Act on Assurance of Medical Care for Elderly People

Pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, the Association of Medical Care Systems for the Elderly Aged 75 and older must notify the Organization of the amount subject to insurance payment in each fiscal year and other matters specified by Order of the Ministry of Health, Labour and Welfare.

The Association of Medical Care Systems for the Elderly Aged 75 and older may delegate the affairs concerning the notification under the preceding paragraph to the NHI Federations.

The provisions of Article 41 and Articles 43 through 46 apply mutatis mutandis to Medical Care Assistance for the Elderly Aged 75 and over money, etc.

The Organization collects childbirth and childcare support benefits from the Association of Medical Care Systems for the Elderly Aged 75 and older each fiscal year to cover the expenses required for the services listed in Article 139, paragraph (1), item (iii).

A Association of Medical Care Systems for the Elderly Aged 75 and older is liable to pay childbirth and childcare support benefits.

The amount of childbirth and childcare support benefits to be collected from each Association of Medical Care Systems for the Elderly Aged 75 and older pursuant to the provisions of paragraph (1) of the preceding Article is the amount obtained by multiplying the amount calculated, as specified by Order of the Ministry of Health, Labour and Welfare, on the basis of the total amount of expenses required for payment of lump-sum allowance for childbirth and childcare, family lump-sum allowance for childbirth and childcare, childbirth expenses and family childbirth expenses under the provisions of the Medical Insurance Acts (referred to as "expenses required for payment of lump-sum allowance for childbirth and childcare, etc." in paragraph (1) of the following Article and Article 124-7, paragraph (1)), by the childbirth and childcare support rate and the ratio of the number of insured pertaining to that Association of Medical Care Systems for the Elderly Aged 75 and older to the total number of insured pertaining to all Associations of Medical Care Systems for the Elderly Aged 75 and older.

The childbirth and childcare support rate referred to in the preceding paragraph for fiscal year 2024 and fiscal year 2025 is 7 / 100.

The childbirth and childcare support rate referred to in paragraph (1) in fiscal year 2026 and subsequent fiscal years is specified by Cabinet Order every two years based on the number obtained by dividing the rate set forth in item (i) by the number set forth in item (ii):

the rate arrived at when 7 percent is multiplied by the rate arrived at when the prospective total number of insured pertaining to all of the Association of Medical Care Systems for the Elderly Aged 75 and older in the relevant fiscal year is divided by the total number of insured pertaining to all of the Association of Medical Care Systems for the Elderly Aged 75 and older in fiscal 2024;

the number arrived at when the rate set forth in the preceding item is added to the rate arrived at when 93 percent is multiplied by the rate arrived at when the prospective total number of participants for all insurers in the relevant fiscal year is divided by the total number of participants for all insurers in fiscal 2024.

The Organization provides childbirth and childcare grants to Insurers in order to cover part of the expenses required for payment of lump-sum allowance for childbirth and childcare, etc.

The childbirth and childcare grants referred to in the preceding paragraph are to be covered by the childbirth and childcare support benefits collected by the Organization pursuant to the provisions of Article 124-2, paragraph (1).

The amount of childbirth and childcare grant to be granted to each insurer pursuant to the provisions of paragraph (1) is the amount calculated pursuant to the provisions of the Medical Insurance Acts.

The Organization collects contributions for childbirth and childcare related office expenses from Insurers each fiscal year in order to cover the expenses required for the processing of affairs concerning the services listed in Article 139, paragraph (1), item (iii).

An insurer is liable to pay contributions for childbirth and childcare related office expenses.

The amount of contributions for childbirth and childcare related office expenses collected from each Insurer pursuant to the provisions of paragraph (1) of the preceding Article is 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 processing of affairs concerning the services of the Organization set forth in Article 139, paragraph (1), item (iii) in the relevant fiscal year, in accordance with the estimated number of participants pertaining to each Insurer, as specified by Order of the Ministry of Health, Labour and Welfare.

Insurers must, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, notify the Organization of the amount of expenses required for payment of lump-sum allowance for childbirth and childcare, etc. pertaining to the relevant Insurer in each fiscal year and other matters specified by Order of the Ministry of Health, Labour and Welfare.

An Association of Medical Care Systems for the Elderly Aged 75 and older must, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, notify the Organization of the number of insured pertaining to the Association in each fiscal year and other matters specified by Order of the Ministry of Health, Labour and Welfare.

The provisions of Article 41 and Articles 43 through 46 apply mutatis mutandis to childbirth and childcare support benefits and contributions for childbirth and childcare related office expenses. In this case, the necessary technical replacement of terms is specified by Cabinet Order.

The Old-Old Subsidy granted by the Organization to each Association of Medical Care Systems for the Elderly Aged 75 and older pursuant to the provisions of Article 100, paragraph (1) and the childbirth and childcare support benefits collected by the Organization from each Association of Medical Care Systems for the Elderly Aged 75 and older pursuant to the provisions of Article 124-2, paragraph (1) are to be offset.

Aid for the old-old, etc. and contributions for childbirth and childcare related office expenses collected by the Organization from Insurers pursuant to the provisions of Article 118, paragraph (1) and Article 124-5, paragraph (1) and childbirth and childcare grants granted by the Organization to Insurers pursuant to the provisions of Article 124-4, paragraph (1) are to be offset.

A Association of Medical Care Systems for the Elderly Aged 75 and older must endeavor to provide health education, health counseling, health checkups, and health guidance, as well as support for the insured's self-help efforts pertaining to health management and the prevention of diseases, and other services necessary for the maintenance and promotion of the health of the insured (hereinafter referred to as "health services for the elderly"), in accordance with the mental and physical characteristics of elderly persons.

A Association of Medical Care Systems for the Elderly Aged 75 and older is to provide health services for the elderly in an appropriate and effective manner by making use of medical insurance-related information.

In providing health services for the elderly, a Association of Medical Care Systems for the Elderly Aged 75 and older must endeavor to specify the matters concerning the coordination between the Association of Medical Care Systems for the Elderly Aged 75 and older and the municipality in the regional plan provided for in Article 291-7 of the Local Autonomy Act (referred to as the "regional plan" in paragraph (1) of the following Article), so as to promote the provision of health services for the elderly in an effective, efficient, and detailed manner according to the circumstances of each insured.

A Association of Medical Care Systems for the Elderly Aged 75 and older may provide necessary services such as the lending of equipment necessary for medical treatment in the insured and other services necessary to improve the medical treatment environment in the insured, services necessary for the medical care benefit for the old-old, and the lending of funds pertaining to expenses for medical treatment in the insured.

The Minister of Health, Labour and Welfare, with regard to health services for the elderly provided by a Association of Medical Care Systems for the Elderly Aged 75 and older pursuant to the provisions of paragraph (1), is to provide necessary support, such as the publication of guidelines and the provision of information, in order to ensure the appropriate and effective implementation thereof.

The guidelines referred to in the preceding paragraph are to provide for the following particulars:

basic matters concerning the effective and efficient implementation of health services for the elderly;

particulars concerning the efforts made by a Association of Medical Care Systems for the Elderly Aged 75 and older and a municipality entrusted pursuant to the provisions of the first sentence of paragraph (1) of the following Article for the effective and efficient implementation of health services for the elderly;

particulars concerning support for a Association of Medical Care Systems for the Elderly Aged 75 and older and a municipality entrusted pursuant to the provisions of the first sentence of paragraph (1) of the following Article for the effective and efficient implementation of health services for the elderly;

matters concerning cooperation between a Association of Medical Care Systems for the Elderly Aged 75 and older and a municipality for the effective and efficient implementation of health services for the elderly;

particulars concerning coordination between the Association of Medical Care Systems for the Elderly Aged 75 and older and the relevant organizations and groups in the community for the effective and efficient implementation of health services for the elderly;

other matters to be taken into consideration for the effective and efficient implementation of health services for the elderly.

The guidelines referred to in paragraph (6) must be in harmony with the health checkup guidelines prescribed in Article 9, paragraph (1) of the Health Promotion Act, the guidelines prescribed in Article 82, paragraph (11) of the National Health Insurance Act, and the basic guidelines prescribed in Article 116, paragraph (1), Long-Term Care Insurance Act.

A Association of Medical Care Systems for the Elderly Aged 75 and older may entrust a Municipality that is a member of the Association of Medical Care Systems for the Elderly Aged 75 and older with the implementation of part of its elderly health services based on the Regional Plan of the Association of Medical Care Systems for the Elderly Aged 75 and older, and the entrusted Municipality is to, from the viewpoint of ensuring the effective and efficient implementation of the elderly health services for the insured, establish basic policies concerning the implementation of the services, including the ideal way of implementing the services in an integrated manner with national health insurance health services and community support projects. In this case, the Association of Medical Care Systems for the Elderly Aged 75 and older may provide the entrusted Municipality with copies of its own records concerning medical treatment, health checkups, or health guidance pertaining to the insured, and other information specified by Order of the Ministry of Health, Labour and Welfare as necessary for the effective and efficient implementation of the elderly health services, to the extent necessary for the implementation of the entrusted elderly health services.

A person who is or was an official of a municipality entrusted pursuant to the provisions of the first sentence of the preceding paragraph must not, without justifiable grounds, divulge any individual secrets that have come to their knowledge in relation to the implementation of health services for the elderly.