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Act on Assurance of Medical Care for Elderly People

高齢者の医療の確保に関する法律(こうれいしゃのいりょうのかくほにかんするほうりつ)

Chapter III Coordination of Sharing of Expenses between Insurers Pertaining to Young-Old Persons (Articles 40 to 46)

The law as Act Partially Amending the Social Welfare Act, etc. (Act No. 51 of 2026) leaves it, with the words it changes marked.

The main text is read a page at a time: a chapter to a page, and a long chapter in runs of articles. The whole main text, and the supplementary provisions and appended tables this amendment changes. Those it leaves untouched are on the page for the text in force.

Article 40第四十条

Amount of Contributions for Office Expenses Related to the Young-Old(前期高齢者関係事務費拠出金の額)
Article 40, paragraph (1)

The amount of contributions for administrative expenses related to the young-old to be collected from each Insurer pursuant to the provisions of Article 36, paragraph (1) is, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, the amount calculated pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, based on the estimated amount of expenses required for the handling of affairs concerning the services of the Organization set forth in Article 139, paragraph (1), item (i) in the relevant fiscal year, in accordance with the estimated number of participants pertaining to each Insurer.

第三十六条第一項の規定により各保険者から徴収する前期高齢者関係事務費拠出金の額は、厚生労働省令で定めるところにより、当該年度における第百三十九条第一項第一号に掲げる機構の業務に関する事務の処理に要する費用の見込額を基礎として、各保険者に係る加入者の見込数に応じ、厚生労働省令で定めるところにより算定した額とする。

Article 41第四十一条

Special Provisions for the Amount of the Young-Old Subsidy in the Case of a Merger of Insurers(保険者の合併等の場合における前期高齢者交付金等の額の特例)
Article 41, paragraph (1)

Cabinet Order provides for special provisions for the calculation of the amount of Young-Old Subsidies and Young-Old Payments pertaining to an Insurer incorporated as a result of a merger or split, an Insurer surviving a merger or split, or an Insurer succeeding to the rights and obligations of a dissolved Insurer.

合併又は分割により成立した保険者、合併又は分割後存続する保険者及び解散をした保険者の権利義務を承継した保険者に係る前期高齢者交付金及び前期高齢者納付金等の額の算定の特例については、政令で定める。

Article 42第四十二条

Determination and Notification of the Amount of the Young-Old Subsidy(前期高齢者交付金の額の決定、通知等)
Article 42, paragraph (1)

The Organization must determine the amount of the Young-Old Subsidy to be granted to each Insurer for each fiscal year and notify each relevant Insurer of the amount of the Young-Old Subsidy to be granted to it, the method of grant, and other necessary matters.

機構は、各年度につき、各保険者に対し交付すべき前期高齢者交付金の額を決定し、当該各保険者に対し、その者に対し交付すべき前期高齢者交付金の額、交付の方法その他必要な事項を通知しなければならない。

Article 42, paragraph (2)

If it becomes necessary to change the amount of the Young-Old Subsidy after the amount of the Young-Old Subsidy has been determined pursuant to the provisions of the preceding paragraph, the Organization must change the amount of the Young-Old Subsidy to be granted to each of the relevant Insurers and notify each of the relevant Insurers of the changed amount of the Young-Old Subsidy.

前項の規定により前期高齢者交付金の額が定められた後、前期高齢者交付金の額を変更する必要が生じたときは、機構は、当該各保険者に対し交付すべき前期高齢者交付金の額を変更し、当該各保険者に対し、変更後の前期高齢者交付金の額を通知しなければならない。

Article 42, paragraph (3)

The Organization, in the case where the amount of the Young-Old Subsidy granted to an Insurer is less than the amount of the Young-Old Subsidy after the change pursuant to the provisions of the preceding paragraph, must notify the Insurer of the method of grant and other necessary matters, along with the notice pursuant to the provisions of the same paragraph, with regard to the shortfall; and in the case where the amount of the Young-Old Subsidy exceeds the amount of the Young-Old Subsidy after the change pursuant to the provisions of the same paragraph, the Organization must appropriate the excess amount to the unpaid Young-Old Subsidy, if any, and have the Insurer return the balance, if any, or have the Insurer return the excess amount if there is no unpaid subsidy.

機構は、保険者に対し交付した前期高齢者交付金の額が、前項の規定による変更後の前期高齢者交付金の額に満たない場合には、その不足する額について、同項の規定による通知とともに交付の方法その他必要な事項を通知し、同項の規定による変更後の前期高齢者交付金の額を超える場合には、その超える額について、未払の前期高齢者交付金があるときはこれに充当し、なお残余があれば返還させ、未払の交付金がないときはこれを返還させなければならない。

Article 43第四十三条

Determination and Notification of the Amount of Young-Old Payments(前期高齢者納付金等の額の決定、通知等)
Article 43, paragraph (1)

The Organization must determine the amount of young-old payments, etc. to be paid by each Insurer for each fiscal year, and notify each relevant Insurer of the amount of young-old payments, etc. to be paid by it, the method of payment, the due date of payment, and other necessary matters.

機構は、各年度につき、各保険者が納付すべき前期高齢者納付金等の額を決定し、当該各保険者に対し、その者が納付すべき前期高齢者納付金等の額、納付の方法及び納付すべき期限その他必要な事項を通知しなければならない。

Article 43, paragraph (2)

If it becomes necessary to change the amount of young-old payments, etc. after the amount of young-old payments, etc. has been determined pursuant to the provisions of the preceding paragraph, the Organization must change the amount of young-old payments, etc. to be paid by each relevant Insurer and notify each relevant Insurer of the changed amount of young-old payments, etc.

前項の規定により前期高齢者納付金等の額が定められた後、前期高齢者納付金等の額を変更する必要が生じたときは、機構は、当該各保険者が納付すべき前期高齢者納付金等の額を変更し、当該各保険者に対し、変更後の前期高齢者納付金等の額を通知しなければならない。

Article 43, paragraph (3)

If the amount of young-old payments, etc. paid by an Insurer is less than the amount of young-old payments, etc. after the change pursuant to the provisions of the preceding paragraph, the Organization must give notice of the method of payment, due date for payment, and other necessary matters with regard to the shortfall, together with the notice pursuant to the provisions of the same paragraph; and if the amount of young-old payments, etc. exceeds the amount of young-old payments, etc. after the change pursuant to the provisions of the same paragraph, the Organization must appropriate the excess amount to any unpaid young-old payments, etc. or any other money to be collected by the Organization pursuant to the provisions of this Chapter, and return the balance if any, or return the excess amount if there is no unpaid money to be collected.

機構は、保険者が納付した前期高齢者納付金等の額が、前項の規定による変更後の前期高齢者納付金等の額に満たない場合には、その不足する額について、同項の規定による通知とともに納付の方法及び納付すべき期限その他必要な事項を通知し、同項の規定による変更後の前期高齢者納付金等の額を超える場合には、その超える額について、未納の前期高齢者納付金等その他この章の規定による機構の徴収金があるときはこれに充当し、なお残余があれば還付し、未納の徴収金がないときはこれを還付しなければならない。

Article 44第四十四条

Demand and disposition to collect arrears(督促及び滞納処分)
Article 44, paragraph (1)

If an Insurer fails to pay young-old payments, etc. by the due date for payment, the Organization must demand payment, specifying a due date.

機構は、保険者が、納付すべき期限までに前期高齢者納付金等を納付しないときは、期限を指定してこれを督促しなければならない。

Article 44, paragraph (2)

The Organization, when it makes a demand pursuant to the provisions of the preceding paragraph, must issue a written demand to the relevant Insurer. In this case, the due date to be designated in the written demand must be a day on which ten days or more have elapsed from the day on which the written demand is issued.

機構は、前項の規定により督促をするときは、当該保険者に対し、督促状を発する。この場合において、督促状により指定すべき期限は、督促状を発する日から起算して十日以上経過した日でなければならない。

Article 44, paragraph (3)

The Organization, when an Insurer that has received a written demand pursuant to the provisions of paragraph (1) fails to pay in full, by the designated due date, the young-old payments, etc. pertaining to the written demand and the delinquent charge pursuant to the provisions of the following Article, is to request the Minister of Health, Labour and Welfare or the prefectural governor to collect them, pursuant to the provisions of Cabinet Order.

機構は、第一項の規定による督促を受けた保険者がその指定期限までにその督促状に係る前期高齢者納付金等及び次条の規定による延滞金を完納しないときは、政令で定めるところにより、その徴収を、厚生労働大臣又は都道府県知事に請求するものとする。

Article 44, paragraph (4)

When a request for collection under the provisions of the preceding paragraph is received, the Minister of Health, Labour and Welfare or the prefectural governor may make a disposition in accordance with the rules for a national tax disposition to collect arrears.

前項の規定による徴収の請求を受けたときは、厚生労働大臣又は都道府県知事は、国税滞納処分の例により処分することができる。

Article 45第四十五条

Delinquent Charges(延滞金)
Article 45, paragraph (1)

When a demand for payment of young-old payments, etc. is made pursuant to the provisions of paragraph (1) of the preceding Article, the Organization collects a delinquent charge calculated based on the number of days from the day after the due date for payment until the day before the day of full payment or attachment of property, at a rate of 14.5 percent per annum on the amount of young-old payments, etc. pertaining to the demand; provided, however, that this does not apply when the amount of young-old payments, etc. pertaining to the demand is less than one thousand yen.

前条第一項の規定により前期高齢者納付金等の納付を督促したときは、機構は、その督促に係る前期高齢者納付金等の額につき年十四・五パーセントの割合で、納付期日の翌日からその完納又は財産差押えの日の前日までの日数により計算した延滞金を徴収する。ただし、督促に係る前期高齢者納付金等の額が千円未満であるときは、この限りでない。

Article 45, paragraph (2)

In the case referred to in the preceding paragraph, if a part of the amount of the Young-Old Payments, etc. is paid, the amount of the Young-Old Payments, etc. to be used as the basis for calculating the amount of delinquent charge pertaining to the period after the date of the payment is the amount obtained by deducting the amount of the Young-Old Payments, etc. that was paid.

前項の場合において、前期高齢者納付金等の額の一部につき納付があつたときは、その納付の日以降の期間に係る延滞金の額の計算の基礎となる前期高齢者納付金等の額は、その納付のあつた前期高齢者納付金等の額を控除した額とする。

Article 45, paragraph (3)

In the calculation of delinquent charges, if the amount of the young-old payments, etc. set forth in the preceding two paragraphs includes a fraction of less than one thousand yen, the fraction is rounded down.

延滞金の計算において、前二項の前期高齢者納付金等の額に千円未満の端数があるときは、その端数は、切り捨てる。

Article 45, paragraph (4)

If the amount of delinquency calculated pursuant to the provisions of the preceding three paragraphs includes a fraction of less than one hundred yen, the fraction is rounded down.

前三項の規定によつて計算した延滞金の額に百円未満の端数があるときは、その端数は、切り捨てる。

Article 45, paragraph (5)

A delinquent charge is not collected if any of the following items applies; provided, however, that in the case of item (iii), this is limited to the portion of the amount corresponding to the period during which the execution has been suspended or deferred:

延滞金は、次の各号のいずれかに該当する場合には、徴収しない。ただし、第三号の場合には、その執行を停止し、又は猶予した期間に対応する部分の金額に限る。

Article 45, paragraph (5), item (i)

if the young-old payments, etc. are paid in full by the due date designated in the written demand;

督促状に指定した期限までに前期高齢者納付金等を完納したとき。

Article 45, paragraph (5), item (ii)

if the amount of the delinquency charge is less than 100 yen;

延滞金の額が百円未満であるとき。

Article 45, paragraph (5), item (iii)

when the execution of disposition to collect arrears for Young-Old Payments, etc. is suspended or stayed;

前期高齢者納付金等について滞納処分の執行を停止し、又は猶予したとき。

Article 45, paragraph (5), item (iv)

if it is found that there is a compelling reason for not paying Young-Old Payments, etc.

前期高齢者納付金等を納付しないことについてやむを得ない理由があると認められるとき。

Article 46第四十六条

Payment Grace Period(納付の猶予)
Article 46, paragraph (1)

The Organization, when it is found to be extremely difficult for an Insurer to pay young-old payments, etc. due to unavoidable circumstances, may, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, based on an application by the relevant Insurer and with the approval of the Minister of Health, Labour and Welfare, grant a grace period for a part of the payment for a period not exceeding one year from the due date for the payment.

機構は、やむを得ない事情により、保険者が前期高齢者納付金等を納付することが著しく困難であると認められるときは、厚生労働省令で定めるところにより、当該保険者の申請に基づき、厚生労働大臣の承認を受けて、その納付すべき期限から一年以内の期間を限り、その一部の納付を猶予することができる。

Article 46, paragraph (2)

The Organization, when having granted a grace period pursuant to the provisions of the preceding paragraph, must notify the Insurer of that fact, the amount of the young-old payments, etc. pertaining to the grace period, the grace period, and other necessary matters.

機構は、前項の規定による猶予をしたときは、その旨、猶予に係る前期高齢者納付金等の額、猶予期間その他必要な事項を保険者に通知しなければならない。

Article 46, paragraph (3)

If the Organization has granted a grace period pursuant to the provisions of paragraph (1), the Organization may not newly make a demand pursuant to the provisions of Article 44, paragraph (1) or request collection pursuant to the provisions of paragraph (3) of the same Article with respect to the young-old payments, etc. pertaining to the grace period during the grace period.

機構は、第一項の規定による猶予をしたときは、その猶予期間内は、その猶予に係る前期高齢者納付金等につき新たに第四十四条第一項の規定による督促及び同条第三項の規定による徴収の請求をすることができない。

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