Act on Assurance of Medical Care for Elderly People

For each prefecture, Insurers and Association of Medical Care Systems for the Elderly Aged 75 and older are to jointly establish a Council of Insurers in order to promote necessary projects for the maintenance of the health of subscribers in old age and the optimization of medical expenses as well as to ensure the smooth operation of the medical care system for the elderly and cooperation in the operation.

The insurer council referred to in the preceding paragraph performs the following services:

liaison and coordination among insurers and other relevant persons concerning the implementation of Special health examinations, etc., the operation of the medical care system for the elderly, and other matters;

necessary advice or assistance to the insurer;

investigating and analyzing information on the expenses required for medical services and other particulars specified by Order of the Ministry of Health, Labour and Welfare;

investigation and analysis concerning the evaluation of the performance of the prefectural plan for regulating medical expenses.

The Minister of Health, Labour and Welfare is to provide necessary support to ensure that the Council of Insurers smoothly carries out the services set forth in the items of the preceding paragraph.

In order to ensure the sound and smooth implementation of health services for the elderly and the services prescribed by the Article 125, paragraph (5), the national government must endeavor to promote research and development of nursing and other medical care, functional training, etc. according to the mental and physical characteristics of elderly persons, and research and development of equipment for facilitating elderly persons in their daily lives and equipment for functional training, which are intended for use by persons whose mental and physical functions have deteriorated due to illness or injury, etc.

The order of statutory liens on insurance premiums and other money to be collected pursuant to the provisions of this Act comes after national taxes and local taxes.

The right to collect insurance premiums and any other money to be collected pursuant to the provisions of this Act or to receive a refund thereof, and the right to receive an old-old medical care benefit are extinguished by prescription when two years have elapsed from the time when these rights can be exercised.

A notice or demand for the collection of insurance premiums or any other money to be collected pursuant to the provisions of this Act has the effect of renewing the prescription period.

An assessment and determination of insurance premiums may not be made on or after the day on which two years have elapsed from the day following the first due date for payment of insurance premiums in the relevant fiscal year (meaning the due date for payment of insurance premiums pursuant to the provisions of this Act or Prefectural or Municipal Ordinance under this Act, and in cases where it becomes possible to impose insurance premiums after the due date, the day on which it becomes possible to impose the insurance premiums; the same applies in the following paragraph).

Notwithstanding the provisions of the preceding paragraph, an assessment and decision to reduce the amount of insurance premiums in the case where it is found, after an assessment and decision of insurance premiums is made, that adjustment of the applicable relationship between the insured and medical insurance laws (excluding the National Health Insurance Act) is required due to grounds not attributable to insured, may be made on or after the day on which two years have elapsed from the day following the due date of the first insurance premiums in the relevant fiscal year, until the day on which a period equivalent to the period found necessary for the adjustment has elapsed from the day following the due date of the first insurance premiums in the relevant fiscal year.

The provisions of the Civil Code concerning periods of time apply mutatis mutandis to the computation of periods of time prescribed in this Act or in orders based on this Act.

The Minister of Health, Labour and Welfare, an Association of Medical Care Systems for the Elderly Aged 75 and older, a medical institution providing services covered by health insurance, etc., a designated home-nursing provider or any other person specified by Order of the Ministry of Health, Labour and Welfare as a person who uses an insured number, etc. (meaning an insurer's number (meaning a number specified by the Minister of Health, Labour and Welfare for each Association of Medical Care Systems for the Elderly Aged 75 and older as a number for identifying an Association of Medical Care Systems for the Elderly Aged 75 and older in the medical services for the old-old) and an insured number (meaning a number specified by the Association of Medical Care Systems for the Elderly Aged 75 and older for each insured as a number for managing the qualifications of an insured); hereinafter the same applies in this Article) for the implementation of the services for medical services for the old-old or affairs related to the services (hereinafter referred to as the "Minister of Health, Labour and Welfare, etc." in this Article) must not request any person to notify the person or any other person of the insured number, etc. unless it is necessary for the implementation of the services or affairs.

Except in cases specified by Order of the Ministry of Health, Labour and Welfare as cases where the use of the insured person number, etc. is particularly necessary for the conduct of old-old medical care services or affairs related to those services, a person other than the Minister of Health, Labour and Welfare, etc. must not request any person to notify the insured person number, etc. pertaining to that person or to a person other than that person.

No person may, except in the following cases, with regard to an act that the person conducts as a business, request a person who intends to make an application for a contract of sale, lease, employment, or otherwise (hereinafter in this paragraph referred to as a "contract") with the person, a person who makes such an application, or a person who has concluded a contract with the person, to disclose the insured person number, etc. pertaining to the person requested or a person other than the person requested:

when the Minister of Health, Labour and Welfare, etc. requests notification of the insured number, etc. in the case prescribed in paragraph (1);

where a person other than the Minister of Health, Labour and Welfare, etc. requests the disclosure of the insured person number, etc. in a case specified by Order of the Ministry of Health, Labour and Welfare prescribed in the preceding paragraph.

Except in the following cases, it is prohibited for any person to engage in the business of constructing a database in which insured numbers, etc. are recorded (meaning a collection of data that includes insured numbers, etc. for a person other than the person in question, which has been systematically organized so as to be searchable using a computer) and the data recorded in that database is intended to be provided to others (hereinafter referred to as a "provided database" in this paragraph):

if the Minister of Health, Labour and Welfare, etc. constitutes the provided database in the case prescribed in paragraph (1);

when a person other than the Minister of Health, Labour and Welfare, etc. constructs the provided database in cases specified by Order of the Ministry of Health, Labour and Welfare as prescribed in paragraph (2).

If an act in violation of the provisions of the preceding two paragraphs has been committed and the Minister of Health, Labour and Welfare finds that the person who committed that act is likely to commit an act in violation of those provisions again and again, the Minister may recommend the person who committed that act to discontinue that act or take the necessary measures to ensure that that act will be discontinued.

If a person who has received recommendations under the provisions of the preceding paragraph does not follow the recommendations, the Minister of Health, Labour and Welfare may order the person to follow the recommendations by a set deadline.

On finding that it is necessary to do so in connection with a measure under the provisions of paragraph (5) or (6) of the preceding Article, the Minister of Health, Labour and Welfare, within the scope of what is found to be necessary, may ask a person that there are reasonable grounds to find to be in violation of the provisions of paragraph (3) or (4) of that Article to report on the necessary particulars, and may have the relevant officials enter the office or place of business of that person and ask questions or inspect its books, documents, and any other articles.

The provisions of Article 16-7, paragraph (2) apply mutatis mutandis to questions and inspections pursuant to the provisions of the preceding paragraph, and the provisions of paragraph (3) of the same Article apply mutatis mutandis to the authority granted pursuant to the provisions of the preceding paragraph.

When the provisions of Articles 106 and 108 of the National Health Insurance Act are applied to NHI federations, the term "services" in these provisions is deemed to be replaced with "services (including medical services for the elderly as prescribed in Article 156 of the Act on Assurance of Medical Care for Elderly People (Act No. 80 of 1982))".

The authority of the Minister of Health, Labour and Welfare provided for in this Act may be delegated to the Director-General of a Regional Bureau of Health and Welfare pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare.

The authority delegated to the Director-General of a Regional Bureau of Health and Welfare pursuant to the provisions of the preceding paragraph may be delegated to the Director-General of a Regional Branch Bureau of Health and Welfare pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare.

When the Minister of Health, Labour and Welfare or prefectural governors perform the affairs prescribed in this Act, they are to do so in close coordination with each other.

Affairs that are to be administered by a prefecture pursuant to the provisions of Article 44, paragraph (4) (including as applied mutatis mutandis pursuant to Article 124, Article 124-8 and Article 10 of the Supplementary Provisions), Article 61, paragraphs (1) and (2), Article 66, paragraph (1) (including as applied mutatis mutandis pursuant to Article 74, paragraph (10), Article 75, paragraph (7), Article 76, paragraph (7), and Article 82, paragraph (7)) and paragraph (2) (including as applied mutatis mutandis pursuant to Article 72, paragraph (2), Article 74, paragraph (10), Article 75, paragraph (7), Article 76, paragraph (7), and Article 82, paragraph (7)), Article 70, paragraph (2), and Article 72, paragraphs (1) and (3) (including as applied mutatis mutandis pursuant to Article 74, paragraph (10), Article 75, paragraph (7), Article 76, paragraph (7), and Article 82, paragraph (7)), Article 80, and Article 81, paragraphs (1) and (3) (including as applied mutatis mutandis pursuant to Article 82, paragraph (7)), Article 133, paragraph (2), Article 134, paragraph (2) (including as applied mutatis mutandis pursuant to Article 10 of the Supplementary Provisions), Article 152, paragraphs (1) and (3) (including as applied mutatis mutandis pursuant to Article 11, paragraph (2) of the Supplementary Provisions), and Article 88 and Article 89, paragraph (1) of the National Health Insurance Act as applied mutatis mutandis pursuant to Article 127 are deemed to be item (i) statutory entrusted function prescribed in Article 2, paragraph (9), item (i) of the Local Autonomy Act.

In addition to the affairs prescribed in Article 70, paragraph (4) (including as applied mutatis mutandis pursuant to Article 74, paragraph (10), Article 75, paragraph (7), Article 76, paragraph (7) and Article 78, paragraph (8)), the Association of Medical Care Systems for the Elderly Aged 75 and older may entrust the following affairs to the Organization or the NHI federation:

affairs pertaining to the collection or organization of information pertaining to the implementation of an old-old medical care benefit provided for in Article 56, the collection of insurance premiums pursuant to the provisions of Article 104, paragraph (1), the implementation of health services for the elderly pursuant to the provisions of Article 125, paragraph (1), and other affairs specified by Order of the Ministry of Health, Labour and Welfare;

affairs pertaining to the use or provision of information pertaining to the implementation of an old-old medical care benefit provided for in Article 56, the collection of insurance premiums pursuant to the provisions of Article 104, paragraph (1), the implementation of health services for the elderly pursuant to the provisions of Article 125, paragraph (1), and other affairs specified by Order of the Ministry of Health, Labour and Welfare.

The Association of Medical Care Systems for the Elderly Aged 75 and older, when entrusting the affairs listed in the items of the preceding paragraph pursuant to the provisions of the same paragraph, is to entrust them jointly with other Associations of Medical Care Systems for the Elderly Aged 75 and older and Insurers, persons specified by Order of the Ministry of Health, Labour and Welfare who conduct affairs pertaining to benefits related to medical care pursuant to the provisions of laws and regulations, and municipalities that operate long-term care insurance pursuant to the provisions of Article 3 of the Long-Term Care Insurance Act and other persons specified by Order of the Ministry of Health, Labour and Welfare.

The national government, Association of Medical Care Systems for the Elderly Aged 75 and older, medical institutions providing services covered by health insurance, etc., and other relevant persons are to coordinate and cooperate with one another so that the processes implemented pursuant to the provisions of the Medical Insurance Acts, this Act, and other laws and regulations providing benefits related to medical care are implemented smoothly, by introducing a mechanism for confirming electronic qualifications and promoting the use of information and communications technology in other procedures.

Beyond the special provisions in this Act, procedures for the enforcement of this Act and other detailed regulations necessary with regard to the enforcement are specified by Order of the Ministry of Health, Labour and Welfare.