Act on Assurance of Medical Care for Elderly People

The Organization is to conduct operations listed in the following items in order to accomplish the purposes as prescribed in Article 1 in addition to operations as prescribed in Article 18 of the Medical Information Infrastructure and Medical Fee Examination and Payment Organization Act:

operations to collect Young-Old Payments, etc. from an Insurer (or a prefecture in the case of national health insurance; hereinafter the same applies in this Chapter, except in the following Article) and to provide Young-Old Grants to the Insurer, and operations incidental thereto;

services for collecting Medical Care Assistance for the Elderly Aged 75 and over, etc. from insurers and providing the Old-Old Subsidy to the Association of Medical Care Systems for the Elderly Aged 75 and older, and services incidental thereto;

operations to collect childbirth support payments from Associations of Medical Care Systems for the Elderly Aged 75 and older, to collect contributions for administrative expenses related to childbirth from Insurers, and to provide childbirth grants to Insurers, and operations incidental thereto.

The Organization may carry out activities that contribute to achieving the purpose prescribed in Article 1 with the authorization of the Minister of Health, Labour and Welfare to the extent that the activities set forth in the preceding paragraph are not hindered.

The operations prescribed in the preceding two paragraphs are referred to as the operations related to the medical care system for the elderly.

The Organization, with the authorization of the Minister of Health, Labour and Welfare, may entrust part of the operations related to the medical care system for the elderly to an organization which Insurers belong to and which is specified by the Minister of Health, Labour and Welfare.

The Organization, with regard to the operations related to the medical care system for the elderly, must prepare a statement of operational procedures and obtain the authorization of the Minister of Health, Labour and Welfare prior to the commencement of those operations. The same applies when the statement is changed.

The particulars to be stated in the statement of operational procedures referred to in the preceding paragraph are specified by Order of the Ministry of Health, Labour and Welfare.

The Organization may, in addition to requesting reports from Insurers in each fiscal year on the number of participants, the implementation status of Special health examinations, etc., and other particulars specified by Order of the Ministry of Health, Labour and Welfare, request Insurers to submit documents and other items when it finds it necessary in relation to the business of collecting young-old payments, etc. from Insurers prescribed in Article 139, paragraph (1), item (i), the business of collecting aid for the old-old, etc. from Insurers prescribed in item (ii) of the same paragraph, and the business of collecting contributions for administrative expenses related to childbirth from Insurers prescribed in item (iii) of the same paragraph.

The Organization, when it finds it necessary in relation to the business of collecting childbirth support payments from an Association of Medical Care Systems for the Elderly Aged 75 and older prescribed in Article 139, paragraph (1), item (iii), may request the Association to submit documents and other items.

The Organization must establish a special account for the accounting for the operations related to the medical care system for the elderly, separately from the accounting for other services, for each of the services set forth in Article 139, paragraph (1), item (i), the services set forth in items (ii) and (iii) of that paragraph, and the services prescribed in paragraph (2) of that Article.

The Organization must prepare a budget, business plan, and funding plan for each business year with regard to the operations related to the medical care system for the elderly, and obtain the authorization of the Minister of Health, Labour and Welfare prior to the commencement of the relevant business year. The same applies when making any change to these.

The Organization must prepare the inventory of assets, balance sheets, and profit and loss statement (hereinafter referred to as the "financial statements") for each business year with regard to the operations related to the medical care system for the elderly, and must submit them to the Minister of Health, Labour and Welfare within three months after the end of the relevant business year and obtain the approval of the Minister.

The Organization, when submitting financial statements to the Minister of Health, Labour and Welfare pursuant to the provisions of the preceding paragraph, must attach to them a business report of said fiscal year, a statement of accounts that is prepared in accordance with categories of the budget, and a statement of opinion of an auditor concerning the financial statements and the statement of accounts, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare.

The Organization, when it obtains the approval of the Minister of Health, Labour and Welfare pursuant to the provisions of paragraph (1), must give public notice of the financial statements or a summary of the financial statements in the Official Gazette without delay, and maintain said financial statements and supporting detailed statements, and the business report, statement of accounts, and statement of opinion of the auditor as set forth in the preceding paragraph at its principal office, and offer them for public perusal for the period as determined by Order of the Ministry of Health, Labour and Welfare.

The Organization, with regard to the operations related to the medical care system for the elderly (excluding the services prescribed in Article 139, paragraph (2); the same applies in the following paragraph and paragraph (1) of the following Article), in each business year, when profits have accrued based on the profit and loss calculation, must offset any losses carried over from the previous business year, and if there is any surplus even after offsetting the losses, the Organization must keep this surplus amount as a reserve fund.

The Organization, with regard to the operations related to the medical care system for the elderly, in each business year when a loss is incurred based on the calculation of profits and losses, must account for the loss by reducing the amount of the reserve fund under the provisions of the preceding paragraph, and if there is still a shortfall, the amount of the shortfall must be accounted for as a loss carried forward.

The Organization, limited to the amount specified in the budget, may allocate the reserve fund under the provisions of paragraph (1) to the expenses required for the business of providing Young-Old Grants to Insurers prescribed in Article 139, paragraph (1), item (i), the business of providing Old-Old Subsidies to an Association of Medical Care Systems for the Elderly Aged 75 and older prescribed in item (ii) of the same paragraph, and the business of providing childbirth grants to Insurers prescribed in item (iii) of the same paragraph, or the business to be carried out by obtaining approval pursuant to the provisions of paragraph (2) of the same Article.

The Organization, with regard to the operations related to the medical care system for the elderly, may operate long-term borrowings or short-term borrowings, or issue bond certificates, with the authorization of the Minister of Health, Labour and Welfare.

The long-term borrowings and bond certificates under the preceding paragraph must be redeemed within two years.

The short-term borrowings pursuant to the provisions of paragraph (1) must be repaid within the relevant project year; provided, however, that when the short-term borrowings cannot be repaid due to a lack of funds, only the amount that cannot be repaid may be refinanced with the approval of the Minister of Health, Labour and Welfare.

Short-term borrowings that have been refinanced pursuant to the proviso to the preceding paragraph must be repaid within one year.

The Organization, in a case when issuing bonds pursuant to the provisions of paragraph (1), may issue said bonds subject to a bond discount.

The creditors of the bonds under the provisions of paragraph (1) have the right to have their claims satisfied out of the assets of the Organization in preference over other creditors.

The order of the statutory lien set forth in the preceding paragraph is to be next to the general statutory lien under the provisions of the Civil Code (Act No. 89 of 1896).

The Organization may entrust the whole or a portion of affairs concerning issuance of bonds pursuant to the provisions of paragraph (1) to banks and trust companies after obtaining the approval of the Minister of Health, Labour and Welfare.

The provisions of Article 705, paragraphs (1) and (2), and Article 709 of the Companies Act (Act No. 86 of 2005) apply mutatis mutandis to a bank or trust company entrusted with business pursuant to the provisions of the preceding paragraph.

Beyond what is provided for in paragraph (1), paragraph (2), and paragraph (5) through the preceding paragraph, necessary matters concerning the bond certificates referred to in paragraph (1) are specified by Cabinet Order.

Notwithstanding the provisions of Article 3 of the Act on Restrictions on Financial Assistance by the Government to Corporations (Act No. 24 of 1946), the government may, within the amount approved by a resolution of the National Diet, when it finds it necessary for the smooth granting of the Young-Old Subsidies, the Old-Old Subsidies and the childbirth grants by the Organization, guarantee obligations pertaining to the long-term borrowings, short-term borrowings or bonds of the Organization pursuant to the provisions of the preceding Article, within the period found to be necessary.

The Organization must not invest any surplus funds that arise in the course of operations pertaining to the services related to the medical care system for the elderly, except by the following methods:

holding of Japanese government bonds and other securities designated by the Minister of Health, Labour and Welfare;

making deposits with banks and other financial institutions designated by the Minister of Health, Labour and Welfare;

money trust into financial institutions engaged in trust business (meaning financial institutions that have obtained the authorization under Article 1, paragraph (1) of the Act on Engagement in Trust Business Activities by Financial Institutions (Act No. 43 of 1943)).

The Minister of Health, Labour and Welfare must consult with the Minister of Finance in advance in any of the following cases:

when intending to grant the authorization referred to in Article 147, paragraph (1), (3) or (8);

when intending to make a designation referred to in item (i) or (ii) of the preceding Article.

Beyond what is provided for in this Chapter, the necessary matters concerning the finance and accounting of the Organization pertaining to the services related to the medical care system for the elderly are specified by Order of the Ministry of Health, Labour and Welfare.

The Minister of Health, Labour and Welfare or the prefectural governor may, when finding it necessary in relation to the services related to the medical care system for the elderly, collect reports on the status of the services or property of the Organization or a person entrusted pursuant to the provisions of Article 140 (hereinafter referred to as an "entrusted party"), or have the relevant officials inspect the status on site; provided, however, that with regard to an entrusted party, this is limited to the scope of the entrusted services.

When a prefectural governor finds it necessary that a disposition under the provisions of Article 39 of the Medical Information Infrastructure and Medical Fee Examination and Payment Organization Act be made with regard to the Organization in relation to the services related to the medical care system for the elderly, or finds it necessary that a disposition under the provisions of Article 14, paragraph (3) or (4) of the same Act be made with regard to an officer of the Organization in relation to the services related to the medical care system for the elderly, the prefectural governor must notify the Minister of Health, Labour and Welfare to that effect, stating the reasons.

With regard to the application of the provisions of Article 14, paragraphs (3) and (4) of the Medical Information Infrastructure and Medical Fee Examination and Payment Organization Act, an order prescribed in Article 101, paragraph (1) is deemed to be an order prescribed in Article 39 of the same Act, and with regard to the application of the provisions of Article 43, paragraph (2) of the same Act, the services related to the medical care system for the elderly are deemed to be the services prescribed in Article 18 of the same Act.

A person who is dissatisfied with a disposition by the Organization based on this Act or its inaction may file an application for examination with the Minister of Health, Labour and Welfare. In this case, the Minister of Health, Labour and Welfare is deemed to be the superior administrative agency of the Organization for the purpose of the application of the provisions of Article 25, paragraphs (2) and (3), Article 46, paragraphs (1) and (2), Article 47 and Article 49, paragraph (3) of the Administrative Complaint Review Act (Act No. 68 of 2014).