow reasons;An obligator by unfair profits on article 52, Clause 1 of the National Health Insurance Law must be 'a person or institution who get expenses by fraudulent means'. however, the medical institutions(a pharmacy, etc) not have any profits, but also by oneself use any fraudulent means. After the decision of the Supreme Court, the National Health Insurance Corporation deduct from the next medical care expenses to insist on his right of setoff against the indemnity bond based on the tort(as a violation of the authorized criterion). If so, is such a redemption as a indemnity bond on the law of tort(Article 750 of the Civil Law) of health insurance corporation justifiable? and if it could be, may can be uniformly set off by medical care expenses bonds of medical institutions? It has been the subject of discussion. In this dissertation, considered about legal nature of medical care expenses bonds and propriety of exercising a right of setoff as a redemption on article 750 of the Civil Law in order to protect medical care expenses claim of medical institutions.