Act on Assurance of Medical Care for Elderly People
高齢者の医療の確保に関する法律
The whole law on one page. Read it chapter by chapter
Chapter I General Provisions
第一章 総則
第一条（目的）
The purpose of this Act is to formulate a plan for promoting the optimization of medical expenses and to take measures for the implementation of health checkups, etc. by insurers in order to ensure appropriate medical care for the citizens in their old age, and with regard to medical care for the elderly, to establish a system necessary for adjusting the sharing of expenses between insurers pertaining to the young-old and for providing appropriate medical care benefits, etc. for the old-old, based on the principle of joint and several action by citizens, thereby improving the health of the citizens and promoting the welfare of the elderly.
この法律は、国民の高齢期における適切な医療の確保を図るため、医療費の適正化を推進するための計画の作成及び保険者による健康診査等の実施に関する措置を講ずるとともに、高齢者の医療について、国民の共同連帯の理念等に基づき、前期高齢者に係る保険者間の費用負担の調整、後期高齢者に対する適切な医療の給付等を行うために必要な制度を設け、もつて国民保健の向上及び高齢者の福祉の増進を図ることを目的とする。
第二条（基本的理念）
Citizens, based on the spirit of self-help and solidarity, are to endeavor at all times to maintain and improve their health, being conscious of the mental and physical changes that occur as a result of aging, and to bear the expenses required for medical care for elderly persons in a fair manner.
国民は、自助と連帯の精神に基づき、自ら加齢に伴つて生ずる心身の変化を自覚して常に健康の保持増進に努めるとともに、高齢者の医療に要する費用を公平に負担するものとする。
Citizens are to be given the opportunity to receive appropriate health services to help maintain their health in old age, in accordance with their age, mental and physical condition, etc., at work, in the community, or at home.
国民は、年齢、心身の状況等に応じ、職域若しくは地域又は家庭において、高齢期における健康の保持を図るための適切な保健サービスを受ける機会を与えられるものとする。
The national government must take all necessary measures to ensure the smooth implementation of efforts to ensure the appropriateness of the expenses required for medical care by citizens in old age and the sound operation of the medical insurance system for the elderly (meaning the adjustment of the sharing of expenses among insurers pertaining to the young-old provided for in Chapter III and the medical insurance system for the old-old provided for in Chapter IV; the same applies hereinafter), and actively promote medical care, public health, social welfare, and other related measures in order to contribute to the achievement of the purpose provided for in Article 1.
Article 4Responsibilities of Local Governments
第四条（地方公共団体の責務）
A local government must respect the purport of this Act and implement the necessary measures to ensure that efforts are made to ensure the appropriateness of the expenses required for medical care by residents in old age and the management of the medical care system for the elderly is carried out appropriately and smoothly.
地方公共団体は、この法律の趣旨を尊重し、住民の高齢期における医療に要する費用の適正化を図るための取組及び高齢者医療制度の運営が適切かつ円滑に行われるよう所要の施策を実施しなければならない。
In efforts to ensure the optimization of expenses required for medical care by residents in old age as prescribed in the preceding paragraph, the prefecture is to play a central part in obtaining the cooperation of Insurers, the Association of Medical Care Systems for the Elderly Aged 75 and older prescribed in Article 48 (referred to as the "Association of Medical Care Systems for the Elderly Aged 75 and older" in Articles 8 through 16 and Article 27), medical personnel, and other relevant persons, in light of its responsibility to ensure the medical care delivery system (meaning the medical care delivery system prescribed in Article 30-3, paragraph (1) of the Medical Care Act (Act No. 205 of 1948)) in the prefecture and the sound operation of national health insurance services by the prefecture and municipalities (including special wards; the same applies hereinafter) within the prefecture.
前項に規定する住民の高齢期における医療に要する費用の適正化を図るための取組においては、都道府県は、当該都道府県における医療提供体制（医療法（昭和二十三年法律第二百五号）第三十条の三第一項に規定する医療提供体制をいう。）の確保並びに当該都道府県及び当該都道府県内の市町村（特別区を含む。以下同じ。）の国民健康保険事業の健全な運営を担う責務を有することに鑑み、保険者、第四十八条に規定する後期高齢者医療広域連合（第八条から第十六条まで及び第二十七条において「後期高齢者医療広域連合」という。）、医療関係者その他の関係者の協力を得つつ、中心的な役割を果たすものとする。
Article 5Responsibilities of Insurers
第五条（保険者の責務）
An insurer must endeavor to actively promote the services necessary for maintaining the health of its members in old age, and must cooperate so that the operation of the medical care system for the elderly is implemented in a sound and smooth manner.
Article 6Responsibilities of Medical Care Professionals
第六条（医療の担い手等の責務）
Physicians, dentists, pharmacists, nurses, and other medical care professionals, as well as the establishers and administrators of medical institutions prescribed in Article 1-2, paragraph (2) of the Medical Care Act, must cooperate with the various measures, policies, and undertakings prescribed in the preceding three Articles.
医師、歯科医師、薬剤師、看護師その他の医療の担い手並びに医療法第一条の二第二項に規定する医療提供施設の開設者及び管理者は、前三条に規定する各般の措置、施策及び事業に協力しなければならない。
第七条（定義）
The term "Medical Insurance Acts" as used in this Act means the following acts:
この法律において「医療保険各法」とは、次に掲げる法律をいう。
the Mariners Insurance Act (Act No. 73 of 1939);
船員保険法（昭和十四年法律第七十三号）
National Public Officers Mutual Aid Association Act (Act No. 128 of 1958);
国家公務員共済組合法（昭和三十三年法律第百二十八号）
Local Public Officers, etc. Mutual Aid Association Act (Act No. 152 of 1962).
地方公務員等共済組合法（昭和三十七年法律第百五十二号）
the Private School Teachers Mutual Aid Act (Act No. 245 of 1953).
私立学校教職員共済法（昭和二十八年法律第二百四十五号）
The term "Insurers" as used in this Act means Japan Health Insurance Association, health insurance societies, prefectures and municipalities, national health insurance societies, mutual aid association, or the Promotion and Mutual Aid Corporation for Private Schools of Japan, which provide medical care benefits pursuant to the provisions of the Medical Insurance Acts.
この法律において「保険者」とは、医療保険各法の規定により医療に関する給付を行う全国健康保険協会、健康保険組合、都道府県及び市町村、国民健康保険組合、共済組合又は日本私立学校振興・共済事業団をいう。
The term "insurers of employee insurance, etc." as used in this Act means insurers (excluding Japan Health Insurance Association, prefectural and municipal governments, and national health insurance societies as insurers under the provisions of Article 123, paragraph (1) of the Health Insurance Act) or national health insurance societies whose members are persons who do not become insured under the same Act with the approval under the provisions of Article 3, paragraph (1), item (viii) of the Health Insurance Act, as specified by the Minister of Health, Labour and Welfare.
この法律において「被用者保険等保険者」とは、保険者（健康保険法第百二十三条第一項の規定による保険者としての全国健康保険協会、都道府県及び市町村並びに国民健康保険組合を除く。）又は健康保険法第三条第一項第八号の規定による承認を受けて同法の被保険者とならない者を組合員とする国民健康保険組合であつて厚生労働大臣が定めるものをいう。
The term "participant" as used in this Act means the following persons:
この法律において「加入者」とは、次に掲げる者をいう。
an insured pursuant to the provisions of the Health Insurance Act; provided, however, that this does not apply to a specially-permitted insured for day laborers pursuant to the provisions of Article 3, paragraph (2) of the same Act;
an insured under the provisions of the Mariners Insurance Act;
船員保険法の規定による被保険者
an insured pursuant to the provisions of the National Health Insurance Act;
国民健康保険法の規定による被保険者
a member of a mutual aid association based on the National Public Officers mutual aid association Act or the local public employee, etc. mutual aid association Act;
国家公務員共済組合法又は地方公務員等共済組合法に基づく共済組合の組合員
a member of the Private School Teachers mutual aid system under the provisions of the Private School Teachers Mutual Aid Act;
私立学校教職員共済法の規定による私立学校教職員共済制度の加入者
a dependent pursuant to the provisions of the Health Insurance Act, the Mariners Insurance Act, the National Public Officers mutual aid association Act (including as applied mutatis mutandis pursuant to other Acts), or the local public employee, etc. mutual aid association Act; provided, however, that this does not apply to a dependent pursuant to the provisions of the Health Insurance Act of a specially-insured day laborer insured pursuant to the provisions of Article 3, paragraph (2) of the same Act;
健康保険法、船員保険法、国家公務員共済組合法（他の法律において準用する場合を含む。）又は地方公務員等共済組合法の規定による被扶養者。ただし、健康保険法第三条第二項の規定による日雇特例被保険者の同法の規定による被扶養者を除く。
a person whose specially-insured day laborer certificate book received pursuant to the provisions of Article 126 of the Health Insurance Act has not run out of blank space to affix additional health insurance stamps, or such person's dependent pursuant to the provisions of the same Act; provided, however, that this shall not apply to any person for whom a period during which said person shall not be eligible as a specially-insured day laborer pursuant to the provisions of Article 3, paragraph (2) of the same Act is running upon the approval obtained pursuant to the provisions of the proviso of the same paragraph or who has returned such specially-insured day laborer certificate book pursuant to the provisions of Article 126, paragraph (3) of the same Act or such person's dependent pursuant to the provisions of the same Act.
健康保険法第百二十六条の規定により日雇特例被保険者手帳の交付を受け、その手帳に健康保険印紙をはり付けるべき余白がなくなるに至るまでの間にある者及び同法の規定によるその者の被扶養者。ただし、同法第三条第二項ただし書の規定による承認を受けて同項の規定による日雇特例被保険者とならない期間内にある者及び同法第百二十六条第三項の規定により当該日雇特例被保険者手帳を返納した者並びに同法の規定によるその者の被扶養者を除く。
Section 1 Plans to Optimize Medical Expenses
第一節 医療費適正化計画等
第八条（医療費適正化基本方針及び全国医療費適正化計画）
From the perspective of ensuring appropriate medical care for the people in old age, in order to promote the optimization of expenses required for medical care (hereinafter referred to as "optimization of medical expenses") in a comprehensive and systematic manner, the Minister of Health, Labour and Welfare is to establish basic policies concerning measures for the optimization of medical expenses (hereinafter referred to as the "basic policies for the optimization of medical expenses"), and establish a plan for promoting the optimization of medical expenses every six years (hereinafter referred to as the "national plan for the optimization of medical expenses") with six years as one period.
厚生労働大臣は、国民の高齢期における適切な医療の確保を図る観点から、医療に要する費用の適正化（以下「医療費適正化」という。）を総合的かつ計画的に推進するため、医療費適正化に関する施策についての基本的な方針（以下「医療費適正化基本方針」という。）を定めるとともに、六年ごとに、六年を一期として、医療費適正化を推進するための計画（以下「全国医療費適正化計画」という。）を定めるものとする。
The Basic Policy on Regulating Medical Expenses is to provide for the following matters:
医療費適正化基本方針においては、次に掲げる事項を定めるものとする。
the standards to be taken into consideration pertaining to the targets to be specified in the Prefectural Plan for Regulating Medical Expenses as prescribed in paragraph (1) of the following Article and other basic matters to be guidelines in preparing the plan;
次条第一項に規定する都道府県医療費適正化計画において定めるべき目標に係る参酌すべき標準その他の当該計画の作成に当たつて指針となるべき基本的な事項
basic matters concerning the evaluation of the degree of achievement of the prefectural plan for regulating medical expenses prescribed in paragraph (1) of the following Article;
次条第一項に規定する都道府県医療費適正化計画の達成状況の評価に関する基本的な事項
basic particulars concerning investigation and analysis of the expenses required for medical services;
医療に要する費用の調査及び分析に関する基本的な事項
beyond what is set forth in the preceding three items, important matters concerning the promotion of the optimization of medical expenses.
The basic policies for regulating medical expenses must be in harmony with the basic policies prescribed in Article 30-3, paragraph (1) of the Medical Care Act, the basic guidelines prescribed in the Article 116, paragraph (1) of the Long-Term Care Insurance Act (Act No. 123 of 1997), and the basic policies prescribed in Article 7, paragraph (1) of the Health Promotion Act (Act No. 103 of 2002).
医療費適正化基本方針は、医療法第三十条の三第一項に規定する基本方針、介護保険法（平成九年法律第百二十三号）第百十六条第一項に規定する基本指針及び健康増進法（平成十四年法律第百三号）第七条第一項に規定する基本方針と調和が保たれたものでなければならない。
The National Plan for Regulating Medical Expenses is to specify the following matters:
全国医療費適正化計画においては、次に掲げる事項を定めるものとする。
the particulars of the goals that the national government must achieve to advance the optimization of medical expenses in connection with the furtherance of the people's commitment to maintaining their health;
国民の健康の保持の推進に関し、医療費適正化の推進のために国が達成すべき目標に関する事項
with regard to the promotion of the efficient provision of medical care, matters concerning the targets to be achieved by the national government for the promotion of the optimization of medical expenses;
医療の効率的な提供の推進に関し、医療費適正化の推進のために国が達成すべき目標に関する事項
matters concerning measures to be taken by the national government in order to achieve the goals set forth in the preceding two items;
前二号の目標を達成するために国が取り組むべき施策に関する事項
particulars concerning coordination and cooperation among insurers, Association of Medical Care Systems for the Elderly Aged 75 and older, medical institutions, and other relevant persons in order to achieve the goals set forth in items (i) and (ii);
第一号及び第二号の目標を達成するための保険者、後期高齢者医療広域連合、医療機関その他の関係者の連携及び協力に関する事項
in light of the implementation of projects based on the medical care plan (meaning the medical care plan prescribed in Article 30-4, paragraph (1) of the Medical Care Act; the same applies hereinafter) of each prefecture, matters concerning the results of the promotion of the differentiation and coordination of the bed functions (meaning the bed functions prescribed in Article 30-3, paragraph (2), item (vi) of the same Act; the same applies hereinafter) expected during the period of the plan;
各都道府県の医療計画（医療法第三十条の四第一項に規定する医療計画をいう。以下同じ。）に基づく事業の実施を踏まえ、計画の期間において見込まれる病床の機能（同法第三十条の三第二項第六号に規定する病床の機能をいう。以下同じ。）の分化及び連携の推進の成果に関する事項
matters concerning the prospective expenses required for medical care during the period of the plan calculated pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, based on the matters set forth in the preceding item, the expected effects of the optimization of medical expenses through the promotion of the maintenance of citizens' health and the promotion of the efficient provision of medical care to achieve the goals set forth in items (i) and (ii), and other matters specified by Order of the Ministry of Health, Labour and Welfare (referred to as the "national target of expenses required for medical care" in Article 11, paragraph (7));
matters concerning the evaluation of the status of the achievement of the plan;
計画の達成状況の評価に関する事項
beyond what is set forth in the preceding items, matters necessary for promoting the optimization of medical expenses.
In specifying the particulars set forth in items (i) through (iii) of the preceding paragraph, the Minister of Health, Labour and Welfare is to pay attention to the significance of promoting the differentiation and coordination of bed functions, securing the family doctor function prescribed in Article 6-3, paragraph (1) of the Medical Care Act (referred to as the "family doctor function" in paragraph (4) of the following Article), efforts towards the establishment of the community-based integrated care system prescribed in Article 2, paragraph (1) of the Act on Promotion of Comprehensive Securing of Medical and Long-Term Care in Communities (Act No. 64 of 1989) (referred to as the "community-based integrated care system" in paragraph (4) of the following Article), and the effective and efficient provision of medical care and nursing care in light of the physical, mental and social characteristics of the citizens as they age.
厚生労働大臣は、前項第一号から第三号までに掲げる事項を定めるに当たつては、病床の機能の分化及び連携の推進、医療法第六条の三第一項に規定するかかりつけ医機能（次条第四項において「かかりつけ医機能」という。）の確保並びに地域における医療及び介護の総合的な確保の促進に関する法律（平成元年法律第六十四号）第二条第一項に規定する地域包括ケアシステム（次条第四項において「地域包括ケアシステム」という。）の構築に向けた取組並びに国民の加齢に伴う身体的、精神的及び社会的な特性を踏まえた医療及び介護の効果的かつ効率的な提供の重要性に留意するものとする。
The Minister of Health, Labour and Welfare is to consult with the head of a relevant administrative organ in advance, when intending to establish or change the Basic Policies for Regulating Medical Expenses or the National Plan for Regulating Medical Expenses.
厚生労働大臣は、医療費適正化基本方針及び全国医療費適正化計画を定め、又はこれを変更しようとするときは、あらかじめ、関係行政機関の長に協議するものとする。
When the Minister of Health, Labour and Welfare has established or revised the Basic Policies for Ensuring Appropriate Medical Expenses and the National Plan for Ensuring Appropriate Medical Expenses, the Minister is to publicize this without delay.
厚生労働大臣は、医療費適正化基本方針及び全国医療費適正化計画を定め、又はこれを変更したときは、遅滞なく、これを公表するものとする。
The Minister of Health, Labour and Welfare may request necessary cooperation from insurers, Association of Medical Care Systems for the Elderly Aged 75 and older, medical institutions, and other relevant persons, when the Minister finds it necessary for the preparation of the national plan for regulating medical expenses and the implementation of measures based on the national plan for regulating medical expenses.
厚生労働大臣は、全国医療費適正化計画の作成及び全国医療費適正化計画に基づく施策の実施に関して必要があると認めるときは、保険者、後期高齢者医療広域連合、医療機関その他の関係者に対して必要な協力を求めることができる。
Article 9Prefectural Plan for Regulating Medical Expenses
第九条（都道府県医療費適正化計画）
A prefecture is to establish a plan to promote the optimization of medical expenses in the prefecture (hereinafter referred to as the "prefectural plan for the optimization of medical expenses") every six years, with six years as one period, in line with the basic policy for the optimization of medical expenses.
都道府県は、医療費適正化基本方針に即して、六年ごとに、六年を一期として、当該都道府県における医療費適正化を推進するための計画（以下「都道府県医療費適正化計画」という。）を定めるものとする。
The Prefectural Plan for Regulating Medical Expenses is to provide for the following matters:
都道府県医療費適正化計画においては、次に掲げる事項を定めるものとする。
with regard to the promotion of the maintenance of residents' health, matters concerning targets to be achieved for the promotion of the optimization of medical expenses in the prefecture;
住民の健康の保持の推進に関し、当該都道府県における医療費適正化の推進のために達成すべき目標に関する事項
with regard to the promotion of the efficient provision of medical care, matters concerning targets to be achieved for the promotion of the optimization of medical expenses in the relevant prefecture;
医療の効率的な提供の推進に関し、当該都道府県における医療費適正化の推進のために達成すべき目標に関する事項
particulars concerning the results of the promotion of the differentiation and coordination of the bed functions expected during the period of the plan, based on the implementation of the project under the medical care plan of the relevant prefecture;
当該都道府県の医療計画に基づく事業の実施を踏まえ、計画の期間において見込まれる病床の機能の分化及び連携の推進の成果に関する事項
matters concerning the prospective expenses required for medical care during the plan period calculated pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, based on the matters set forth in the preceding item and the effects of the optimization of medical expenses that are expected to be achieved by promoting the maintenance of residents' health and promoting the efficient provision of medical care in order to achieve the goals set forth in item (i) and item (ii) (referred to as the "prefectural target for expenses required for medical care" in Article 11, paragraph (4)).
In addition to the matters prescribed in the preceding paragraph, a prefectural plan for regulating medical expenses is to, in general, provide for the following matters concerning the prefecture:
都道府県医療費適正化計画においては、前項に規定する事項のほか、おおむね都道府県における次に掲げる事項について定めるものとする。
matters concerning measures to be taken by the prefecture in order to achieve the goals set forth in items (i) and (ii) of the preceding paragraph;
particulars concerning coordination and cooperation among insurers, Association of Medical Care Systems for the Elderly Aged 75 and older, medical institutions, and other relevant persons in order to achieve the goals set forth in items (i) and (ii) of the preceding paragraph;
前項第一号及び第二号の目標を達成するための保険者、後期高齢者医療広域連合、医療機関その他の関係者の連携及び協力に関する事項
particulars concerning the investigation and analysis of the expenses required for medical services in the prefecture;
当該都道府県における医療に要する費用の調査及び分析に関する事項
matters concerning the evaluation of the status of the achievement of the plan.
計画の達成状況の評価に関する事項
In specifying the particulars set forth in paragraph (2), items (i) and (ii) and item (i) of the preceding paragraph, the prefecture is to pay attention to the importance of promoting the differentiation and coordination of the bed functions in the region, securing the family doctor function, efforts towards the construction of a community-based integrated care system, and the effective and efficient provision of medical care and nursing care in light of the physical, mental and social characteristics of residents as they age.
A prefecture, in providing for the particulars set forth in paragraph (3), item (iii), is to take into consideration the expenses required for medical services in a prefecture other than the relevant prefecture and other particulars specified by Order of the Ministry of Health, Labour and Welfare.
都道府県は、第三項第三号に掲げる事項を定めるに当たつては、当該都道府県以外の都道府県における医療に要する費用その他厚生労働省令で定める事項を踏まえるものとする。
A prefectural plan for regulating medical expenses must be in harmony with the medical care plan, the prefectural insured long-term care services plan as prescribed in Article 118, paragraph (1), Long-Term Care Insurance Act, and the prefectural health promotion plan as prescribed in Article 8, paragraph (1) of the Health Promotion Act.
都道府県医療費適正化計画は、医療計画、介護保険法第百十八条第一項に規定する都道府県介護保険事業支援計画及び健康増進法第八条第一項に規定する都道府県健康増進計画と調和が保たれたものでなければならない。
When a prefecture intends to establish or change a prefectural plan for the optimization of medical expenses, it must consult in advance with the relevant municipalities and the Council of Insurers under Article 157-2, paragraph (1) (referred to as the "Council of Insurers" in paragraph (10) and Article 12, paragraph (1)).
都道府県は、都道府県医療費適正化計画を定め、又はこれを変更しようとするときは、あらかじめ、関係市町村及び第百五十七条の二第一項の保険者協議会（第十項及び第十二条第一項において「保険者協議会」という。）に協議しなければならない。
When a prefecture has formulated or revised its prefectural plan for regulating medical expenses, it is to endeavor to publicize the plan and submit it to the Minister of Health, Labour and Welfare without delay.
都道府県は、都道府県医療費適正化計画を定め、又はこれを変更したときは、遅滞なく、これを公表するよう努めるとともに、厚生労働大臣に提出するものとする。
A prefecture may request necessary cooperation from Insurers, Association of Medical Care Systems for the Elderly Aged 75 and older, medical institutions, and other relevant persons when it finds it necessary for the preparation of a Prefectural Plan for Regulating Medical Expenses and the implementation of measures based on the Prefectural Plan for Regulating Medical Expenses.
都道府県は、都道府県医療費適正化計画の作成及び都道府県医療費適正化計画に基づく施策の実施に関して必要があると認めるときは、保険者、後期高齢者医療広域連合、医療機関その他の関係者に対して必要な協力を求めることができる。
If a prefecture requests necessary cooperation from insurers or Association of Medical Care Systems for the Elderly Aged 75 and older pursuant to the provisions of the preceding paragraph, the prefecture may request the cooperation through the council of insurers.
都道府県が、前項の規定により保険者又は後期高齢者医療広域連合に対して必要な協力を求める場合においては、保険者協議会を通じて協力を求めることができる。
The Minister of Health, Labour and Welfare may provide a prefecture with necessary advice on methods for formulating a prefectural plan for optimization of medical expenses and other important technical matters for formulating a prefectural plan for optimization of medical expenses.
厚生労働大臣は、都道府県に対し、都道府県医療費適正化計画の作成の手法その他都道府県医療費適正化計画の作成上重要な技術的事項について必要な助言をすることができる。
Article 11Publication of the Progress of Plans
第十一条（計画の進捗状況の公表等）
A prefecture is to endeavor to publicize the state of progress of the prefectural plan for regulating medical expenses in each fiscal year (meaning the period from April 1 of each year to March 31 of the following year; the same applies hereinafter) (excluding the fiscal year in which the results under the following paragraph were publicized and the evaluation set forth in paragraph (1) of the following Article was conducted) pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare.
都道府県は、厚生労働省令で定めるところにより、年度（毎年四月一日から翌年三月三十一日までをいう。以下同じ。）（次項の規定による結果の公表及び次条第一項の評価を行つた年度を除く。）ごとに、都道府県医療費適正化計画の進捗状況を公表するよう努めるものとする。
In order to contribute to the preparation of the Prefectural Plan for Regulating Medical Expenses in the next term, the prefecture is to endeavor to publicize the results of surveys and analyses on the state of progress of the Prefectural Plan for Regulating Medical Expenses during the plan period (hereinafter referred to as the "Plan Period" in this paragraph and paragraph (4)) in the fiscal year that includes the end date of the Prefectural Plan for Regulating Medical Expenses, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare.
都道府県は、次期の都道府県医療費適正化計画の作成に資するため、厚生労働省令で定めるところにより、都道府県医療費適正化計画の期間（以下この項及び第四項において「計画期間」という。）の終了の日の属する年度において、当該計画期間における当該都道府県医療費適正化計画の進捗状況に関する調査及び分析の結果を公表するよう努めるものとする。
In order to contribute to the preparation of the Basic Policies for Regulating Medical Expenses, when a prefecture has conducted the investigation and analysis set forth in the preceding paragraph, it is to endeavor to report the results to the Minister of Health, Labour and Welfare pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare.
都道府県は、医療費適正化基本方針の作成に資するため、前項の調査及び分析を行つたときは、厚生労働省令で定めるところにより、その結果を厚生労働大臣に報告するよう努めるものとする。
If a prefecture finds that the goals set forth in Article 9, paragraph (2), items (i) and (ii) cannot be achieved during the plan period, or that the expenses required for medical care in the prefecture significantly exceed the target expenses required for medical care by the prefecture, the prefecture is to analyze the causes of this, and endeavor to take necessary measures in cooperation with insurers, Association of Medical Care Systems for the Elderly Aged 75 and older, medical institutions, and other relevant persons to eliminate the causes.
都道府県は、計画期間において、第九条第二項第一号及び第二号の目標を達成できないと認める場合又は当該都道府県における医療に要する費用が都道府県の医療に要する費用の目標を著しく上回ると認める場合には、その要因を分析するとともに、当該要因の解消に向けて、保険者、後期高齢者医療広域連合、医療機関その他の関係者と協力して必要な対策を講ずるよう努めるものとする。
The Minister of Health, Labour and Welfare is to publicize the status of progress of the national plan for regulating medical expenses in each fiscal year (excluding the fiscal year in which the results under the following paragraph were publicized and the evaluation referred to in paragraph (3) of the following Article was conducted) pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare.
厚生労働大臣は、厚生労働省令で定めるところにより、年度（次項の規定による結果の公表及び次条第三項の評価を行つた年度を除く。）ごとに、全国医療費適正化計画の進捗状況を公表するものとする。
In order to contribute to the preparation of the national medical expense optimization plan for the next term, the Minister of Health, Labour and Welfare is to publicize the results of the investigation and analysis of the state of progress of the national medical expense optimization plan during the plan period (hereinafter referred to as the "plan period" in this paragraph and the following paragraph) in the fiscal year that includes the end date of the plan period, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare.
厚生労働大臣は、次期の全国医療費適正化計画の作成に資するため、厚生労働省令で定めるところにより、全国医療費適正化計画の期間（以下この項及び次項において「計画期間」という。）の終了の日の属する年度において、当該計画期間における当該全国医療費適正化計画の進捗状況に関する調査及び分析の結果を公表するものとする。
If the Minister of Health, Labour and Welfare finds that the goals set forth in Article 8, paragraph (4), items (i) and (ii) cannot be achieved during the plan period, or that the expenses required for medical care by the national government significantly exceed the target expenses required for medical care by the national government, the Minister is to analyze the causes of this, and take necessary measures to resolve the causes in cooperation with insurers, Association of Medical Care Systems for the Elderly Aged 75 and older, medical institutions, and other relevant parties.
厚生労働大臣は、計画期間において、第八条第四項第一号及び第二号の目標を達成できないと認める場合又は国における医療に要する費用が国の医療に要する費用の目標を著しく上回ると認める場合には、その要因を分析するとともに、当該要因の解消に向けて、保険者、後期高齢者医療広域連合、医療機関その他の関係者と協力して必要な対策を講ずるものとする。
Article 12Evaluation of Plan Performance
第十二条（計画の実績に関する評価）
A prefecture, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, in the fiscal year following the fiscal year that includes the last day of the period of the Prefectural Plan for Regulating Medical Expenses, is to investigate and analyze the status of achievement of the objectives of the plan and the status of implementation of measures, hear the opinions of the Council of Insurers, and evaluate the performance of the plan.
都道府県は、厚生労働省令で定めるところにより、都道府県医療費適正化計画の期間の終了の日の属する年度の翌年度において、当該計画の目標の達成状況及び施策の実施状況の調査及び分析を行い、保険者協議会の意見を聴いて、当該計画の実績に関する評価を行うものとする。
When the prefectural government has conducted the evaluation referred to in the preceding paragraph, the prefectural government is to endeavor to make the results public and report them to the Minister of Health, Labour and Welfare pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare.
都道府県は、前項の評価を行つたときは、厚生労働省令で定めるところにより、その結果を公表するよう努めるとともに、厚生労働大臣に報告するものとする。
In the fiscal year following the fiscal year that includes the last day of the period of the National Plan for Regulating Medical Expenses, the Minister of Health, Labour and Welfare is to investigate and analyze the status of the achievement of the objectives of the plan and the status of the implementation of measures, and evaluate the results of the plan, as well as evaluate the results of the Prefectural Plan for Regulating Medical Expenses in each prefecture by hearing the opinions of the prefectures concerned based on the report set forth in the preceding paragraph, as specified by Order of the Ministry of Health, Labour and Welfare.
厚生労働大臣は、厚生労働省令で定めるところにより、全国医療費適正化計画の期間の終了の日の属する年度の翌年度において、当該計画の目標の達成状況及び施策の実施状況の調査及び分析を行い、当該計画の実績に関する評価を行うとともに、前項の報告を踏まえ、関係都道府県の意見を聴いて、各都道府県における都道府県医療費適正化計画の実績に関する評価を行うものとする。
When the Minister of Health, Labour and Welfare conducts the evaluation referred to in the preceding paragraph, the Minister is to publicize the results of the evaluation.
厚生労働大臣は、前項の評価を行つたときは、その結果を公表するものとする。
Article 13Submission of Opinions on Medical Fees
第十三条（診療報酬に係る意見の提出等）
If a prefecture finds it necessary for achieving the goals set forth in Article 9, paragraph (2), item (ii) as a result of the evaluation referred to in paragraph (1) of the preceding Article, the prefecture may submit to the Minister of Health, Labour and Welfare its opinions on the provisions under Article 76, paragraph (2) of the Health Insurance Act, the provisions under Article 88, paragraph (4) of the same Act, the standards for calculating the amount of expenses required for benefits for medical treatment provided in Article 71, paragraph (1), and the standards specified by the Minister of Health, Labour and Welfare provided in Article 78, paragraph (4) (referred to as "medical fees" in the following paragraph and paragraph (1) of the following Article).
都道府県は、前条第一項の評価の結果、第九条第二項第二号の目標の達成のために必要があると認めるときは、厚生労働大臣に対し、健康保険法第七十六条第二項の規定による定め及び同法第八十八条第四項の規定による定め並びに第七十一条第一項に規定する療養の給付に要する費用の額の算定に関する基準及び第七十八条第四項に規定する厚生労働大臣が定める基準（次項及び次条第一項において「診療報酬」という。）に関する意見を提出することができる。
When the prefectural government submits its opinions pursuant to the provisions of the preceding paragraph, the Minister of Health, Labour and Welfare must endeavor to determine the medical fees in consideration of the opinions.
Article 14Special Provisions for Medical Fees
第十四条（診療報酬の特例）
If, as a result of the evaluation referred to in Article 12, paragraph (3), the Minister of Health, Labour and Welfare finds it necessary for achieving the goals set forth in Article 8, paragraph (4), item (ii) and in Article 9, paragraph (2), item (ii) in each prefecture and for promoting the optimization of medical expenses, the Minister may specify medical fees in the areas of one prefecture that are different from those in the areas of other prefectures, within a scope that is found to be reasonable from the viewpoint of providing appropriate medical care fairly among the prefectures, while taking into account the actual conditions of the area.
In establishing the provisions of the preceding paragraph, the Minister of Health, Labour and Welfare is to consult with the relevant prefectural governors in advance.
厚生労働大臣は、前項の定めをするに当たつては、あらかじめ、関係都道府県知事に協議するものとする。
Article 15Cooperation and Advice on the Submission of Materials
第十五条（資料提出の協力及び助言等）
If the Minister of Health, Labour and Welfare or the prefectural governor finds it necessary to make public the status of progress referred to in Article 11, paragraph (1) or (5) or the results referred to in paragraph (2) or (6) of the same Article, or to make the evaluation referred to in Article 12, paragraph (1) or (3), the Minister or the governor may request cooperation from insurers, Association of Medical Care Systems for the Elderly Aged 75 and older, medical institutions, and other relevant persons for the submission of necessary materials.
The Minister of Health, Labour and Welfare and the prefectural governor may provide necessary advice or assistance to insurers, Association of Medical Care Systems for the Elderly Aged 75 and older, or medical institutions based on the progress made public pursuant to the provisions of Article 11, paragraph (1) or paragraph (5), the results referred to in paragraph (2) or paragraph (6) of the same Article, or the results of the evaluation referred to in Article 12, paragraph (1) or paragraph (3).
Article 16Investigation and Analysis for the Preparation of Plans for Regulating Medical Expenses
第十六条（医療費適正化計画の作成等のための調査及び分析等）
The Minister of Health, Labour and Welfare is to investigate and analyze data concerning the following particulars (hereinafter referred to as "medical insurance-related data"), and publicize the results thereof, for the purpose of contributing to the preparation, implementation, and evaluation of the national plan for regulating medical expenses and the prefectural plan for regulating medical expenses:
厚生労働大臣は、全国医療費適正化計画及び都道府県医療費適正化計画の作成、実施及び評価に資するため、次に掲げる事項に関する情報（以下「医療保険等関連情報」という。）について調査及び分析を行い、その結果を公表するものとする。
the status of expenses required for medical care by area, age group, or disease, and other particulars specified by Order of the Ministry of Health, Labour and Welfare;
医療に要する費用に関する地域別、年齢別又は疾病別の状況その他の厚生労働省令で定める事項
the status of changes in the number of beds concerning the provision of medical care by area and other particulars specified by the Order of the Ministry of Health, Labour and Welfare.
医療の提供に関する地域別の病床数の推移の状況その他の厚生労働省令で定める事項
Insurers and Associations of Medical Care Systems for the Elderly Aged 75 and older must provide the Minister of Health, Labour and Welfare with medical insurance-related information by the method specified by Order of the Ministry of Health, Labour and Welfare.
保険者及び後期高齢者医療広域連合は、厚生労働大臣に対し、医療保険等関連情報を、厚生労働省令で定める方法により提供しなければならない。
The Minister of Health, Labour and Welfare, when finding it necessary, may request a prefecture, municipality, or any other person specified by Order of the Ministry of Health, Labour and Welfare to provide medical insurance-related information by a method specified by Order of the Ministry of Health, Labour and Welfare.
厚生労働大臣は、必要があると認めるときは、都道府県、市町村その他厚生労働省令で定める者に対し、医療保険等関連情報を、厚生労働省令で定める方法により提供するよう求めることができる。
Article 16-2Use or Provision of Anonymized Medical Data to Improve People's Health
第十六条の二（国民保健の向上のための匿名医療保険等関連情報の利用又は提供）
The Minister of Health, Labour and Welfare may, in order to contribute to the improvement of national health, use anonymized medical data (meaning medical insurance-related information processed in accordance with the standards specified by Order of the Ministry of Health, Labour and Welfare so as to make it impossible to identify a specific insured or other person specified by Order of the Ministry of Health, Labour and Welfare pertaining to the medical insurance-related information (referred to as "the person themselves" in the following Article) and to restore the medical insurance-related information used to prepare it; the same applies hereinafter), or may provide it, as specified by Order of the Ministry of Health, Labour and Welfare, to a person listed in the following items who conducts the business specified respectively in those items as business found to have considerable public interest in being conducted upon receiving the provision of anonymized medical data.
other national administrative organs and local governments:surveys concerning the planning and drafting of policies that contribute to the provision of appropriate health and medical services;
国の他の行政機関及び地方公共団体 適正な保健医療サービスの提供に資する施策の企画及び立案に関する調査
universities and other research institutes:research on the causes of diseases and methods of prevention, diagnosis, and treatment of diseases, and other research on the improvement and promotion of public health;
大学その他の研究機関 疾病の原因並びに疾病の予防、診断及び治療の方法に関する研究その他の公衆衛生の向上及び増進に関する研究
private business operators and other persons specified by Order of the Ministry of Health, Labour and Welfare:analyses that contribute to research and development in the medical field and other services specified by Order of the Ministry of Health, Labour and Welfare (excluding those carried out for the purpose of using them in the advertisement or promotion of specific goods or services).
民間事業者その他の厚生労働省令で定める者 医療分野の研究開発に資する分析その他の厚生労働省令で定める業務（特定の商品又は役務の広告又は宣伝に利用するために行うものを除く。）
The Minister of Health, Labour and Welfare, when using or providing information pursuant to the provisions of the preceding paragraph, may use the anonymized medical data, etc. in a way that links it to anonymized medical data, etc. provided for in Article 150-2, paragraph (1) of the Health Insurance Act, anonymized long-term care insurance data, etc. provided for in Article 118-3, paragraph (1), Long-Term Care Insurance Act, and other data specified by Order of the Ministry of Health, Labour and Welfare, or provide the anonymized medical data, etc. in a way that allows it to be used in a way that links it to other data.
厚生労働大臣は、前項の規定による利用又は提供を行う場合には、当該匿名医療保険等関連情報を健康保険法第百五十条の二第一項に規定する匿名診療等関連情報及び介護保険法第百十八条の三第一項に規定する匿名介護保険等関連情報その他の厚生労働省令で定めるものと連結して利用し、又は連結して利用することができる状態で提供することができる。
If the Minister of Health, Labour and Welfare intends to provide anonymized medical data pursuant to the provisions of paragraph (1), the Minister must hear the opinion of the Social Security Council in advance.
厚生労働大臣は、第一項の規定により匿名医療保険等関連情報を提供しようとする場合には、あらかじめ、社会保障審議会の意見を聴かなければならない。
Article 16-3Prohibition of Collation
第十六条の三（照合等の禁止）
A person who receives and uses anonymized medical data, etc. pursuant to the provisions of paragraph (1) of the preceding Article (hereinafter referred to as a "user of anonymized medical data, etc. related information"), in handling the anonymized medical data, etc. related information, in order to identify the principal pertaining to the medical insurance related information used to prepare the anonymized medical data, etc. related information, must not obtain information on descriptions, etc. (meaning any and all matters stated or recorded in a document, drawing, or electronic or magnetic record (meaning a record made in an electronic or magnetic form (meaning an electronic form, a magnetic form, or any other form that cannot be recognized by human perception)), or expressed by using sound, motion, or any other method) deleted from the medical insurance related information or information on the processing method used to prepare the anonymized medical data, etc. related information, or cross-check the anonymized medical data, etc. related information with other information.
前条第一項の規定により匿名医療保険等関連情報の提供を受け、これを利用する者（以下「匿名医療保険等関連情報利用者」という。）は、匿名医療保険等関連情報を取り扱うに当たつては、当該匿名医療保険等関連情報の作成に用いられた医療保険等関連情報に係る本人を識別するために、当該医療保険等関連情報から削除された記述等（文書、図画若しくは電磁的記録（電磁的方式（電子的方式、磁気的方式その他人の知覚によつては認識することができない方式をいう。）で作られる記録をいう。）に記載され、若しくは記録され、又は音声、動作その他の方法を用いて表された一切の事項をいう。）若しくは匿名医療保険等関連情報の作成に用いられた加工の方法に関する情報を取得し、又は当該匿名医療保険等関連情報を他の情報と照合してはならない。
第十六条の四（消去）
When a user of anonymized medical data, etc. no longer needs to use the provided anonymized medical data, etc., the user must delete the anonymized medical data, etc. without delay.
匿名医療保険等関連情報利用者は、提供を受けた匿名医療保険等関連情報を利用する必要がなくなつたときは、遅滞なく、当該匿名医療保険等関連情報を消去しなければならない。
Article 16-5Safety Management Measures
第十六条の五（安全管理措置）
Users of anonymized medical data must take measures specified by Order of the Ministry of Health, Labour and Welfare as necessary and appropriate for the security control of the anonymized medical data, such as the prevention of leakage, loss, or damage to the anonymized medical data.
匿名医療保険等関連情報利用者は、匿名医療保険等関連情報の漏えい、滅失又は毀損の防止その他の当該匿名医療保険等関連情報の安全管理のために必要かつ適切なものとして厚生労働省令で定める措置を講じなければならない。
Article 16-6Obligations of Users
第十六条の六（利用者の義務）
A person who is or was a user of anonymized medical data related to medical insurance, etc. must not disclose the anonymized medical data related to medical insurance, etc. acquired in relation to the use of the anonymized medical data related to medical insurance, etc. to other persons without justifiable grounds or use the anonymized medical data related to medical insurance, etc. for an unjust purpose.
匿名医療保険等関連情報利用者又は匿名医療保険等関連情報利用者であつた者は、匿名医療保険等関連情報の利用に関して知り得た匿名医療保険等関連情報の内容をみだりに他人に知らせ、又は不当な目的に利用してはならない。
Article 16-7On-Site Inspections
第十六条の七（立入検査等）
To the extent necessary for the enforcement of the provisions of this Section, the Minister of Health, Labour and Welfare may order users of anonymized medical data (excluding other administrative organs of the national government; hereinafter the same applies in this paragraph and the following Article) to make a report or submit or present books and documents, or have the relevant officials question the relevant persons or enter the offices or other places of business of the users of anonymized medical data to inspect the books, documents, and any other articles of the users of anonymized medical data.
厚生労働大臣は、この節の規定の施行に必要な限度において、匿名医療保険等関連情報利用者（国の他の行政機関を除く。以下この項及び次条において同じ。）に対し報告若しくは帳簿書類の提出若しくは提示を命じ、又は当該職員に関係者に対して質問させ、若しくは匿名医療保険等関連情報利用者の事務所その他の事業所に立ち入り、匿名医療保険等関連情報利用者の帳簿書類その他の物件を検査させることができる。
When carrying out questioning or on-site inspections under the provisions of the preceding paragraph, the relevant officials must carry an identification card and present it when requested by any person concerned.
前項の規定による質問又は立入検査を行う場合においては、当該職員は、その身分を示す証明書を携帯し、かつ、関係人の請求があるときは、これを提示しなければならない。
The authority under the provisions of paragraph (1) must not be construed as being granted for the purpose of criminal investigation.
第一項の規定による権限は、犯罪捜査のために認められたものと解釈してはならない。
Article 16-8Rectification Order
第十六条の八（是正命令）
When the Minister of Health, Labour and Welfare finds that a user of anonymized medical data is in violation of any of the provisions of Articles 16-3 through 16-6, the Minister of Health, Labour and Welfare may order the person to take necessary measures to rectify the violation.
厚生労働大臣は、匿名医療保険等関連情報利用者が第十六条の三から第十六条の六までの規定に違反していると認めるときは、その者に対し、当該違反を是正するため必要な措置をとるべきことを命ずることができる。
Article 17Entrustment to the Organization, etc.
第十七条（機構等への委託）
The Minister of Health, Labour and Welfare may entrust the investigation and analysis prescribed in Article 16, paragraph (1) and the affairs pertaining to the use or provision under Article 16-2, paragraph (1), in whole or in part, to the Medical Information Infrastructure and Medical Fee Examination and Payment Organization under the Medical Information Infrastructure and Medical Fee Examination and Payment Organization Act (Act No. 129 of 1948) (hereinafter referred to as the "Organization"), the Federation of National Health Insurance Associations prescribed in Article 45, paragraph (5) of the National Health Insurance Act (hereinafter referred to as the "NHI federation"), or other persons specified by Order of the Ministry of Health, Labour and Welfare (referred to as the "Organization, etc." in the following Article).
厚生労働大臣は、第十六条第一項に規定する調査及び分析並びに第十六条の二第一項の規定による利用又は提供に係る事務の全部又は一部を医療情報基盤・診療報酬審査支払機構法（昭和二十三年法律第百二十九号）による医療情報基盤・診療報酬審査支払機構（以下「機構」という。）又は国民健康保険法第四十五条第五項に規定する国民健康保険団体連合会（以下「国保連合会」という。）その他厚生労働省令で定める者（次条において「機構等」という。）に委託することができる。
第十七条の二（手数料）
Users of anonymized medical data must pay a fee in the amount specified by Cabinet Order in consideration of the actual costs to the national government (when the Organization, etc. conducts all of the affairs related to the provision of anonymized medical data under Article 16-2, paragraph (1) upon entrustment from the Minister of Health, Labour and Welfare pursuant to the provisions of the preceding Article, the Organization, etc.).
匿名医療保険等関連情報利用者は、実費を勘案して政令で定める額の手数料を国（前条の規定により厚生労働大臣からの委託を受けて、機構等が第十六条の二第一項の規定による匿名医療保険等関連情報の提供に係る事務の全部を行う場合にあつては、機構等）に納めなければならない。
If a person who intends to pay the fee set forth in the preceding paragraph is a prefecture or any other person specified by Cabinet Order as a person who plays particularly important roles in improving the health of the people, the Minister of Health, Labour and Welfare may grant the person a reduction of or exemption from the fee pursuant to the provisions of Cabinet Order.
厚生労働大臣は、前項の手数料を納めようとする者が都道府県その他の国民保健の向上のために特に重要な役割を果たす者として政令で定める者であるときは、政令で定めるところにより、当該手数料を減額し、又は免除することができる。
A fee paid to the Organization, etc. pursuant to the provisions of paragraph (1) is to be the revenue of the Organization, etc.
Section 2 Basic Guidelines for Special health examinations
第二節 特定健康診査等基本指針等
Article 18Basic Guidelines for Special health examinations
第十八条（特定健康診査等基本指針）
The Minister of Health, Labour and Welfare is to establish basic guidelines for the appropriate and effective implementation of Special health examinations (meaning health checkups for diabetes and other lifestyle diseases specified by Cabinet Order; the same applies hereinafter) and specified health guidance (meaning health guidance given to a person specified by Order of the Ministry of Health, Labour and Welfare as one who needs to endeavor to maintain their health based on the results of a Special health examinations by a person specified by Order of the Ministry of Health, Labour and Welfare as one who has expert knowledge and skills concerning health guidance; the same applies hereinafter) (hereinafter referred to as the "basic guidelines for Special health examinations, etc.").
厚生労働大臣は、特定健康診査（糖尿病その他の政令で定める生活習慣病に関する健康診査をいう。以下同じ。）及び特定保健指導（特定健康診査の結果により健康の保持に努める必要がある者として厚生労働省令で定めるものに対し、保健指導に関する専門的知識及び技術を有する者として厚生労働省令で定めるものが行う保健指導をいう。以下同じ。）の適切かつ有効な実施を図るための基本的な指針（以下「特定健康診査等基本指針」という。）を定めるものとする。
The Basic Guidelines on Special health examinations, etc. are to provide for the following matters:
特定健康診査等基本指針においては、次に掲げる事項を定めるものとする。
basic matters concerning the implementation method of Special health examinations and specified health guidance (hereinafter referred to as "Special health examinations, etc.");
basic matters concerning the goals pertaining to the implementation of a Special health examinations, etc. and the results thereof;
特定健康診査等の実施及びその成果に係る目標に関する基本的な事項
beyond what is set forth in the preceding two items, important matters concerning the preparation of a Special health examinations plan provided in paragraph (1) of the following Article.
前二号に掲げるもののほか、次条第一項に規定する特定健康診査等実施計画の作成に関する重要事項
The Basic Guidelines on Special health examinations, etc. must be harmonized with the Guidelines on Health Checkups, etc. provided for in Article 9, paragraph (1) of the Health Promotion Act.
特定健康診査等基本指針は、健康増進法第九条第一項に規定する健康診査等指針と調和が保たれたものでなければならない。
When the Minister of Health, Labour and Welfare intends to establish or change the basic guidelines for Special health examinations, etc., the Minister is to consult with the head of the relevant administrative organ in advance.
厚生労働大臣は、特定健康診査等基本指針を定め、又はこれを変更しようとするときは、あらかじめ、関係行政機関の長に協議するものとする。
When the Minister of Health, Labour and Welfare has established or changed the basic guidelines for Special health examinations, etc., the Minister is to publicize the established or changed guidelines without delay.
厚生労働大臣は、特定健康診査等基本指針を定め、又はこれを変更したときは、遅滞なく、これを公表するものとする。
Article 19Special health examinations Implementation Plan
第十九条（特定健康診査等実施計画）
In line with the Basic Guidelines for Special health examinations, etc., Insurers (or Municipalities, in the case of National Health Insurance provided by a prefecture together with the Municipalities within the relevant prefecture pursuant to the provisions of the National Health Insurance Act (hereinafter referred to as "National Health Insurance"); the same applies hereinafter in this Section and in Article 125-3, paragraphs (1) and (4)) are to establish a plan for the implementation of Special health examinations, etc. (hereinafter referred to as the "Implementation Plan for Special health examinations, etc.") every six years, with six years as one period.
保険者（国民健康保険法の定めるところにより都道府県が当該都道府県内の市町村とともに行う国民健康保険（以下「国民健康保険」という。）にあつては、市町村。以下この節並びに第百二十五条の三第一項及び第四項において同じ。）は、特定健康診査等基本指針に即して、六年ごとに、六年を一期として、特定健康診査等の実施に関する計画（以下「特定健康診査等実施計画」という。）を定めるものとする。
The Special health examinations plan is to specify the following matters:
特定健康診査等実施計画においては、次に掲げる事項を定めるものとする。
matters concerning the specific implementation method of the Special health examinations, etc.;
特定健康診査等の具体的な実施方法に関する事項
specific goals related to the implementation and outcomes of the Special health examinations, etc.;
特定健康診査等の実施及びその成果に関する具体的な目標
beyond what is set forth in the preceding two items, matters necessary for the appropriate and effective implementation of Special health examinations, etc.
When providing or changing the Special health examinations implementation plan, insurers must make it public without delay.
保険者は、特定健康診査等実施計画を定め、又はこれを変更したときは、遅滞なく、これを公表しなければならない。
Article 20Special health examinations
第二十条（特定健康診査）
Insurers are to provide special health examinations to participants who are 40 years of age or older, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, based on the Implementation Plan for Special health examinations, etc.; provided, however, that this does not apply when a participant has undergone an examination equivalent to a special health examination and has been provided with a copy of the record of the results pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, or when a record concerning special health examinations has been sent pursuant to the provisions of Article 26, paragraph (2).
保険者は、特定健康診査等実施計画に基づき、厚生労働省令で定めるところにより、四十歳以上の加入者に対し、特定健康診査を行うものとする。ただし、加入者が特定健康診査に相当する診査を受け、厚生労働省令で定めるところによりその結果の記録の写しの提供を受けたとき、又は第二十六条第二項の規定により特定健康診査に関する記録の送付を受けたときは、この限りでない。
Article 21Relationship with Medical Examinations Based on Other Laws and Regulations
第二十一条（他の法令に基づく健康診断との関係）
If a participant has undergone, or is able to undergo, a medical examination equivalent to a special health examination conducted under the Industrial Safety and Health Act (Act No. 57 of 1972) or other laws and regulations, the Insurer is deemed to have conducted all or part of the special health examination under the preceding Article, as specified by Order of the Ministry of Health, Labour and Welfare.
保険者は、加入者が、労働安全衛生法（昭和四十七年法律第五十七号）その他の法令に基づき行われる特定健康診査に相当する健康診断を受けた場合又は受けることができる場合は、厚生労働省令で定めるところにより、前条の特定健康診査の全部又は一部を行つたものとする。
An employer prescribed in Article 2, item (iii) of the Industrial Safety and Health Act or any other person responsible for conducting medical examinations equivalent to Special health examinations pursuant to laws and orders (hereinafter referred to as an "employer, etc.") may entrust the implementation of the medical examinations to insurers. In this case, the employer, etc. that intends to entrust the implementation of the medical examinations must pay the necessary expenses to the insurers.
労働安全衛生法第二条第三号に規定する事業者その他の法令に基づき特定健康診査に相当する健康診断を実施する責務を有する者（以下「事業者等」という。）は、当該健康診断の実施を保険者に対し委託することができる。この場合において、委託をしようとする事業者等は、その健康診断の実施に必要な費用を保険者に支払わなければならない。
Article 22Preservation of Records Concerning Special health examinations
第二十二条（特定健康診査に関する記録の保存）
When Insurers have conducted special health examinations pursuant to the provisions of Article 20, they must preserve the records concerning the special health examinations pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare. The same applies when they have been provided with a copy of the record of the results of an examination equivalent to a special health examination, or sent the records concerning special health examinations, pursuant to the provisions of the proviso to the same Article, or when they have been provided with a copy of the records concerning special health examinations, the health checkup prescribed in Article 125, paragraph (1) or medical checkups pursuant to the provisions of Article 27, paragraph (4).
Article 23Notice of Special health examinations Results
第二十三条（特定健康診査の結果の通知）
Insurers, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, must notify a member who has undergone a Special health examinations of the results of the Special health examinations. The same applies where records concerning the Special health examinations have been sent pursuant to the provisions of Article 26, paragraph (2).
Article 24Specific Health Guidance
第二十四条（特定保健指導）
Insurers are to provide specified health guidance pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare based on the implementation plan for Special health examinations, etc.
保険者は、特定健康診査等実施計画に基づき、厚生労働省令で定めるところにより、特定保健指導を行うものとする。
Article 25Preservation of Records Concerning Specific Health Guidance
第二十五条（特定保健指導に関する記録の保存）
When providing specified health guidance pursuant to the provisions of the preceding Article, Insurers must maintain records concerning the specified health guidance pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare. The same applies when receiving records concerning specified health guidance pursuant to the provisions of paragraph (2) of the following Article or when receiving a copy of records concerning specified health guidance or health guidance provided by Article 125, paragraph (1) pursuant to the provisions of Article 27, paragraph (4).
Article 26Special health examinations for Subscribers of Other Insurers
第二十六条（他の保険者の加入者への特定健康診査等）
An Insurer may, if it does not hinder the implementation of Special health examinations, etc. for its Subscribers, provide Special health examinations or Specific Health Guidance pertaining to the Subscribers of other Insurers. In this case, the Insurer may, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, claim the expenses required for the Special health examinations or Specific Health Guidance from the person who received the Special health examinations or Specific Health Guidance.
If an Insurer provides Special health examinations or Specific Health Guidance to a member of another Insurer pursuant to the provisions of the preceding paragraph, it must promptly send the records concerning the Special health examinations or Specific Health Guidance to the other Insurer which the member is currently enrolled in, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare.
If a member of an Insurer receives Special health examinations or Specific Health Guidance provided by another Insurer pursuant to the provisions of paragraph (1) and pays the expenses thereof to the other Insurer, the Insurer pays a reasonable amount of money to the member as expenses required for the Special health examinations or Specific Health Guidance pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare.
Notwithstanding the provisions of paragraph (1) and the preceding paragraph, an Insurer may, upon consultation with other Insurers, specify otherwise with regard to the treatment of claims and payments of expenses for Special health examinations or Specific Health Guidance pertaining to the Subscribers of the other Insurers.
Article 27Provision of Records Concerning Special health examinations
第二十七条（特定健康診査等に関する記録の提供）
For the purpose of ensuring the appropriate and effective implementation of Special health examinations, etc., when there is a person who has acquired the status of a Participant (in the case of national health insurance, including an insured whose address has been changed from the area of another Municipality within the same prefecture; the same applies in the following paragraph), Insurers may request other Insurers to which the relevant Participant belonged to provide copies of records concerning Special health examinations or Specific Health Guidance pertaining to the relevant Participant which the relevant other Insurers have preserved.
For the purpose of ensuring the appropriate and effective implementation of Special health examinations, etc., when a person who has acquired the eligibility as a member was eligible to be an insured of a Association of Medical Care Systems for the Elderly Aged 75 and older in the past, insurers may request the Association of Medical Care Systems for the Elderly Aged 75 and older to provide a copy of the record kept by the Association of Medical Care Systems for the Elderly Aged 75 and older concerning the health checkups or health guidance prescribed in the Article 125, paragraph (1) pertaining to the member.
保険者は、特定健康診査等の適切かつ有効な実施を図るため、加入者の資格を取得した者が後期高齢者医療広域連合の被保険者の資格を有していたことがあるときは、当該後期高齢者医療広域連合に対し、当該後期高齢者医療広域連合が保存している当該加入者に係る第百二十五条第一項に規定する健康診査又は保健指導に関する記録の写しを提供するよう求めることができる。
In order to ensure the appropriate and effective implementation of Special health examinations, etc., insurers may, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, request employers, etc. (including those specified by Order of the Ministry of Health, Labour and Welfare; hereinafter the same applies in this paragraph and the following paragraph) that employ or used to employ subscribers to provide copies of records concerning medical examinations pertaining to the relevant subscribers that are kept by the relevant employers, etc. pursuant to the Industrial Safety and Health Act and other laws and orders, or other documents specified by Order of the Ministry of Health, Labour and Welfare as being equivalent thereto.
Other Insurers, Association of Medical Care Systems for the Elderly Aged 75 and older, or Employers, etc. that have been requested, pursuant to the provisions of the preceding three paragraphs, to provide copies of records concerning Special health examinations or Specific Health Guidance, records concerning Health Checkups or Health Guidance provided for in Article 125, paragraph (1), or records concerning medical examinations kept on file pursuant to the Industrial Safety and Health Act or other laws and orders must provide copies of the records as specified by Order of the Ministry of Health, Labour and Welfare.
Article 28Entrustment of Implementation
第二十八条（実施の委託）
Insurers may entrust the implementation of Special health examinations, etc., to hospitals or clinics listed in each item of Article 63, paragraph (3) of the Health Insurance Act or others that are found to be appropriate. In this case, Insurers may provide copies of records on Special health examinations or specific health guidance that they maintain and other necessary information to the trustee to the extent necessary for the implementation of Special health examinations, etc., to be entrusted, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare.
保険者は、特定健康診査等について、健康保険法第六十三条第三項各号に掲げる病院又は診療所その他適当と認められるものに対し、その実施を委託することができる。この場合において、保険者は、受託者に対し、委託する特定健康診査等の実施に必要な範囲内において、厚生労働省令で定めるところにより、自らが保存する特定健康診査又は特定保健指導に関する記録の写しその他必要な情報を提供することができる。
Article 29Coordination with Relevant Parties
第二十九条（関係者との連携）
In providing Special health examinations, etc. to subscribers who are young-old as prescribed in Article 32, paragraph (1), insurers are to pay attention to appropriate coordination with municipalities that provide community support projects pursuant to the provisions of Article 115-45, paragraphs (1) and (2), Long-Term Care Insurance Act, while taking into account the mental and physical characteristics of subscribers who are young-old, and are to endeavor to ensure the efficient implementation of the Special health examinations, etc.
Beyond what is provided for in the preceding paragraph, Insurers must endeavor to cooperate with other Insurers, medical institutions, and other relevant persons for the efficient implementation of Special health examinations.
Article 29-2Scope of Persons Eligible for Special health examinations Administered by a Municipality
第二十九条の二（市町村の行う特定健康診査等の対象者の範囲）
A municipality set forth in Article 3, paragraph (1) of the National Health Insurance Act is to perform the affairs under the provisions of this Section with regard to an insured that has an address within the area of the municipality.
国民健康保険法第三条第一項の市町村は、当該市町村の区域内に住所を有する被保険者について、この節の規定による事務を行うものとする。
Article 30duty of confidentiality
第三十条（秘密保持義務）
A person who has been entrusted with the implementation of Special health examinations, etc., by Insurers pursuant to the provisions of Article 28 (if the person is a corporation, its officers) or its employees, or a person who used to be any of these persons must not, without justifiable grounds, divulge any personal secrets that have come to their knowledge in the course of the implementation.
Article 31Harmonization with the Health Checkup Guidelines
第三十一条（健康診査等指針との調和）
An Order of the Ministry of Health, Labour and Welfare prescribed in Article 18, paragraph (1), Article 20, Article 21, paragraph (1), Articles 22 through 25, Article 26, paragraph (2), Article 27, paragraphs (3) and (4), and Article 28 must be in harmony with the health checkup guidelines prescribed in Article 9, paragraph (1) of the Health Promotion Act.
第三十二条（前期高齢者交付金）
The Organization is to provide Insurers with Young-Old Subsidies, pursuant to the provisions of Cabinet Order, in order to adjust the imbalances in the burden related to the proportion of participants who are young-old adults (meaning participants who are in or after the month following the month in which they reach 65 years of age (if that day is the first day of a month, the month in which that day falls) and in or before the month in which they reach 75 years of age, and other persons specified by Order of the Ministry of Health, Labour and Welfare; the same applies hereinafter) in the number of participants pertaining to each Insurer (in the case of National Health Insurance, the prefecture; the same applies hereinafter in this Chapter).
The Young-Old Subsidies referred to in the preceding paragraph are to be covered by the young-old payments collected by the Organization pursuant to the provisions of Article 36, paragraph (1).
Article 33Amount of the Young-Old Subsidy
第三十三条（前期高齢者交付金の額）
The amount of the Young-Old Subsidy to be provided to each Insurer pursuant to the provisions of paragraph (1) of the preceding Article is to be the estimated amount of the Young-Old Subsidy for the relevant fiscal year; provided, however, that when the estimated amount of the Young-Old Subsidy for the fiscal year before the previous fiscal year exceeds the fixed amount of the Young-Old Subsidy for that fiscal year, it is to be the amount obtained by deducting from the estimated amount of the Young-Old Subsidy for the relevant fiscal year the sum total of the excess amount and the Young-Old Subsidy Adjustment Amount pertaining to the excess amount, and when the estimated amount of the Young-Old Subsidy for the fiscal year before the previous fiscal year is less than the fixed amount of the Young-Old Subsidy for that fiscal year, it is to be the amount obtained by adding to the estimated amount of the Young-Old Subsidy for the relevant fiscal year the sum total of the shortfall and the Young-Old Subsidy Adjustment Amount pertaining to the shortfall.
The Young-Old Subsidy Adjustment Amount prescribed in the preceding paragraph is the amount calculated for each of the Insurers pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare by taking into consideration the interest arising from the difference between the estimated amount of the Young-Old Subsidy and the fixed amount of the Young-Old Subsidy pertaining to all of the Insurers in the fiscal year before the previous fiscal year and other circumstances.
Article 34Estimated Young-Old Subsidies
第三十四条（概算前期高齢者交付金）
The estimated amount of the Young-Old Subsidy referred to in paragraph (1) of the preceding Article is the amount specified in the following items in accordance with the category of Insurer set forth in each of those items:
insurers of employee insurance, etc.: the sum of the amounts listed in (a) and (b):
被用者保険等保険者 イ及びロに掲げる額の合計額
the amount equivalent to two-thirds of the amount obtained by subtracting the amount set forth in 3. from the sum of the amounts set forth in 1. and 2. (if the amount is less than zero, it is deemed to be zero):
（１）及び（２）に掲げる額の合計額から（３）に掲げる額を控除して得た額（当該額が零を下回る場合には、零とする。）の三分の二に相当する額
the estimated amount of benefit expenses subject to adjustment pertaining to the relevant Insurer in the relevant fiscal year;
the amount obtained by multiplying the amount obtained by dividing the estimated amount of aid for the old-old under Article 119, paragraph (1) pertaining to the relevant Insurer in the relevant fiscal year by the estimated old-old aid adjustment rate set forth in the items of Article 120, paragraph (1) pertaining to the relevant Insurer in the same fiscal year, by a rate calculated for each Insurer on the basis of the ratio of the estimated number of participants who are young-old adults to the estimated number of participants pertaining to the relevant Insurer in the same fiscal year (hereinafter referred to as the "estimated amount of aid for the old-old pertaining to the young-old");
the estimated base amount subject to adjustment in the relevant fiscal year.
当該年度における概算調整対象基準額
the amount equivalent to one third of the amount obtained by deducting the estimated base amount for adjustment after adjustment of remunerations in the relevant fiscal year from the sum of the estimated amount of benefit expenses subject to adjustment pertaining to the insurer and the estimated amount of Medical Care Assistance for the Elderly Aged 75 and over pertaining to the young-old in the relevant fiscal year (if the amount is less than zero, it is deemed to be zero);
当該年度における当該保険者に係る調整対象給付費見込額及び前期高齢者に係る後期高齢者支援金の概算額の合計額から同年度における概算報酬調整後調整対象基準額を控除して得た額（当該額が零を下回る場合には、零とする。）の三分の一に相当する額
insurers other than insurers covered by employee insurance, etc.:the amount obtained by deducting the estimated base amount for adjustment in the relevant fiscal year from the sum of the estimated amount of benefit expenses subject to adjustment pertaining to the relevant insurers and the estimated amount of Medical Care Assistance for the Elderly Aged 75 and over pertaining to the young-old in the relevant fiscal year (if the amount is less than zero, it is deemed to be zero).
被用者保険等保険者以外の保険者 当該年度における当該保険者に係る調整対象給付費見込額及び前期高齢者に係る後期高齢者支援金の概算額の合計額から同年度における概算調整対象基準額を控除して得た額（当該額が零を下回る場合には、零とする。）
The estimated amount of benefits expenses subject to adjustment referred to in the items of the preceding paragraph is the amount obtained by multiplying the amount calculated pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare as the average of the estimated average per person amount of benefits expenses subject to adjustment (meaning the amount obtained by dividing the amount obtained by deducting the amount set forth in item (ii) from the amount set forth in item (i) in each fiscal year by the estimated number of subscribers who are young-old adults pertaining to the insurer in each fiscal year calculated pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare) pertaining to the insurer in each fiscal year of the relevant fiscal year, the fiscal year preceding the relevant fiscal year, and the fiscal year before the fiscal year preceding the relevant fiscal year by the estimated number of subscribers who are young-old adults pertaining to the insurer in the relevant fiscal year calculated 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 as the amount pertaining to subscribers who are young-old among the prospective amount of expenses required for benefits of the relevant insurers (in the case of national health insurance, benefits of municipalities within a prefecture) which fall under those specified by Order of the Ministry of Health, Labour and Welfare among benefits concerning medical care pursuant to the provisions of medical insurance acts (excluding other benefits prescribed in Article 53 of the Health Insurance Act and benefits equivalent thereto) (hereinafter referred to as "expenses required for benefits by insurers") (hereinafter referred to as "prospective amount of young-old benefit expenses");
当該保険者の給付（国民健康保険にあつては、都道府県内の市町村の給付）であつて医療保険各法の規定による医療に関する給付（健康保険法第五十三条に規定するその他の給付及びこれに相当する給付を除く。）のうち厚生労働省令で定めるものに該当するものに要する費用（以下「保険者の給付に要する費用」という。）の見込額のうち前期高齢者である加入者に係るものとして厚生労働省令で定めるところにより算定される額（以下「前期高齢者給付費見込額」という。）
the amount calculated pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare as the portion of the prospective Young-Old Benefit pertaining to the Insurers if the Insurers are Insurers in Excess of the Estimated Standard (meaning Insurers for which the rate obtained by dividing the amount set forth in (a) by the amount set forth in (b) exceeds the rate specified by Cabinet Order in consideration of the distribution, etc. of the prospective Young-Old Benefit per participant who is a Young-Old Person pertaining to all Insurers), which exceeds the amount obtained by multiplying the amount set forth in (b) by the rate specified by Cabinet Order:
当該保険者が概算基準超過保険者（イに掲げる額をロに掲げる額で除して得た率が、全ての保険者に係る前期高齢者である加入者一人当たりの前期高齢者給付費見込額の分布状況等を勘案して政令で定める率を超える保険者をいう。）である場合における当該保険者に係る前期高齢者給付費見込額のうち、ロに掲げる額に当該政令で定める率を乗じて得た額を超える部分として厚生労働省令で定めるところにより算定される額
the amount calculated pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare as the prospective amount of young-old benefit expenses per Participant who is a young-old pertaining to a single Insurer;
一の保険者に係る前期高齢者である加入者一人当たりの前期高齢者給付費見込額として厚生労働省令で定めるところにより算定される額
the estimated average per person of young-old benefit expenses.
一人平均前期高齢者給付費見込額
The estimated base amount subject to adjustment set forth in the items of paragraph (1) is the amount obtained by multiplying the sum of the estimated amount of benefit expenses subject to adjustment set forth in the items of the same paragraph pertaining to the relevant insurer and the estimated amount of Medical Care Assistance for the Elderly Aged 75 and over pertaining to the young-old (in the case of an insurer of employee insurance, etc., the amount obtained by multiplying the relevant amount by the estimated amount adjustment rate) by the estimated participant adjustment rate.
第一項各号の概算調整対象基準額は、当該保険者に係る同項各号の調整対象給付費見込額及び前期高齢者に係る後期高齢者支援金の概算額（被用者保険等保険者にあつては、当該額に概算額補正率を乗じて得た額）の合計額に概算加入者調整率を乗じて得た額とする。
The estimated base amount subject to adjustment after remuneration adjustment set forth in paragraph (1), item (i), (b) is the amount obtained by multiplying by the estimated participant adjustment rate the sum total of the amount obtained by multiplying the estimated amount of benefit expenses subject to adjustment set forth in the items of that paragraph pertaining to the relevant Insurer by the rate obtained by dividing the amount set forth in item (i) for the relevant fiscal year by the amount set forth in item (ii) (referred to as the "estimated remuneration adjustment rate" in paragraph (6), item (i)) and the estimated benefit expense correction rate, and the amount obtained by multiplying the estimated amount of aid for the old-old pertaining to the young-old by the estimated amount correction rate.
the amount obtained by dividing the amount calculated pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare as the prospective amount of the total amount of standardized remunerations pertaining to the insurer (referred to as the "prospective amount of the total amount of standardized remunerations" in the following item and Article 120, paragraph (1), item (i), (a) and (b)) by the prospective number of subscribers pertaining to the insurer calculated pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare;
当該保険者に係る標準報酬総額の見込額として厚生労働省令で定めるところにより算定される額（次号並びに第百二十条第一項第一号イ及びロにおいて「標準報酬総額の見込額」という。）を厚生労働省令で定めるところにより算定した当該保険者に係る加入者の見込数で除して得た額
the amount calculated pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare as the amount obtained by dividing the sum of the prospective amounts of the total amount of standardized remunerations pertaining to all Insurers of employee insurance, etc. by the prospective total number of subscribers pertaining to all Insurers of employee insurance, etc.
全ての被用者保険等保険者に係る標準報酬総額の見込額の合計額を全ての被用者保険等保険者に係る加入者の見込総数で除して得た額として厚生労働省令で定めるところにより算定した額
The estimated amount correction rate referred to in the preceding two paragraphs is the rate calculated pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare so that the sum of the amounts obtained by subtracting the amount set forth in item (ii) from the amount set forth in item (i) pertaining to each of the Insurers of employee insurance, etc. is equal to the sum of the amounts obtained by subtracting the amount set forth in item (iv) from the amount set forth in item (iii):
the amount obtained by multiplying the estimated amount of Medical Care Assistance for the Elderly Aged 75 and over pertaining to the Young-Old by the estimated participant adjustment rate;
前期高齢者に係る後期高齢者支援金の概算額に概算加入者調整率を乗じて得た額
the estimated amount of Medical Care Assistance for the Elderly Aged 75 and over pertaining to the Young-Old;
the amount obtained by multiplying the estimated amount of Medical Care Assistance for the Elderly Aged 75 and over pertaining to the Young-Old, when an Insurer of employee insurance, etc. is deemed to be an Insurer other than an Insurer of employee insurance, etc., by the estimated participant adjustment rate;
被用者保険等保険者を被用者保険等保険者以外の保険者とみなした場合における前期高齢者に係る後期高齢者支援金の概算額に概算加入者調整率を乗じて得た額
the estimated amount of Medical Care Assistance for the Elderly Aged 75 and over pertaining to the Young-Old when Insurers of employee insurance, etc. are deemed to be insurers other than Insurers of employee insurance, etc.
被用者保険等保険者を被用者保険等保険者以外の保険者とみなした場合における前期高齢者に係る後期高齢者支援金の概算額
The estimated benefit expense adjustment rate referred to in paragraph (4) is the rate calculated pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare so that the total of the amounts set forth in item (i) pertaining to each of the Insurers of employee insurance, etc. is equal to the total of the amounts set forth in item (ii):
the amount arrived at when the estimated amount of the covered benefit expenses referred to in the items of paragraph (1) is multiplied by the estimated remuneration adjustment rate and the estimated participant adjustment rate;
the amount arrived at when the estimated amount of the covered benefit expenses referred to in the items of paragraph (1) is multiplied by the estimated participant adjustment rate.
第一項各号の調整対象給付費見込額に概算加入者調整率を乗じて得た額
The estimated participant adjustment rate referred to in paragraph (3), paragraph (4), paragraph (5), items (i) and (iii), and the items of the preceding paragraph is the rate calculated for each insurer based on the rate arrived at when the prospective total number of subscribers who are young-old adults accounts for the prospective total number of subscribers for all insurers in the relevant fiscal year is divided by the prospective total number of subscribers who are young-old adults accounts for the prospective total number of subscribers for the relevant insurers in the same fiscal year (or, if that rate is less than the minimum rate in the same fiscal year (meaning the rate specified by Cabinet Order in consideration of trends in the rate of the prospective total number of subscribers who are young-old adults accounts for the prospective total number of subscribers for all insurers in the same fiscal year; hereinafter the same applies in this paragraph and paragraph (7) of the following Article), the minimum rate), pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare.
The total standardized amount of remuneration referred to in paragraph (4), item (i) is the amount obtained by correcting, pursuant to the provisions of Cabinet Order, the total sum of the amounts specified in the following items for each fiscal year in accordance with the category of insurer set forth in each of those items:
a Japan Health Insurance Association or health insurance society:the standard remuneration (meaning the standard monthly remuneration amount and the Bonus Amount) prescribed in the Health Insurance Act or the Mariners Insurance Act for each insured;
全国健康保険協会及び健康保険組合 被保険者ごとの健康保険法又は船員保険法に規定する標準報酬（標準報酬月額及び標準賞与額をいう。）
Mutual aid association: the standard monthly remuneration amount and the standard amount of end-of-term allowances, etc. prescribed in the National Public Officers Mutual Aid Association Act or the Local Public Officers, etc. Mutual Aid Association Act for each member;
共済組合 組合員ごとの国家公務員共済組合法又は地方公務員等共済組合法に規定する標準報酬の月額及び標準期末手当等の額
the standard monthly remuneration amount and the Bonus Amount prescribed in the Private School Teachers Mutual Aid Act for each member of the Promotion and Mutual Aid Corporation for Private Schools of Japan;
日本私立学校振興・共済事業団 加入者ごとの私立学校教職員共済法に規定する標準報酬月額及び標準賞与額
national health insurance societies (limited to those who are insurers of employee insurance, etc.):the amount specified by Order of the Ministry of Health, Labour and Welfare as equivalent to the amounts specified in the preceding three items for each member.
The per capita average estimated amount of young-old benefit expenses referred to in paragraph (2), item (ii), (b) is the amount calculated pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare as the average of the estimated amount of young-old benefit expenses per Participant who is a young-old pertaining to all Insurers.
第二項第二号ロの一人平均前期高齢者給付費見込額は、全ての保険者に係る前期高齢者である加入者一人当たりの前期高齢者給付費見込額の平均額として厚生労働省令で定めるところにより算定される額とする。
Article 35Fixed Young-Old Subsidies
第三十五条（確定前期高齢者交付金）
The amount of the fixed Young-Old Subsidy referred to in Article 33, paragraph (1) is the amount specified in the following items in accordance with the category of Insurer set forth in each of those items.
insurers of employee insurance, etc.: the sum of the amounts listed in (a) and (b):
被用者保険等保険者 イ及びロに掲げる額の合計額
the amount equivalent to two-thirds of the amount obtained by subtracting the amount set forth in 4. from the sum of the amounts set forth in 1. through 3. (if the amount is less than zero, it is deemed to be zero):
（１）から（３）までに掲げる額の合計額から（４）に掲げる額を控除して得た額（当該額が零を下回る場合には、零とする。）の三分の二に相当する額
the amount of benefit expenses subject to adjustment pertaining to the relevant Insurer in the fiscal year before the previous fiscal year;
前々年度における当該保険者に係る調整対象給付費額
the amount obtained by multiplying the amount obtained by dividing the fixed amount of aid for the old-old under Article 119, paragraph (1) pertaining to the relevant Insurer in the fiscal year before the previous fiscal year by the fixed old-old aid adjustment rate set forth in the items of Article 121, paragraph (1) pertaining to the relevant Insurer in the same fiscal year, by a rate calculated for each Insurer on the basis of the ratio of the number of participants who are young-old adults to the number of participants pertaining to the relevant Insurer in the same fiscal year (hereinafter referred to as the "fixed amount of aid for the old-old pertaining to the young-old");
the portion of the amount of the contribution for securing medical care in the early phase of an epidemic under the Act on the Prevention of Infectious Diseases and Medical Care for Patients with Infectious Diseases (Act No. 114 of 1998) (hereinafter referred to as the "contribution for securing medical care in the early phase of an epidemic") pertaining to the relevant Insurer in the fiscal year before the previous fiscal year that is calculated, as pertaining to participants who are young-old adults, as specified by Order of the Ministry of Health, Labour and Welfare (hereinafter referred to as the "amount of contribution for securing medical care in the early phase of an epidemic pertaining to the young-old");
the fixed base amount subject to adjustment in the fiscal year before the previous fiscal year.
前々年度における確定調整対象基準額
the amount equivalent to one third of the amount obtained by subtracting the base amount subject to adjustment after the adjustment of fixed remunerations in the fiscal year before the previous fiscal year from the sum of the amount of benefit expenses subject to adjustment pertaining to the insurer, the fixed amount of Medical Care Assistance for the Elderly Aged 75 and over pertaining to the young-old, and the amount of contributions for securing medical care in the early stage of an epidemic pertaining to the young-old in the same fiscal year (if the amount is less than zero, it is deemed to be zero);
前々年度における当該保険者に係る調整対象給付費額、前期高齢者に係る後期高齢者支援金の確定額及び前期高齢者に係る流行初期医療確保拠出金の額の合計額から同年度における確定報酬調整後調整対象基準額を控除して得た額（当該額が零を下回る場合には、零とする。）の三分の一に相当する額
insurers other than insurers of employee insurance, etc.:the amount obtained by subtracting the final base amount for adjustment in the fiscal year before the previous fiscal year from the sum of the amount of benefit expenses subject to adjustment pertaining to the relevant insurers, the final amount of Medical Care Assistance for the Elderly Aged 75 and over pertaining to the young-old, and the amount of contributions for securing medical care in the early stage of an epidemic pertaining to the young-old in the same fiscal year (if the amount is less than zero, it is deemed to be zero).
被用者保険等保険者以外の保険者 前々年度における当該保険者に係る調整対象給付費額、前期高齢者に係る後期高齢者支援金の確定額及び前期高齢者に係る流行初期医療確保拠出金の額の合計額から同年度における確定調整対象基準額を控除して得た額（当該額が零を下回る場合には、零とする。）
The amount of benefit expenses subject to adjustment set forth in the items of the preceding paragraph is the amount obtained by multiplying the amount calculated, as specified by Order of the Ministry of Health, Labour and Welfare, as the average of the average amount of benefit expenses subject to adjustment per person pertaining to the relevant Insurer (meaning the amount obtained by dividing the amount obtained by deducting the amount set forth in item (ii) from the amount set forth in item (i) in each fiscal year by the number of participants who are young-old adults pertaining to the relevant Insurer in each fiscal year, calculated as specified by Order of the Ministry of Health, Labour and Welfare) in each of the fiscal year before the previous fiscal year, the fiscal year that includes April 1 of the year preceding the year in which the first day of the fiscal year before the previous fiscal year falls, and the fiscal year that includes April 1 of the year two years before the year in which the first day of the fiscal year before the previous fiscal year falls, by the number of participants who are young-old adults pertaining to the relevant Insurer in the fiscal year before the previous fiscal year, calculated as specified by 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 as the amount of expenses required for benefits by the insurer which pertain to subscribers who are young-old (hereinafter referred to as the "amount of young-old benefit expenses");
当該保険者の給付に要する費用の額のうち前期高齢者である加入者に係るものとして厚生労働省令で定めるところにより算定される額（以下「前期高齢者給付費額」という。）
the amount calculated pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare as the portion of the amount of young-old benefit expenses pertaining to the insurers if the insurers are the insurers in excess of the fixed standards (meaning the insurers for which the rate obtained by dividing the amount listed in (a) by the amount listed in (b) exceeds the rate specified by Cabinet Order set forth in paragraph (2), item (ii) of the preceding Article), which exceeds the amount obtained by multiplying the amount listed in (b) by the rate specified by the Cabinet Order:
the amount calculated pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare as the amount of young-old benefit expenses per member who is a young-old pertaining to a single insurer;
the average per person young-old benefit cost.
一人平均前期高齢者給付費額
The final base amount for adjustment set forth in the items of paragraph (1) is the amount obtained by multiplying the total of the amount of benefit expenses subject to adjustment set forth in the items of the same paragraph pertaining to the insurer, the final amount of Medical Care Assistance for the Elderly Aged 75 and over pertaining to the young-old (in the case of Insurers of employee insurance, etc., the amount obtained by multiplying the amount by the final amount adjustment rate), and the amount of contributions to ensure medical care in the early stage of an epidemic pertaining to the young-old, by the final participant adjustment rate.
第一項各号の確定調整対象基準額は、当該保険者に係る同項各号の調整対象給付費額、前期高齢者に係る後期高齢者支援金の確定額（被用者保険等保険者にあつては、当該額に確定額補正率を乗じて得た額）及び前期高齢者に係る流行初期医療確保拠出金の額の合計額に確定加入者調整率を乗じて得た額とする。
The fixed base amount subject to adjustment after remuneration adjustment set forth in paragraph (1), item (i), (b) is the amount obtained by multiplying by the fixed participant adjustment rate the sum total of the amount obtained by multiplying the sum total of the amount of benefit expenses subject to adjustment set forth in the items of that paragraph pertaining to the relevant Insurer and the amount of contribution for securing medical care in the early phase of an epidemic pertaining to the young-old by the rate obtained by dividing the amount set forth in item (i) by the amount set forth in item (ii) for the fiscal year before the previous fiscal year (referred to as the "fixed remuneration adjustment rate" in paragraph (6), item (i)) and the correction rate for fixed benefit expenses, etc., and the amount obtained by multiplying the fixed amount of aid for the old-old pertaining to the young-old by the fixed amount correction rate.
第一項第一号ロの確定報酬調整後調整対象基準額は、当該保険者に係る同項各号の調整対象給付費額及び前期高齢者に係る流行初期医療確保拠出金の額の合計額に前々年度における第一号に掲げる額を第二号に掲げる額で除して得た率（第六項第一号において「確定報酬調整率」という。）及び確定給付費等補正率を乗じて得た額並びに前期高齢者に係る後期高齢者支援金の確定額に確定額補正率を乗じて得た額の合計額に確定加入者調整率を乗じて得た額とする。
the amount arrived at when the insurer's total standardized amount of compensation (meaning the total standardized amount of compensation as prescribed in paragraph (8) of the preceding Article; the same applies in the following item and in Article 121, paragraph (1), item (i), (a) and (b)) is divided by the number of participants associated with that insurer, as calculated pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare;
当該保険者に係る標準報酬総額（前条第八項に規定する標準報酬総額をいう。次号並びに第百二十一条第一項第一号イ及びロにおいて同じ。）を厚生労働省令で定めるところにより算定した当該保険者に係る加入者の数で除して得た額
the amount calculated pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare as the amount obtained by dividing the sum of the total amount of standardized remunerations pertaining to all Insurers of employee insurance, etc. by the total number of subscribers pertaining to all Insurers of employee insurance, etc.
The fixed amount adjustment rate referred to in the preceding two paragraphs is the rate calculated pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare so that the sum of the amounts obtained by subtracting the amount set forth in item (ii) from the amount set forth in item (i) pertaining to each of the insurers of employee insurance, etc. is equal to the sum of the amounts obtained by subtracting the amount set forth in item (iv) from the amount set forth in item (iii):
the amount arrived at when the final amount of the Medical Care Assistance for the Elderly Aged 75 and over pertaining to the Young-Old is multiplied by the final participant adjustment rate;
前期高齢者に係る後期高齢者支援金の確定額に確定加入者調整率を乗じて得た額
the fixed amount of Medical Care Assistance for the Elderly Aged 75 and over pertaining to the Young-Old;
the amount obtained by multiplying the fixed amount of Medical Care Assistance for the Elderly Aged 75 and over pertaining to the Young-Old by the Fixed Participant Adjustment Rate when an Insurer of employee insurance, etc. is deemed to be an Insurer other than an Insurer of employee insurance, etc.;
被用者保険等保険者を被用者保険等保険者以外の保険者とみなした場合における前期高齢者に係る後期高齢者支援金の確定額に確定加入者調整率を乗じて得た額
the fixed amount of Medical Care Assistance for the Elderly Aged 75 and over pertaining to the Young-Old when an Insurer of employee insurance, etc. is deemed to be an Insurer other than an Insurer of employee insurance, etc.
被用者保険等保険者を被用者保険等保険者以外の保険者とみなした場合における前期高齢者に係る後期高齢者支援金の確定額
The adjustment rate for fixed benefit expenses, etc. set forth in paragraph (4) is the rate calculated pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare so that the total of the amounts listed in item (i) pertaining to each of the Insurers of employee insurance, etc. is equal to the total of the amounts listed in item (ii):
the amount obtained by multiplying the sum of the amount of payment expenses subject to adjustment and the amount of contributions for ensuring medical care in the early stage of an epidemic pertaining to young-old persons set forth in the items of paragraph (1) by the fixed remuneration adjustment rate and the fixed participant adjustment rate;
第一項各号の調整対象給付費額及び前期高齢者に係る流行初期医療確保拠出金の額の合計額に確定報酬調整率及び確定加入者調整率を乗じて得た額
the amount obtained by multiplying the sum of the amount of payment expenses subject to adjustment set forth in the items of paragraph (1) and the amount of contributions to ensure medical care in the early stage of an epidemic pertaining to the young-old by the fixed participant adjustment rate.
第一項各号の調整対象給付費額及び前期高齢者に係る流行初期医療確保拠出金の額の合計額に確定加入者調整率を乗じて得た額
The fixed participant adjustment rate referred to in paragraph (3), paragraph (4), paragraph (5), items (i) and (iii), and the items of the preceding paragraph is the rate calculated for each of the insurers pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, based on the rate arrived at when the percentage of the total number of participants who are young-old to the total number of participants for all insurers in the fiscal year before the previous fiscal year is divided by the percentage of the number of participants who are young-old to the number of participants for the relevant insurers in the same fiscal year (if that percentage is less than the minimum percentage in the same fiscal year, the minimum percentage).
The per capita average amount of young-old benefit expenses referred to in paragraph (2), item (ii), (b) is the amount calculated pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare as the average amount of young-old benefit expenses per one member who is a young-old pertaining to all insurers.
Article 36Collection and Payment Obligation of Young-Old Payments
第三十六条（前期高齢者納付金等の徴収及び納付義務）
The Organization collects young-old payments and contributions for administrative expenses related to the young-old (hereinafter referred to as "young-old payments, etc.") from Insurers each fiscal year in order to cover the expenses required for the services listed in Article 139, paragraph (1), item (i) and the handling of affairs relating to the services.
機構は、第百三十九条第一項第一号に掲げる業務及び当該業務に関する事務の処理に要する費用に充てるため、年度ごとに、保険者から、前期高齢者納付金及び前期高齢者関係事務費拠出金（以下「前期高齢者納付金等」という。）を徴収する。
An insurer is liable to pay young-old payments.
Article 37Amount of Young-Old Payments
第三十七条（前期高齢者納付金の額）
The amount of young-old payments to be collected from each Insurer pursuant to the provisions of paragraph (1) of the preceding Article is to be the estimated amount of young-old payments for the relevant fiscal year; provided, however, that when the estimated amount of young-old payments for the fiscal year before the previous fiscal year exceeds the fixed amount of young-old payments for that fiscal year, it is to be the amount obtained by deducting from the estimated amount of young-old payments for the relevant fiscal year the sum total of the excess amount and the young-old payment adjustment amount pertaining to the excess amount, and when the estimated amount of young-old payments for the fiscal year before the previous fiscal year is less than the fixed amount of young-old payments for that fiscal year, it is to be the amount obtained by adding to the estimated amount of young-old payments for the relevant fiscal year the sum total of the shortfall and the young-old payment adjustment amount pertaining to the shortfall.
The Young-Old Payment Adjustment Amount prescribed in the preceding paragraph is the amount calculated for each of the Insurers pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare by taking into consideration the interest arising from the excess or deficiency between the estimated Young-Old Payments and the fixed Young-Old Payments pertaining to all of the Insurers in the fiscal year before the previous fiscal year and other circumstances.
Article 38Estimated Young-Old Payments
第三十八条（概算前期高齢者納付金）
The estimated amount of Young-Old Payments referred to in paragraph (1) of the preceding Article is the amount specified in each of the following items in accordance with the category of Insurer set forth in the relevant item:
an insurer exceeding the estimated burden adjustment standard (meaning, among Insurers for which the amount equivalent to the estimated young-old payment before burden adjustment for the relevant fiscal year exceeds zero, an Insurer for which the sum total set forth in (a) exceeds the amount set forth in (b) (excluding an insurer exceeding the special estimated burden adjustment standard in the following item); the same applies hereinafter in this Article): the sum total of the amount obtained by deducting the estimated amount subject to burden adjustment (meaning the amount obtained by deducting the amount set forth in (b) from the sum total set forth in (a) (if that amount exceeds the amount equivalent to the estimated young-old payment before burden adjustment, the amount equivalent to the estimated young-old payment before burden adjustment); the same applies in paragraph (3)) from the amount equivalent to the estimated young-old payment before burden adjustment, and the estimated amount of burden adjustment;
the sum total of the following amounts:
次に掲げる額の合計額
the amount equivalent to the estimated young-old payment before burden adjustment for the relevant fiscal year;
当該年度における負担調整前概算前期高齢者納付金相当額
the amount obtained by dividing the estimated amount of aid for the old-old under Article 119, paragraph (1) pertaining to the relevant Insurer in the relevant fiscal year by the estimated old-old aid adjustment rate set forth in the items of Article 120, paragraph (1) pertaining to the relevant Insurer in the same fiscal year;
the amount arrived at when the sum total of the following amounts is multiplied by the base rate for burden adjustment for the relevant fiscal year:
次に掲げる額の合計額に当該年度の負担調整基準率を乗じて得た額
the sum total set forth in (a);
イに掲げる合計額
the amount calculated as specified by Order of the Ministry of Health, Labour and Welfare as the estimated amount of the expenses required for benefits by insurers in the relevant fiscal year (including the expenses required for the payment of the day laborer contribution prescribed in Article 173, paragraph (2) of the Health Insurance Act; referred to as "expenses required for benefits by insurers, etc." in the following item, (b), (2) and Article 39, paragraph (1), item (i), (b), (2) and item (ii), (b), (2));
当該年度における当該保険者の給付に要する費用（健康保険法第百七十三条第二項に規定する日雇拠出金の納付に要する費用を含む。次号ロ（２）、次条第一項第一号ロ（２）及び第二号ロ（２）において「保険者の給付に要する費用等」という。）の見込額として厚生労働省令で定めるところにより算定される額
an insurer exceeding the special estimated burden adjustment standard (meaning, among Insurers for which the amount equivalent to the estimated young-old payment before burden adjustment for the relevant fiscal year exceeds zero, an Insurer for which the sum total set forth in (a) exceeds the amount set forth in (b) and for which the estimated financial capacity in the same fiscal year, calculated as specified by Cabinet Order, falls short of the standard specified by Cabinet Order; the same applies hereinafter in this Article): the sum total of the amount obtained by deducting the estimated amount subject to special burden adjustment (meaning the amount obtained by deducting the amount set forth in (b) from the sum total set forth in (a) (if that amount exceeds the amount equivalent to the estimated young-old payment before burden adjustment, the amount equivalent to the estimated young-old payment before burden adjustment); the same applies in paragraph (3)) from the amount equivalent to the estimated young-old payment before burden adjustment, and the estimated amount of burden adjustment;
the sum total of the following amounts:
次に掲げる額の合計額
the amount equivalent to the estimated young-old payment before burden adjustment for the relevant fiscal year;
当該年度における負担調整前概算前期高齢者納付金相当額
the amount obtained by dividing the estimated amount of aid for the old-old under Article 119, paragraph (1) pertaining to the relevant Insurer in the relevant fiscal year by the estimated old-old aid adjustment rate set forth in the items of Article 120, paragraph (1) pertaining to the relevant Insurer in the same fiscal year;
the amount arrived at when the sum total of the following amounts is multiplied by the base rate for special burden adjustment for the relevant fiscal year;
次に掲げる額の合計額に当該年度の特別負担調整基準率を乗じて得た額
the sum total set forth in (a);
イに掲げる合計額
the amount calculated as specified by Order of the Ministry of Health, Labour and Welfare as the estimated amount of the expenses required for benefits by insurers, etc. in the relevant fiscal year.
当該年度における当該保険者の給付に要する費用等の見込額として厚生労働省令で定めるところにより算定される額
an insurer other than an insurer in excess of the standard for estimated burden adjustment and an insurer in excess of the special standard for estimated burden adjustment:the sum of the amount equivalent to estimated young-old payments before burden adjustment and the estimated amount of burden adjustment.
概算負担調整基準超過保険者及び特別概算負担調整基準超過保険者以外の保険者 負担調整前概算前期高齢者納付金相当額と負担調整見込額との合計額
The estimated amount equivalent to Young-Old Payments before burden adjustment referred to in the items of the preceding paragraph is the amount specified in the following items according to the categories of Insurers set forth in the respective items.
insurers of employee insurance, etc.: the sum of the amounts listed in (a) and (b):
被用者保険等保険者 イ及びロに掲げる額の合計額
the amount equivalent to two-thirds of the amount obtained by deducting the sum total of the estimated amount of benefit expenses subject to adjustment set forth in the items of Article 34, paragraph (1) pertaining to the relevant Insurer and the estimated amount of aid for the old-old pertaining to the young-old from the estimated base amount subject to adjustment set forth in the items of Article 34, paragraph (1) (if the amount is less than zero, it is deemed to be zero);
第三十四条第一項各号の概算調整対象基準額から、当該保険者に係る同項各号の調整対象給付費見込額及び前期高齢者に係る後期高齢者支援金の概算額の合計額を控除して得た額（当該額が零を下回る場合には、零とする。）の三分の二に相当する額
the amount equivalent to one third of the amount obtained by deducting the sum total of the estimated amount of benefit expenses subject to adjustment set forth in the items of Article 34, paragraph (1) pertaining to the relevant Insurer and the estimated amount of aid for the old-old pertaining to the young-old from the estimated base amount subject to adjustment after remuneration adjustment set forth in Article 34, paragraph (1), item (i), (b) (if the amount is less than zero, it is deemed to be zero).
第三十四条第一項第一号ロの概算報酬調整後調整対象基準額から、当該保険者に係る同項各号の調整対象給付費見込額及び前期高齢者に係る後期高齢者支援金の概算額の合計額を控除して得た額（当該額が零を下回る場合には、零とする。）の三分の一に相当する額
insurers other than insurers covered by employee insurance, etc.:the amount obtained by deducting the sum of the estimated amount of benefit expenses subject to adjustment set forth in the items of Article 34, paragraph (1) pertaining to the relevant insurers and the estimated amount of Medical Care Assistance for the Elderly Aged 75 and over pertaining to the young-old (if the relevant amount is less than zero, it is deemed to be zero) from the estimated base amount subject to adjustment set forth in the items of the same paragraph.
被用者保険等保険者以外の保険者 第三十四条第一項各号の概算調整対象基準額から、当該保険者に係る同項各号の調整対象給付費見込額及び前期高齢者に係る後期高齢者支援金の概算額の合計額を控除して得た額（当該額が零を下回る場合には、零とする。）
The estimated amount of burden adjustment referred to in the items of paragraph (1) is the amount obtained by multiplying the amount obtained by first dividing the sum of the amounts set forth in the following items for the relevant fiscal year by the estimated total number of subscribers for all insurers in the relevant fiscal year calculated as specified by Order of the Ministry of Health, Labour and Welfare, then multiplying the product by the estimated number of subscribers for the relevant insurers in the relevant fiscal year calculated as specified by Order of the Ministry of Health, Labour and Welfare, then multiplying the product by the estimated adjustment rate for the burden adjustment:
the total estimated amount subject to burden adjustment pertaining to all insurers in excess of the standard for estimated burden adjustment;
全ての概算負担調整基準超過保険者に係る負担調整対象見込額の総額
the total of the prospective amounts subject to burden adjustment pertaining to all insurers in excess of the special estimated burden adjustment standards;
全ての特別概算負担調整基準超過保険者に係る負担調整対象見込額の総額
one third of the total amount calculated by deducting the prospective amount subject to burden adjustment from the prospective amount subject to special burden adjustment pertaining to all insurers exceeding the special estimated burden adjustment standards (referred to as the "total amount, etc. of the prospective amount of special burden adjustment" in Article 93, paragraph (3)).
全ての特別概算負担調整基準超過保険者に係る特別負担調整対象見込額から負担調整対象見込額を控除した額の総額（第九十三条第三項において「特別負担調整見込額の総額等」という。）の三分の一
The base rate for burden adjustment referred to in paragraph (1), item (i), (b) is the rate specified by Cabinet Order for each fiscal year so that the ratio of insurers in excess of the estimated burden adjustment standard to all insurers is the ratio specified by Cabinet Order as being extremely small.
第一項第一号ロの負担調整基準率は、全ての保険者に占める概算負担調整基準超過保険者の割合が著しく少ないものとして政令で定める割合となるよう、年度ごとに政令で定める率とする。
The standard rate for special burden adjustment referred to in paragraph (1), item (ii), (b) is a rate specified by Cabinet Order for each fiscal year so that the percentage of insurers exceeding the special estimated burden adjustment standard among all insurers is the percentage specified by Cabinet Order as being small.
第一項第二号ロの特別負担調整基準率は、全ての保険者に占める特別概算負担調整基準超過保険者の割合が少ないものとして政令で定める割合となるよう、年度ごとに政令で定める率とする。
The estimated burden adjustment adjustment rate referred to in paragraph (3) is calculated pursuant to the provisions of Cabinet Order within the range of 90 percent to 110 percent, taking into consideration the estimated amount of young-old benefit expenses per participant who is a young-old.
第三項の概算負担調整額調整率は、前期高齢者である加入者一人当たりの前期高齢者給付費見込額を勘案し、百分の九十から百分の百十の範囲内で政令で定めるところにより算定する。
Article 39Fixed Young-Old Payments
第三十九条（確定前期高齢者納付金）
The amount of the final and binding young-old payments referred to in Article 37, paragraph (1) is the amount specified in the following items in accordance with the category of the insurer set forth in each of those items:
an insurer exceeding the fixed burden adjustment standard (meaning, among Insurers for which the amount equivalent to the fixed young-old payment before burden adjustment for the fiscal year before the previous fiscal year exceeds zero, an Insurer for which the sum total set forth in (a) exceeds the amount set forth in (b) (excluding an insurer exceeding the special fixed burden adjustment standard in the following item); the same applies hereinafter in this Article): the sum total of the amount obtained by deducting the amount subject to burden adjustment (meaning the amount obtained by deducting the amount set forth in (b) from the sum total set forth in (a) (if that amount exceeds the amount equivalent to the fixed young-old payment before burden adjustment, the amount equivalent to the fixed young-old payment before burden adjustment); the same applies in paragraph (3)) from the amount equivalent to the fixed young-old payment before burden adjustment, and the burden adjustment amount;
the sum total of the following amounts:
次に掲げる額の合計額
the amount equivalent to the fixed young-old payment before burden adjustment for the fiscal year before the previous fiscal year;
前々年度における負担調整前確定前期高齢者納付金相当額
the amount obtained by dividing the fixed amount of aid for the old-old under Article 119, paragraph (1) pertaining to the relevant Insurer in the fiscal year before the previous fiscal year by the fixed old-old aid adjustment rate set forth in the items of Article 121, paragraph (1) pertaining to the relevant Insurer in the same fiscal year;
the amount arrived at when the sum total of the following amounts is multiplied by the base rate for burden adjustment referred to in paragraph (1), item (i), (b) of the preceding Article for the fiscal year before the previous fiscal year;
次に掲げる額の合計額に前々年度の前条第一項第一号ロの負担調整基準率を乗じて得た額
the sum total set forth in (a);
イに掲げる合計額
the amount of the expenses required for benefits by insurers, etc. of the relevant Insurer and the amount of the contribution for securing medical care in the early phase of an epidemic, in the fiscal year before the previous fiscal year;
前々年度における当該保険者の給付に要する費用等の額及び流行初期医療確保拠出金の額
an insurer exceeding the special fixed burden adjustment standard (meaning, among Insurers for which the amount equivalent to the fixed young-old payment before burden adjustment for the fiscal year before the previous fiscal year exceeds zero, an Insurer for which the sum total set forth in (a) exceeds the amount set forth in (b) and for which the financial capacity in the same fiscal year, calculated as specified by Cabinet Order, falls short of the standard specified by Cabinet Order; the same applies hereinafter in this Article): the sum total of the amount obtained by deducting the amount subject to special burden adjustment (meaning the amount obtained by deducting the amount set forth in (b) from the sum total set forth in (a) (if that amount exceeds the amount equivalent to the fixed young-old payment before burden adjustment, the amount equivalent to the fixed young-old payment before burden adjustment); the same applies in paragraph (3)) from the amount equivalent to the fixed young-old payment before burden adjustment, and the burden adjustment amount;
the sum total of the following amounts:
次に掲げる額の合計額
the amount equivalent to the fixed young-old payment before burden adjustment for the fiscal year before the previous fiscal year;
前々年度における負担調整前確定前期高齢者納付金相当額
the amount obtained by dividing the fixed amount of aid for the old-old under Article 119, paragraph (1) pertaining to the relevant Insurer in the fiscal year before the previous fiscal year by the fixed old-old aid adjustment rate set forth in the items of Article 121, paragraph (1) pertaining to the relevant Insurer in the same fiscal year;
the amount arrived at when the sum total of the following amounts is multiplied by the base rate for special burden adjustment referred to in paragraph (1), item (ii), (b) of the preceding Article for the fiscal year before the previous fiscal year:
次に掲げる額の合計額に前々年度の前条第一項第二号ロの特別負担調整基準率を乗じて得た額
the sum total set forth in (a);
イに掲げる合計額
the amount of the expenses required for benefits by insurers, etc. of the relevant Insurer and the amount of the contribution for securing medical care in the early phase of an epidemic, in the fiscal year before the previous fiscal year.
前々年度における当該保険者の給付に要する費用等の額及び流行初期医療確保拠出金の額
an insurer other than an insurer in excess of the fixed burden adjustment standard and a special insurer in excess of the fixed burden adjustment standard:the sum of the amount equivalent to the determined young-old payments before burden adjustment and the burden adjustment amount.
確定負担調整基準超過保険者及び特別確定負担調整基準超過保険者以外の保険者 負担調整前確定前期高齢者納付金相当額と負担調整額との合計額
The amount equivalent to the confirmed young-old payments before burden adjustment referred to in the items of the preceding paragraph is the amount specified in the following items in accordance with the category of insurer set forth in each of those items.
insurers of employee insurance, etc.: the sum of the amounts listed in (a) and (b):
被用者保険等保険者 イ及びロに掲げる額の合計額
the amount equivalent to two-thirds of the amount obtained by subtracting the sum of the amount of benefits expenses subject to adjustment set forth in the items of Article 35, paragraph (1) pertaining to the insurer, the fixed amount of Medical Care Assistance for the Elderly Aged 75 and over pertaining to the young-old, and the amount of contributions to ensure medical care in the early stage of an epidemic pertaining to the young-old (if the amount is less than zero, it is deemed to be zero) from the fixed base amount subject to adjustment set forth in the items of the same paragraph;
第三十五条第一項各号の確定調整対象基準額から、当該保険者に係る同項各号の調整対象給付費額、前期高齢者に係る後期高齢者支援金の確定額及び前期高齢者に係る流行初期医療確保拠出金の額の合計額を控除して得た額（当該額が零を下回る場合には、零とする。）の三分の二に相当する額
the amount equivalent to one third of the amount obtained by deducting, from the base amount for adjustment after adjustment of fixed compensation set forth in Article 35, paragraph (1), item (i), (b), the sum of the amount of benefit expenses subject to adjustment set forth in the items of the same paragraph pertaining to the insurer, the fixed amount of Medical Care Assistance for the Elderly Aged 75 and over pertaining to the young-old, and the amount of contributions to ensure medical care in the early stage of an epidemic pertaining to the young-old (if the amount is less than zero, it is deemed to be zero);
第三十五条第一項第一号ロの確定報酬調整後調整対象基準額から、当該保険者に係る同項各号の調整対象給付費額、前期高齢者に係る後期高齢者支援金の確定額及び前期高齢者に係る流行初期医療確保拠出金の額の合計額を控除して得た額（当該額が零を下回る場合には、零とする。）の三分の一に相当する額
insurers other than insurers of employee insurance, etc.:the amount obtained by subtracting the sum of the amount of benefit expenses subject to adjustment set forth in the items of Article 35, paragraph (1) pertaining to the relevant insurers, the fixed amount of Medical Care Assistance for the Elderly Aged 75 and over pertaining to the young-old, and the amount of contributions to ensure medical care in the early stage of an epidemic pertaining to the young-old from the fixed base amount subject to adjustment set forth in the items of the same paragraph (if the amount is less than zero, it is deemed to be zero).
被用者保険等保険者以外の保険者 第三十五条第一項各号の確定調整対象基準額から、当該保険者に係る同項各号の調整対象給付費額、前期高齢者に係る後期高齢者支援金の確定額及び前期高齢者に係る流行初期医療確保拠出金の額の合計額を控除して得た額（当該額が零を下回る場合には、零とする。）
The burden adjustment amount set forth in the items of paragraph (1) is the amount obtained by multiplying the amount obtained by first dividing the sum of the amounts set forth in the following items for the fiscal year before the previous fiscal year by the total number of subscribers for all insurers in the same fiscal year calculated as specified by Order of the Ministry of Health, Labour and Welfare, and then multiplying the product by the number of subscribers for the relevant insurers in the same fiscal year calculated as specified by Order of the Ministry of Health, Labour and Welfare, and then multiplying the product by the fixed burden adjustment adjustment rate:
the total amount subject to burden adjustment pertaining to all insurers in excess of the fixed burden adjustment standards;
全ての確定負担調整基準超過保険者に係る負担調整対象額の総額
the total amount subject to burden adjustment pertaining to all insurers in excess of the special standards for burden adjustment;
全ての特別確定負担調整基準超過保険者に係る負担調整対象額の総額
one third of the total amount (referred to as the "total amount of special burden adjustment, etc." in Article 93, paragraph (3)) arrived at when the amount subject to burden adjustment is deducted from the amount subject to special burden adjustment pertaining to all insurers in excess of the special established standard for burden adjustment.
全ての特別確定負担調整基準超過保険者に係る特別負担調整対象額から負担調整対象額を控除した額の総額（第九十三条第三項において「特別負担調整額の総額等」という。）の三分の一
The adjustment rate for the amount of settled burden adjustment referred to in the preceding paragraph is calculated pursuant to the provisions of Cabinet Order within the range of 90 percent to 110 percent, taking into consideration the amount of young-old benefit expenses per participant who is a young-old.
Article 40Amount of Contributions for Office Expenses Related to the Young-Old
第四十条（前期高齢者関係事務費拠出金の額）
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.
第四十一条（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）
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.
Article 42Determination and Notification of the Amount of the Young-Old Subsidy
第四十二条（前期高齢者交付金の額の決定、通知等）
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.
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.
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.
Article 43Determination and Notification of the Amount of Young-Old Payments
第四十三条（前期高齢者納付金等の額の決定、通知等）
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.
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.
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.
Article 44Demand and disposition to collect arrears
第四十四条（督促及び滞納処分）
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.
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.
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.
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。
第四十五条（延滞金）
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.
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.
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.
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。
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。
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。
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。
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。
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 46Payment Grace Period
第四十六条（納付の猶予）
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.
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.
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.
Section 1 General Provisions
第一節 総則
第四十七条（後期高齢者医療）
Medical care for the elderly is to provide necessary benefits in relation to the illness, injury, or death of an elderly person.
後期高齢者医療は、高齢者の疾病、負傷又は死亡に関して必要な給付を行うものとする。
Article 48Establishment of a Cross-Regional Federation
第四十八条（広域連合の設立）
A Municipality, in order to administer affairs concerning Old-Old Healthcare (excluding affairs concerning the collection of insurance premiums and affairs specified by a Cabinet Order as contributing to the promotion of the benefits of the insured), is to establish, for each area of a prefecture, a cross-regional federation to which all Municipalities within the relevant area belong (hereinafter referred to as a "Association of Medical Care Systems for the Elderly Aged 75 and older").
市町村は、後期高齢者医療の事務（保険料の徴収の事務及び被保険者の便益の増進に寄与するものとして政令で定める事務を除く。）を処理するため、都道府県の区域ごとに当該区域内のすべての市町村が加入する広域連合（以下「後期高齢者医療広域連合」という。）を設けるものとする。
第四十九条（特別会計）
A Association of Medical Care Systems for the Elderly Aged 75 and older and a municipality, pursuant to the provisions of a Cabinet Order, must establish a special account for revenue and expenses related to medical care for the elderly.
後期高齢者医療広域連合及び市町村は、後期高齢者医療に関する収入及び支出について、政令で定めるところにより、特別会計を設けなければならない。
Section 2 Insured
第二節 被保険者
第五十条（被保険者）
A person who falls under any of the following items is to be an insured for medical care for the elderly provided by the Association of Medical Care Systems for the Elderly Aged 75 and older:
次の各号のいずれかに該当する者は、後期高齢者医療広域連合が行う後期高齢者医療の被保険者とする。
a person who is 75 years of age or older and has a domicile within the area of the Association of Medical Care Systems for the Elderly Aged 75 and older;
後期高齢者医療広域連合の区域内に住所を有する七十五歳以上の者
a person who is domiciled within the district of a Association of Medical Care Systems for the Elderly Aged 75 and older and is 65 years of age or older but under 75 years of age, who has been certified by the Association of Medical Care Systems for the Elderly Aged 75 and older, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, as being disabled to the extent specified by Cabinet Order.
後期高齢者医療広域連合の区域内に住所を有する六十五歳以上七十五歳未満の者であつて、厚生労働省令で定めるところにより、政令で定める程度の障害の状態にある旨の当該後期高齢者医療広域連合の認定を受けたもの
Article 51Exclusion from Application
第五十一条（適用除外）
Notwithstanding the provisions of the preceding Article, a person who falls under any of the following items is not eligible to be an insured for medical care for the elderly provided by the Association of Medical Care Systems for the Elderly Aged 75 and older:
前条の規定にかかわらず、次の各号のいずれかに該当する者は、後期高齢者医療広域連合が行う後期高齢者医療の被保険者としない。
a person who belongs to a household receiving public assistance under the Public Assistance Act (Act No. 144 of 1950) (excluding a household for which public assistance has been suspended);
生活保護法（昭和二十五年法律第百四十四号）による保護を受けている世帯（その保護を停止されている世帯を除く。）に属する者
beyond what is set forth in the preceding item, a person who has a special reason to be excluded from the application of Old-Old Healthcare and who is specified by Order of the Ministry of Health, Labour and Welfare.
前号に掲げるもののほか、後期高齢者医療の適用除外とすべき特別の理由がある者で厚生労働省令で定めるもの
Article 52Time of Acquisition of Qualification
第五十二条（資格取得の時期）
A insured for medical care for the elderly provided by a Association of Medical Care Systems for the Elderly Aged 75 and older acquires eligibility from the day on which the person comes to fall under any of the following items or the day on which the person no longer falls under any of the items of the preceding Article:
後期高齢者医療広域連合が行う後期高齢者医療の被保険者は、次の各号のいずれかに該当するに至つた日又は前条各号のいずれにも該当しなくなつた日から、その資格を取得する。
when a person who is domiciled within the area of the relevant Association of Medical Care Systems for the Elderly Aged 75 and older (excluding a person who has received the certification set forth in Article 50, item (ii)) has reached 75 years of age;
当該後期高齢者医療広域連合の区域内に住所を有する者（第五十条第二号の認定を受けた者を除く。）が七十五歳に達したとき。
when a person who is 75 years of age or older has come to have a domicile within the area of the relevant Association of Medical Care Systems for the Elderly Aged 75 and older;
七十五歳以上の者が当該後期高齢者医療広域連合の区域内に住所を有するに至つたとき。
when a person who is 65 years of age or older and under 75 years of age and who has a domicile within the area of the relevant Association of Medical Care Systems for the Elderly Aged 75 and older has received the certification set forth in Article 50, item (ii).
当該後期高齢者医療広域連合の区域内に住所を有する六十五歳以上七十五歳未満の者が、第五十条第二号の認定を受けたとき。
Article 53Time of Forfeiture of Status
第五十三条（資格喪失の時期）
A insured for medical care for the elderly provided by a Association of Medical Care Systems for the Elderly Aged 75 and older loses eligibility from the day following the day on which the person no longer has domicile in the area of the relevant Association of Medical Care Systems for the Elderly Aged 75 and older, no longer falls under the condition set forth in Article 50, item (ii), or comes to fall under the person set forth in Article 51, item (ii); provided, however, that if the person comes to have domicile in the area of another Association of Medical Care Systems for the Elderly Aged 75 and older on the day on which the person no longer has domicile in the area of the relevant Association of Medical Care Systems for the Elderly Aged 75 and older, the person loses eligibility from that day.
後期高齢者医療広域連合が行う後期高齢者医療の被保険者は、当該後期高齢者医療広域連合の区域内に住所を有しなくなつた日若しくは第五十条第二号の状態に該当しなくなつた日又は第五十一条第二号に掲げる者に該当するに至つた日の翌日から、その資格を喪失する。ただし、当該後期高齢者医療広域連合の区域内に住所を有しなくなつた日に他の後期高齢者医療広域連合の区域内に住所を有するに至つたときは、その日から、その資格を喪失する。
A insured for medical care for the elderly provided by a Association of Medical Care Systems for the Elderly Aged 75 and older loses eligibility as such from the day on which the person comes to fall under the category of a person provided for in Article 51, item (i).
後期高齢者医療広域連合が行う後期高齢者医療の被保険者は、第五十一条第一号に規定する者に該当するに至つた日から、その資格を喪失する。
第五十四条（届出等）
A insured, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, must notify the Association of Medical Care Systems for the Elderly Aged 75 and older of particulars concerning the acquisition and forfeiture of status as a insured and other necessary particulars.
被保険者は、厚生労働省令で定めるところにより、被保険者の資格の取得及び喪失に関する事項その他必要な事項を後期高齢者医療広域連合に届け出なければならない。
The householder of a household to which an insured belongs may make a notification under the provisions of the preceding paragraph pertaining to the insured on behalf of the insured belonging to the household.
被保険者の属する世帯の世帯主は、その世帯に属する被保険者に代わつて、当該被保険者に係る前項の規定による届出をすることができる。
When an insured is in a situation where the insured cannot receive the electronic eligibility confirmation prescribed in Article 64, paragraph (3), the insured may, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, request the Association of Medical Care Systems for the Elderly Aged 75 and older to deliver a document stating the matters specified by Order of the Ministry of Health, Labour and Welfare as information pertaining to the status of the insured in that situation, or to provide those matters by electronic or magnetic means (meaning a method using an electronic data processing system or any other method using information and communications technology, as specified by Order of the Ministry of Health, Labour and Welfare; the same applies hereinafter in this paragraph through paragraph (5)). In this case, the Association, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, is to promptly deliver the document to an insured who has requested the delivery of the document, and is to provide those matters by electronic or magnetic means to an insured who has requested the provision by electronic or magnetic means.
被保険者が第六十四条第三項に規定する電子資格確認を受けることができない状況にあるときは、当該被保険者は、厚生労働省令で定めるところにより、後期高齢者医療広域連合に対し、当該状況にある被保険者の資格に係る情報として厚生労働省令で定める事項を記載した書面の交付又は当該事項の電磁的方法（電子情報処理組織を使用する方法その他の情報通信の技術を利用する方法であつて厚生労働省令で定めるものをいう。以下この項から第五項までにおいて同じ。）による提供を求めることができる。この場合において、当該後期高齢者医療広域連合は、厚生労働省令で定めるところにより、速やかに、当該書面の交付の求めを行つた被保険者に対しては当該書面を交付するものとし、当該電磁的方法による提供の求めを行つた被保険者に対しては当該事項を電磁的方法により提供するものとする。
An insured who has received delivery of the document referred to in the preceding paragraph pursuant to that paragraph, or provision by electronic or magnetic means of the matters specified by Order of the Ministry of Health, Labour and Welfare referred to in that paragraph, may receive the confirmation under Article 64, paragraph (3), main clause (including as applied mutatis mutandis in Article 74, paragraph (10), Article 75, paragraph (7), Article 76, paragraph (6) and Article 82, paragraph (6)) or Article 78, paragraph (3) (including as applied mutatis mutandis in Article 82, paragraph (6)) by presenting that document or those matters displayed by a method specified by Order of the Ministry of Health, Labour and Welfare.
An insured may, for the confirmation of the facts pertaining to the qualifications of the insured, request the Association of Medical Care Systems for the Elderly Aged 75 and older, as specified by Order of the Ministry of Health, Labour and Welfare, to deliver a document stating those facts or to provide, by electronic or magnetic means, the matters to be stated in that document. In this case, the Association is to, as specified by Order of the Ministry of Health, Labour and Welfare, deliver that document to an insured who has requested delivery of the document, and provide the matters to be stated in the document by electronic or magnetic means to an insured who has requested provision by electronic or magnetic means.
被保険者は、当該被保険者の資格に係る事実の確認のため、厚生労働省令で定めるところにより、後期高齢者医療広域連合に対し、当該事実を記載した書面の交付又は当該書面に記載すべき事項の電磁的方法による提供を求めることができる。この場合において、当該後期高齢者医療広域連合は、厚生労働省令で定めるところにより、当該書面の交付の求めを行つた被保険者に対しては当該書面を交付するものとし、当該電磁的方法による提供の求めを行つた被保険者に対しては当該書面に記載すべき事項を電磁的方法により提供するものとする。
If a notification under Articles 22 through 24, Article 25, Article 30-46, or Article 30-47 of the Act for Basic Register of Residents (Act No. 81 of 1967) has been filed (but only if a supplementary note under Article 28-2 of that Act has been added to a document connected with that notification), the notification under paragraph (1) is deemed to have been filed based on the same grounds as the notification.
Beyond what is provided for in the preceding paragraphs, matters necessary for notification concerning insured and confirmation concerning the qualifications of insured are specified by Order of the Ministry of Health, Labour and Welfare.
前各項に規定するもののほか、被保険者に関する届出及び被保険者の資格に関する確認に関して必要な事項は、厚生労働省令で定める。
Article 55Special Provisions for insured During Hospitalization, Admission or Occupancy in Hospitals
第五十五条（病院等に入院、入所又は入居中の被保険者の特例）
An insured who is found to have changed the insured's address to the place where a hospital, clinic or facility prescribed in the following items (hereinafter in this Article referred to as the "hospital, etc.") is located as a result of the hospitalization, admission or occupancy listed in the following items (hereinafter in this Article referred to as "hospitalization, etc.") (excluding a person who is deemed to be an insured for old-old medical care provided by the Association of Medical Care Systems for the Elderly Aged 75 and older of the previous domicile prescribed in paragraph (1) of the following Article pursuant to the provisions of that paragraph), and who is found to have had an address within the area of another Association of Medical Care Systems for the Elderly Aged 75 and older (meaning an Association of Medical Care Systems for the Elderly Aged 75 and older other than the Association of Medical Care Systems for the Elderly Aged 75 and older in whose area the hospital, etc. is located) at the time of the hospitalization, etc. in the hospital, etc., is, notwithstanding the provisions of Article 50, to be an insured for old-old medical care provided by that other Association of Medical Care Systems for the Elderly Aged 75 and older; provided, however, that this does not apply to an insured who is continuously hospitalized, etc. in two or more hospitals, etc. and who is found, as a result of being hospitalized, etc. in both the hospital, etc. in which the insured is currently hospitalized, etc. (hereinafter in this Article referred to as the "current hospital, etc.") and the hospital, etc. in which the insured was hospitalized, etc. immediately before being hospitalized, etc. in the current hospital, etc. (hereinafter in this paragraph referred to as the "last hospital, etc."), to have sequentially changed the insured's address to the places where the last hospital, etc. and the current hospital, etc. are respectively located (referred to as a "specified continuously hospitalized insured person" in the following paragraph).
次の各号に掲げる入院、入所又は入居（以下この条において「入院等」という。）をしたことにより、当該各号に規定する病院、診療所又は施設（以下この条において「病院等」という。）の所在する場所に住所を変更したと認められる被保険者（次条第一項の規定により同項に規定する従前住所地後期高齢者医療広域連合が行う後期高齢者医療の被保険者とされる者を除く。）であつて、当該病院等に入院等をした際他の後期高齢者医療広域連合（当該病院等が所在する後期高齢者医療広域連合以外の後期高齢者医療広域連合をいう。）の区域内に住所を有していたと認められるものは、第五十条の規定にかかわらず、当該他の後期高齢者医療広域連合が行う後期高齢者医療の被保険者とする。ただし、二以上の病院等に継続して入院等をしている被保険者であつて、現に入院等をしている病院等（以下この条において「現入院病院等」という。）に入院等をする直前に入院等をしていた病院等（以下この項において「直前入院病院等」という。）及び現入院病院等のそれぞれに入院等をしたことにより直前入院病院等及び現入院病院等のそれぞれの所在する場所に順次住所を変更したと認められるもの（次項において「特定継続入院等被保険者」という。）については、この限りでない。
admission to a hospital or clinic;
病院又は診療所への入院
admission to a Support Facility for Persons with Disabilities prescribed in Article 5, paragraph (11) of the Act on Providing Comprehensive Support for the Daily Life and Life in Society of Persons with Disabilities (Act No. 123 of 2005) or a facility specified by order of the competent ministry as referred to in paragraph (1) of that Article;
障害者の日常生活及び社会生活を総合的に支援するための法律（平成十七年法律第百二十三号）第五条第十一項に規定する障害者支援施設又は同条第一項の主務省令で定める施設への入所
admission to a facility established by the National Center for Persons with Severe Intellectual Disabilities, "Nozominosono," Independent Administrative Agency pursuant to the provisions of Article 11, item (i) of the Act on the National Center for Persons with Severe Intellectual Disabilities, "Nozominosono," Independent Administrative Agency (Act No. 167 of 2002);
独立行政法人国立重度知的障害者総合施設のぞみの園法（平成十四年法律第百六十七号）第十一条第一号の規定により独立行政法人国立重度知的障害者総合施設のぞみの園の設置する施設への入所
admission to a nursing home for the elderly or an intensive care home for the elderly as prescribed in Article 20-4 or 20-5 of the Act on Social Welfare for the Elderly (Act No. 133 of 1963) (limited to the case where admission measures pursuant to the provisions of Article 11, paragraph (1), item (i) or (ii) of the same Act have been taken);
老人福祉法（昭和三十八年法律第百三十三号）第二十条の四又は第二十条の五に規定する養護老人ホーム又は特別養護老人ホームへの入所（同法第十一条第一項第一号又は第二号の規定による入所措置が採られた場合に限る。）
residence in a specified facility prescribed in Article 8, paragraph (11) of the Long-Term Care Insurance Act or admission to a long-term care insurance facility prescribed in paragraph (25) of that Article.
介護保険法第八条第十一項に規定する特定施設への入居又は同条第二十五項に規定する介護保険施設への入所
Notwithstanding the provisions of Article 50, an insured for specified continuous hospitalization, etc. that is set forth in each of the following items is an insured for late-stage elderly medical care provided by a Association of Medical Care Systems for the Elderly Aged 75 and older specified in each of the following items:
特定継続入院等被保険者のうち、次の各号に掲げるものは、第五十条の規定にかかわらず、当該各号に定める後期高齢者医療広域連合が行う後期高齢者医療の被保険者とする。
an insured whose address is found to have been sequentially changed to the location of two or more hospitals, etc., due to the fact that the person was hospitalized, etc. in each of the hospitals, etc., continuously, and who is found to have been domiciled in the area of another Association of Medical Care Systems for the Elderly Aged 75 and older (meaning a Association of Medical Care Systems for the Elderly Aged 75 and older other than the Association of Medical Care Systems for the Elderly Aged 75 and older where the current hospital, etc. is located) at the time of the hospitalization, etc. in the first of the two or more hospitals, etc.:the relevant other Association of Medical Care Systems for the Elderly Aged 75 and older;
継続して入院等をしている二以上の病院等のそれぞれに入院等をすることによりそれぞれの病院等の所在する場所に順次住所を変更したと認められる被保険者であつて、当該二以上の病院等のうち最初の病院等に入院等をした際他の後期高齢者医療広域連合（現入院病院等が所在する後期高齢者医療広域連合以外の後期高齢者医療広域連合をいう。）の区域内に住所を有していたと認められるもの 当該他の後期高齢者医療広域連合
an insured that is found to have changed its address from a place other than the location of one of the two or more hospitals, etc. in which the relevant person has been continuously hospitalized, etc. to a place where the relevant other hospital, etc. is located (hereinafter referred to as a "specified change of address" in this item) as a result of being continuously hospitalized, etc. from one of the hospitals, etc. to another (hereinafter referred to as "continuous hospitalization, etc." in this item), and that is found to have been domiciled in the area of another Association of Medical Care Systems for the Elderly Aged 75 and older (meaning a Association of Medical Care Systems for the Elderly Aged 75 and older other than the Association of Medical Care Systems for the Elderly Aged 75 and older where the current hospital, etc. is located) at the time of the last specified change of address pertaining to continuous hospitalization, etc.:the relevant other Association of Medical Care Systems for the Elderly Aged 75 and older.
継続して入院等をしている二以上の病院等のうち一の病院等から継続して他の病院等に入院等をすること（以下この号において「継続入院等」という。）により当該一の病院等の所在する場所以外の場所から当該他の病院等の所在する場所への住所の変更（以下この号において「特定住所変更」という。）を行つたと認められる被保険者であつて、最後に行つた特定住所変更に係る継続入院等の際他の後期高齢者医療広域連合（現入院病院等が所在する後期高齢者医療広域連合以外の後期高齢者医療広域連合をいう。）の区域内に住所を有していたと認められるもの 当該他の後期高齢者医療広域連合
Hospitals, etc. in which an insured to which the provisions of the preceding two paragraphs are applied is Hospitalized, etc. must provide necessary cooperation to the Association of Medical Care Systems for the Elderly Aged 75 and older where the Hospitals, etc. are located and the Association of Medical Care Systems for the Elderly Aged 75 and older which provides Old-Old Healthcare to the insured.
前二項の規定の適用を受ける被保険者が入院等をしている病院等は、当該病院等の所在する後期高齢者医療広域連合及び当該被保険者に対し後期高齢者医療を行う後期高齢者医療広域連合に、必要な協力をしなければならない。
第五十五条の二（国民健康保険法第百十六条の二の規定の適用を受ける者の特例）
When an insured of National Health Insurance to whom Article 116-2, paragraphs (1) and (2) of the National Health Insurance Act apply, and who has an address within the area of an Association of Medical Care Systems for the Elderly Aged 75 and older other than the Association of Medical Care Systems for the Elderly Aged 75 and older to which the municipality in which the insured is deemed to have an address pursuant to those provisions (hereinafter in this paragraph referred to as the "municipality of the previous domicile") belongs (in the case of item (ii), limited to a person who is 65 years of age or older and less than 75 years of age), comes to fall under any of the following items, the person is, notwithstanding the provisions of Article 50, to be an insured for old-old medical care provided by the Association of Medical Care Systems for the Elderly Aged 75 and older to which the municipality of the previous domicile belongs (referred to as the "Association of Medical Care Systems for the Elderly Aged 75 and older of the previous domicile" in item (ii) and the following paragraph). In this case, notwithstanding the provisions of Article 52, the insured acquires the qualification from the day on which the insured comes to fall under any of those items.
国民健康保険法第百十六条の二第一項及び第二項の規定の適用を受ける国民健康保険の被保険者であつて、これらの規定により住所を有するものとみなされた市町村（以下この項において「従前住所地市町村」という。）の加入する後期高齢者医療広域連合以外の後期高齢者医療広域連合の区域内に住所を有する者（第二号の場合においては、六十五歳以上七十五歳未満の者に限る。）が、次の各号のいずれかに該当するに至つた場合は、第五十条の規定にかかわらず、従前住所地市町村の加入する後期高齢者医療広域連合（第二号及び次項において「従前住所地後期高齢者医療広域連合」という。）が行う後期高齢者医療の被保険者とする。この場合において、当該被保険者は、第五十二条の規定にかかわらず、当該各号のいずれかに該当するに至つた日から、その資格を取得する。
when the person has reached 75 years of age;
七十五歳に達したとき。
if the person has been certified by the Association of Medical Care Systems for the Elderly Aged 75 and older of the previous domicile as having a disability of a degree of severity specified by Cabinet Order as referred to in Article 50, item (ii), pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare.
厚生労働省令で定めるところにより、第五十条第二号の政令で定める程度の障害の状態にある旨の従前住所地後期高齢者医療広域連合の認定を受けたとき。
The provisions of the preceding Article apply mutatis mutandis to a person who is deemed to be an insured for Old-Old Healthcare provided by the Association of Medical Care Systems for the Elderly Aged 75 and older of the Previous Domicile pursuant to the provisions of the preceding paragraph. In this case, the necessary technical replacement of terms is specified by Cabinet Order.
前条の規定は、前項の規定により従前住所地後期高齢者医療広域連合が行う後期高齢者医療の被保険者とされる者について準用する。この場合において、必要な技術的読替えは、政令で定める。
Section 3 Old-Old Age medical care benefit
第三節 後期高齢者医療給付
Subsection 1 General Rules
第一款 通則
Article 56Types of medical care benefit for Old-Old Persons
第五十六条（後期高齢者医療給付の種類）
The benefits under this Act pertaining to an insured (hereinafter referred to as an "old-old medical care benefit") are as follows:
被保険者に係るこの法律による給付（以下「後期高齢者医療給付」という。）は、次のとおりとする。
benefits for medical treatment, and payment of dietary treatment expenses for inpatients, living support expenses for inpatients, medical expenses combined with treatment outside insurance coverage, medical expenses, medical expenses for home-nursing, special medical expenses, and transport expenses;
療養の給付並びに入院時食事療養費、入院時生活療養費、保険外併用療養費、療養費、訪問看護療養費、特別療養費及び移送費の支給
payment of high-cost medical expenses and Sizable medical and nursing expenses;
高額療養費及び高額介護合算療養費の支給
beyond what is set forth in the preceding two items, benefits provided pursuant to the provisions of Ordinance of the Association of Medical Care Systems for the Elderly Aged 75 and older.
前二号に掲げるもののほか、後期高齢者医療広域連合の条例で定めるところにより行う給付
第五十七条（他の法令による医療に関する給付との調整）
The provision of benefits for medical treatment, or the payment of dietary treatment expenses for inpatients, living support expenses for inpatients, medical expenses combined with treatment outside insurance coverage, medical expenses, medical expenses for home-nursing, special medical expenses or transport expenses, is not made in the case where the insured is able to receive, for the relevant illness or injury, benefits related to medical care based on laws and regulations such as medical compensation benefits, medical benefits for multiple-business workers or medical benefits under the provisions of the Industrial Accident Compensation Insurance Act (Act No. 50 of 1947), medical compensation under the provisions of the National Public Officers' Accident Compensation Act (Act No. 191 of 1951; including as applied mutatis mutandis pursuant to other Acts), medical compensation under the provisions of the Local Public Officers Accident Compensation Act (Act No. 121 of 1967) or a Prefectural or Municipal Ordinance based on that Act, or other laws and regulations specified by Cabinet Order, in the case where the insured is able to receive benefits equivalent to the respective benefits pursuant to the provisions of the Long-Term Care Insurance Act, or in the case where benefits related to medical care have been provided at the expense of the national government or a local government under laws and regulations other than these.
療養の給付又は入院時食事療養費、入院時生活療養費、保険外併用療養費、療養費、訪問看護療養費、特別療養費若しくは移送費の支給は、被保険者の当該疾病又は負傷につき、労働者災害補償保険法（昭和二十二年法律第五十号）の規定による療養補償給付、複数事業労働者療養給付若しくは療養給付、国家公務員災害補償法（昭和二十六年法律第百九十一号。他の法律において準用する場合を含む。）の規定による療養補償、地方公務員災害補償法（昭和四十二年法律第百二十一号）若しくは同法に基づく条例の規定による療養補償その他政令で定める法令に基づく医療に関する給付を受けることができる場合、介護保険法の規定によつて、それぞれの給付に相当する給付を受けることができる場合又はこれらの法令以外の法令により国若しくは地方公共団体の負担において医療に関する給付が行われた場合には、行わない。
If benefits under a law or regulation as prescribed in the preceding paragraph are benefits in kind related to medical care, and co-payment or collection of actual costs has been made for the benefits and the amount of co-payment or collection of actual costs exceeds the amount of co-payment under this Act if the benefits are considered to have been provided as benefits for medical treatment under this Act, or if benefits under a law or regulation as prescribed in the same paragraph (excluding the Long-Term Care Insurance Act) are payment of medical expenses and the amount paid is less than the amount of dietary treatment expenses for inpatients, living support expenses for inpatients, medical expenses combined with treatment outside insurance coverage, medical expenses, medical expenses for home-nursing, special medical expenses, or transport expenses if dietary treatment expenses for inpatients, living support expenses for inpatients, medical expenses combined with treatment outside insurance coverage, medical expenses, medical expenses for home-nursing, special medical expenses, or transport expenses are to be paid for the medical treatment under this Act, the Association of Medical Care Systems for the Elderly Aged 75 and older must pay the difference between those amounts to the insured.
後期高齢者医療広域連合は、前項に規定する法令による給付が医療に関する現物給付である場合において、その給付に関し一部負担金の支払若しくは実費徴収が行われ、かつ、その一部負担金若しくは実費徴収の額が、その給付がこの法律による療養の給付として行われたものとした場合におけるこの法律による一部負担金の額を超えるとき、又は同項に規定する法令（介護保険法を除く。）による給付が医療費の支給である場合において、その支給額が、当該療養につきこの法律による入院時食事療養費、入院時生活療養費、保険外併用療養費、療養費、訪問看護療養費、特別療養費又は移送費の支給をすべきものとした場合における入院時食事療養費、入院時生活療養費、保険外併用療養費、療養費、訪問看護療養費、特別療養費又は移送費の額に満たないときは、それぞれその差額を当該被保険者に支給しなければならない。
In the case referred to in the preceding paragraph, when an insured receives the medical treatment at a medical institution providing services covered by health insurance, etc. (meaning a medical institution providing services covered by health insurance prescribed in Article 63, paragraph (3), item (i) of the Health Insurance Act (hereinafter referred to as a "medical institution providing services covered by health insurance") or pharmacies providing services covered by health insurance; the same applies hereinafter), the Association of Medical Care Systems for the Elderly Aged 75 and older may, on behalf of the insured, pay to the medical institution providing services covered by health insurance, etc. the expenses required for the medical treatment payable by the insured to the medical institution providing services covered by health insurance, etc., within the limit of the amount payable to the insured pursuant to the provisions of the preceding paragraph.
前項の場合において、被保険者が保険医療機関等（健康保険法第六十三条第三項第一号に規定する保険医療機関（以下「保険医療機関」という。）又は保険薬局をいう。以下同じ。）について当該療養を受けたときは、後期高齢者医療広域連合は、前項の規定により被保険者に支給すべき額の限度において、当該被保険者が保険医療機関等に支払うべき当該療養に要した費用を、当該被保険者に代わつて保険医療機関等に支払うことができる。
When expenses have been paid to a medical institution providing services covered by health insurance, etc. pursuant to the provisions of the preceding paragraph, the payment under paragraph (2) is deemed to have been made to insured to the extent of the payment.
Article 58Right to Claim Damages
第五十八条（損害賠償請求権）
When the Association of Medical Care Systems for the Elderly Aged 75 and older has provided an old-old medical care benefit (including payment of the difference under the provisions of paragraph (2) of the preceding Article; the same applies hereinafter) in the case where the grounds for the benefit arose from an act of a third party, it acquires the insured's right to claim damages against the third party to the extent of the value of that old-old medical care benefit (where that old-old medical care benefit is benefits for medical treatment, the amount obtained by deducting from the amount of expenses required for those benefits for medical treatment the amount equivalent to the co-payment that the insured must bear in relation to those benefits for medical treatment; the same applies in paragraph (1) of the following Article).
後期高齢者医療広域連合は、給付事由が第三者の行為によつて生じた場合において、後期高齢者医療給付（前条第二項の規定による差額の支給を含む。以下同じ。）を行つたときは、その後期高齢者医療給付の価額（当該後期高齢者医療給付が療養の給付であるときは、当該療養の給付に要する費用の額から当該療養の給付に関し被保険者が負担しなければならない一部負担金に相当する額を控除した額。次条第一項において同じ。）の限度において、被保険者が第三者に対して有する損害賠償の請求権を取得する。
In the case referred to in the preceding paragraph, if a person who is to receive an old-old medical care benefit has received compensation for loss or damage from a third party for the same reason, the Association of Medical Care Systems for the Elderly Aged 75 and older is exempt from the responsibility to provide the old-old medical care benefit to the extent of the amount of the compensation.
前項の場合において、後期高齢者医療給付を受けるべき者が第三者から同一の事由について損害賠償を受けたときは、後期高齢者医療広域連合は、その価額の限度において、後期高齢者医療給付を行う責めを免れる。
A Association of Medical Care Systems for the Elderly Aged 75 and older may entrust its affairs concerning the collection or receipt of compensation for damage pertaining to the right to claim acquired pursuant to the provisions of paragraph (1) to a federation of national health insurance associations specified by Order of the Ministry of Health, Labour and Welfare.
後期高齢者医療広域連合は、第一項の規定により取得した請求権に係る損害賠償金の徴収又は収納の事務を国保連合会であつて厚生労働省令で定めるものに委託することができる。
Article 59Collection of Fraudulent Gains
第五十九条（不正利得の徴収等）
If a person receives an old-old medical care benefit by deception or other wrongful acts, the Association of Medical Care Systems for the Elderly Aged 75 and older may collect all or part of the value of the old-old medical care benefit from that person.
偽りその他不正の行為によつて後期高齢者医療給付を受けた者があるときは、後期高齢者医療広域連合は、その者からその後期高齢者医療給付の価額の全部又は一部を徴収することができる。
In the case referred to in the preceding paragraph, when a physician providing health insurance treatment at a medical institution providing services covered by health insurance or an attending physician as prescribed in Article 78, paragraph (1) has made a false entry on a written diagnosis to be submitted to the Association of Medical Care Systems for the Elderly Aged 75 and older, and as a result, the late-stage elderly medical care benefit has been provided, the Association of Medical Care Systems for the Elderly Aged 75 and older may order the physician providing health insurance treatment or the attending physician to pay the money to be collected pursuant to the preceding paragraph jointly and severally with the person who has received the late-stage elderly medical care benefit.
When a medical institution providing services covered by health insurance, etc. or a designated home-nursing provider (meaning the designated home-nursing provider prescribed in Article 88, paragraph (1) of the Health Insurance Act; the same applies hereinafter) has received, by deception or other wrongful acts, any payment of expenses relating to benefits for medical treatment or any payment pursuant to the provisions of Article 74, paragraph (5) (including as applied mutatis mutandis pursuant to Article 75, paragraph (7), Article 76, paragraph (6), and Article 78, paragraph (8)), the Association of Medical Care Systems for the Elderly Aged 75 and older may have the medical institution providing services covered by health insurance, etc. or the designated home-nursing provider return the amount so paid and, in addition, pay the amount obtained by multiplying the amount to be returned by forty one hundredth (40 / 100).
後期高齢者医療広域連合は、保険医療機関等又は指定訪問看護事業者（健康保険法第八十八条第一項に規定する指定訪問看護事業者をいう。以下同じ。）が偽りその他不正の行為によつて療養の給付に関する費用の支払又は第七十四条第五項（第七十五条第七項、第七十六条第六項及び第七十八条第八項において準用する場合を含む。）の規定による支払を受けたときは、当該保険医療機関等又は指定訪問看護事業者に対し、その支払つた額につき返還させるほか、その返還させる額に百分の四十を乗じて得た額を支払わせることができる。
Article 60Submission of Documents
第六十条（文書の提出等）
If a Association of Medical Care Systems for the Elderly Aged 75 and older finds it necessary in relation to an old-old medical care benefit, it may order the insured, the person who used to be the insured, or the person who receives an old-old medical care benefit to submit or present documents or other objects, or may have its personnel question or diagnose the person.
後期高齢者医療広域連合は、後期高齢者医療給付に関して必要があると認めるときは、当該被保険者若しくは被保険者であつた者又は後期高齢者医療給付を受ける者に対し、文書その他の物件の提出若しくは提示を命じ、又は当該職員に質問若しくは診断をさせることができる。
Article 61Presentation of Medical Records
第六十一条（診療録の提示等）
The Minister of Health, Labour and Welfare or the prefectural governor, when finding it necessary in relation to a medical care benefit for the old-old, may order physicians, dentists, pharmacists, or persons who provided medical care or those who employ them to make a report or present medical records, books and documents, and other objects, or may have their personnel question them, with regard to the medical care, provision of drugs, or medical treatment provided by them.
厚生労働大臣又は都道府県知事は、後期高齢者医療給付に関して必要があると認めるときは、医師、歯科医師、薬剤師若しくは手当を行つた者又はこれを使用する者に対し、その行つた診療、薬剤の支給又は手当に関し、報告若しくは診療録、帳簿書類その他の物件の提示を命じ、又は当該職員に質問させることができる。
The Minister of Health, Labour and Welfare or the prefectural governor may, when finding it necessary, order an insured or a former insured that received payment of benefits for medical treatment, or expenses for dietary treatment for inpatients, expenses for living support for inpatients, medical expenses combined with treatment outside insurance coverage, medical expenses, medical expenses for home-nursing, or special medical expenses to make a report or have their official ask questions about the content of medical care, prescription or designated home-nursing pertaining to the payment of the benefits for medical treatment, or expenses for dietary treatment for inpatients, expenses for living support for inpatients, medical expenses combined with treatment outside insurance coverage, medical expenses, medical expenses for home-nursing, or special medical expenses.
厚生労働大臣又は都道府県知事は、必要があると認めるときは、療養の給付又は入院時食事療養費、入院時生活療養費、保険外併用療養費、療養費、訪問看護療養費若しくは特別療養費の支給を受けた被保険者又は被保険者であつた者に対し、当該療養の給付若しくは入院時食事療養費、入院時生活療養費、保険外併用療養費、療養費、訪問看護療養費若しくは特別療養費の支給に係る診療、調剤又は指定訪問看護の内容に関し、報告を命じ、又は当該職員に質問させることができる。
The provisions of Article 16-7, paragraph (2) apply mutatis mutandis to questions pursuant to the provisions of the preceding two paragraphs, and the provisions of paragraph (3) of the same Article apply mutatis mutandis to the authority granted pursuant to the provisions of the preceding two paragraphs.
The right to receive an old-old medical care benefit may not be transferred, pledged as collateral, or levied.
後期高齢者医療給付を受ける権利は、譲り渡し、担保に供し、又は差し押さえることができない。
Article 63Prohibition of Taxation and Other Public Charges
第六十三条（租税その他の公課の禁止）
Taxes and other public charges may not be imposed on the basis of money and goods received as payment as a medical care benefit for Old-Old Age.
租税その他の公課は、後期高齢者医療給付として支給を受けた金品を標準として、課することができない。
Subsection 2 Benefits for Medical Treatment and Payment of Dietary Treatment Expenses for Inpatients
第二款 療養の給付及び入院時食事療養費等の支給
Division 1 Benefits for Medical Treatment, and Payment of Dietary Treatment Expenses for Inpatients, Living Support Expenses for Inpatients, Medical Expenses Combined with Treatment Outside Insurance Coverage, and Medical Expenses
第一目 療養の給付並びに入院時食事療養費、入院時生活療養費、保険外併用療養費及び療養費の支給
Article 64Benefits for Medical Treatment
第六十四条（療養の給付）
A Association of Medical Care Systems for the Elderly Aged 75 and older provides the following benefits for medical treatment with respect to sickness and injury of an insured; provided, however, that this does not apply during any period to which the provisions of Article 82, paragraph (1) or the main clause of paragraph (2) of the same Article apply to the insured:
後期高齢者医療広域連合は、被保険者の疾病又は負傷に関しては、次に掲げる療養の給付を行う。ただし、当該被保険者が第八十二条第一項又は第二項本文の規定の適用を受けている間は、この限りでない。
medical examination;
診察
provision of medicines or treatment materials;
薬剤又は治療材料の支給
treatment, surgery, or other medical treatment;
処置、手術その他の治療
management of in-home medical treatment and care and other nursing involved in the medical treatment;
居宅における療養上の管理及びその療養に伴う世話その他の看護
admission to a hospital or clinic, and care and other nursing incidental to medical treatment there.
病院又は診療所への入院及びその療養に伴う世話その他の看護
Benefits for the following medical treatment are not to be included in the benefits referred to in the preceding paragraph:
次に掲げる療養に係る給付は、前項の給付に含まれないものとする。
medical treatment consisting of the provision of meals, which is provided in combination with the medical treatment listed in item (v) of the preceding paragraph (excluding hospitalization in a sanatorium ward provided for in Article 7, paragraph (2), item (iv) of the Medical Care Act and care and other nursing incidental to the medical treatment (hereinafter referred to as "long-term hospitalization and medical treatment")) (hereinafter referred to as "dietary treatment");
食事の提供である療養であつて前項第五号に掲げる療養（医療法第七条第二項第四号に規定する療養病床への入院及びその療養に伴う世話その他の看護（以下「長期入院療養」という。）を除く。）と併せて行うもの（以下「食事療養」という。）
the following types of medical treatment given in combination with the type of medical treatment listed in item (v) of the preceding paragraph (limited to long-term inpatient treatment) (hereinafter referred to as "living support"):
medical treatment consisting of the provision of meals;
食事の提供である療養
medical treatment consisting of the creation of an appropriate environment for medical treatment in terms of temperature, lighting and water supply;
温度、照明及び給水に関する適切な療養環境の形成である療養
medical treatment using advanced medical care techniques specified by the Minister of Health, Labour and Welfare and other medical treatment specified by the Minister of Health, Labour and Welfare as medical treatment for which it is necessary to evaluate whether or not it should be subject to the benefits referred to in the preceding paragraph from the viewpoint of efficiently providing appropriate medical care (excluding patient-requested treatment referred to in the following item) (hereinafter referred to as "evaluation treatment");
medical treatment using advanced medical technology, which is specified by the Minister of Health, Labour and Welfare as medical treatment for which it is necessary to evaluate, from the viewpoint of efficiently providing appropriate medical care, whether or not it should be subject to benefits as set forth in the preceding paragraph, based on a request from a person who intends to receive the medical treatment (hereinafter referred to as "patient-requested treatment");
高度の医療技術を用いた療養であつて、当該療養を受けようとする者の申出に基づき、前項の給付の対象とすべきものであるか否かについて、適正な医療の効率的な提供を図る観点から評価を行うことが必要な療養として厚生労働大臣が定めるもの（以下「患者申出療養」という。）
the provision of a special sickroom pertaining to the selection of an insured and other medical treatment specified by the Minister of Health, Labour and Welfare (hereinafter referred to as "selective treatment").
被保険者の選定に係る特別の病室の提供その他の厚生労働大臣が定める療養（以下「選定療養」という。）
When an insured intends to receive the benefits under paragraph (1), the insured is to receive confirmation of being an insured and receive the benefits under paragraph (1) from a medical institution providing services covered by health insurance, etc. of the insured's own choosing, by electronic eligibility confirmation (meaning that a person who intends to receive medical treatment from a medical institution providing services covered by health insurance, etc. or to receive designated home-nursing prescribed in Article 78, paragraph (1) from a designated home-nursing provider makes an inquiry to the Association of Medical Care Systems for the Elderly Aged 75 and older about information pertaining to the status of the insured (including information necessary for claiming expenses related to insurance benefits), by a method of transmitting the electronic certificate for user certification (meaning the electronic certificate for user certification prescribed in Article 22, paragraph (1) of the Act on Certification Business of the Japan Agency for Local Authority Information Systems in Relation to Electronic Signatures, etc. (Act No. 153 of 2002)) recorded on the Individual Number Card (meaning the Individual Number Card prescribed in Article 2, paragraph (7) of the Act on the Use of Numbers to Identify a Specific Individual in Administrative Procedures (Act No. 27 of 2013)) or by any other method specified by Order of the Ministry of Health, Labour and Welfare, and, by a method using an electronic data processing system or any other method using information and communications technology, receives a reply from the Association of Medical Care Systems for the Elderly Aged 75 and older, provides that information to the medical institution providing services covered by health insurance, etc. or the designated home-nursing provider, and receives confirmation of being an insured from the medical institution providing services covered by health insurance, etc. or the designated home-nursing provider; the same applies hereinafter) or by any other method specified by Order of the Ministry of Health, Labour and Welfare (hereinafter referred to as "electronic eligibility confirmation, etc."); provided, however, that when the case falls under a case specified by Order of the Ministry of Health, Labour and Welfare, the insured need not receive that confirmation.
被保険者が第一項の給付を受けようとするときは、自己の選定する保険医療機関等から、電子資格確認（保険医療機関等から療養を受けようとする者又は指定訪問看護事業者から第七十八条第一項に規定する指定訪問看護を受けようとする者が、後期高齢者医療広域連合に対し、個人番号カード（行政手続における特定の個人を識別するための番号の利用等に関する法律（平成二十五年法律第二十七号）第二条第七項に規定する個人番号カードをいう。）に記録された利用者証明用電子証明書（電子署名等に係る地方公共団体情報システム機構の認証業務に関する法律（平成十四年法律第百五十三号）第二十二条第一項に規定する利用者証明用電子証明書をいう。）を送信する方法その他の厚生労働省令で定める方法により、被保険者の資格に係る情報（保険給付に係る費用の請求に必要な情報を含む。）の照会を行い、電子情報処理組織を使用する方法その他の情報通信の技術を利用する方法により、後期高齢者医療広域連合から回答を受けて当該情報を当該保険医療機関等又は指定訪問看護事業者に提供し、当該保険医療機関等又は指定訪問看護事業者から被保険者であることの確認を受けることをいう。以下同じ。）その他厚生労働省令で定める方法（以下「電子資格確認等」という。）により、被保険者であることの確認を受け、第一項の給付を受けるものとする。ただし、厚生労働省令で定める場合に該当するときは、当該確認を受けることを要しない。
The request referred to in paragraph (2), item (iv) is to be made to the Minister of Health, Labour and Welfare, pursuant to the provisions of the Minister of Health, Labour and Welfare, by attaching a written opinion of the establisher of the core hospital for clinical research prescribed in Article 4-3 of the Medical Care Act (limited to medical institutions providing services covered by health insurance) which provides the medical treatment pertaining to the request and other necessary documents.
If the Minister of Health, Labour and Welfare receives a request referred to in paragraph (2), item (iv), the Minister is to promptly review the request, and if the medical treatment related to the request is found to be that which requires the evaluation referred to in the same item, the Minister is to specify the medical treatment as patient-requested treatment.
If the Minister of Health, Labour and Welfare has determined that the medical treatment pertaining to the application prescribed in paragraph (2), item (iv) pursuant to the provisions of the preceding paragraph is patient-requested treatment, the Minister is to promptly notify the person who has made the application to that effect.
If the Minister of Health, Labour and Welfare has reviewed the request referred to in paragraph (2), item (iv) pursuant to the provisions of paragraph (5) and has determined that the medical treatment pertaining to the request is not to be specified as patient-requested treatment, the Minister is to promptly notify the person who has made the request to that effect by giving the reason.
A medical institution providing services covered by health insurance, etc. or a physician providing health insurance treatment, etc. (meaning a physician providing health insurance treatment or pharmacist filling health insurance prescriptions as prescribed in Article 64 of the Health Insurance Act; the same applies hereinafter) must handle or take charge of medical treatment benefits for medical care for elderly people in accordance with the standards for handling and taking charge of medical treatment benefits as set forth in Article 71, paragraph (1).
保険医療機関等又は保険医等（健康保険法第六十四条に規定する保険医又は保険薬剤師をいう。以下同じ。）は、第七十一条第一項の療養の給付の取扱い及び担当に関する基準に従い、後期高齢者医療の療養の給付を取り扱い、又は担当しなければならない。
Article 66Guidance by the Minister of Health, Labour and Welfare or Prefectural Governors
第六十六条（厚生労働大臣又は都道府県知事の指導）
Guidance by the Minister of Health, Labour and Welfare or the prefectural governor must be received by Health Insurance-Covered Medical Institutions, etc. with regard to benefits for medical treatment, and by Health Insurance-Covered Physicians, etc. with regard to medical care or prescription of Old-Old Healthcare.
The Minister of Health, Labour and Welfare or the prefectural governor, when providing the guidance prescribed in the preceding paragraph and finding it necessary, is to have a person with relevant expertise related to medical care or prescription services attend in accordance with the designation by the relevant organization; provided, however, that this does not apply when the relevant organization makes no designation or when the designated person does not attend.
厚生労働大臣又は都道府県知事は、前項の指導をする場合において、必要があると認めるときは、診療又は調剤に関する学識経験者をその関係団体の指定により立ち会わせるものとする。ただし、関係団体が指定を行わない場合又は指定された者が立ち会わない場合は、この限りでない。
第六十七条（一部負担金）
A person who receives benefits for medical treatment from a medical institution providing services covered by health insurance, etc. pursuant to the provisions of Article 64, paragraph (3) must, when receiving those benefits, pay to that medical institution providing services covered by health insurance, etc., as a co-payment, the amount obtained by multiplying the amount calculated for those benefits in accordance with the standards for calculating the amount of expenses required for benefits for medical treatment under Article 70, paragraph (2) or Article 71, paragraph (1) by the ratio specified in the relevant item, in accordance with the category of cases listed in the following items.
in cases other than the cases set forth in the following item and item (iii):ten percent;
if the amount of income calculated pursuant to Cabinet Order for a person receiving benefits for medical treatment or for an insured or other person specified by Cabinet Order who is another Household Member of the household to which the person belongs is not less than the amount specified by Cabinet Order (other than in the case set forth in the following item):20 percent;
当該療養の給付を受ける者又はその属する世帯の他の世帯員である被保険者その他政令で定める者について政令で定めるところにより算定した所得の額が政令で定める額以上である場合（次号に掲げる場合を除く。） 百分の二十
in the case where the amount of income calculated as specified by Cabinet Order for a person receiving the relevant benefits for medical treatment, or for an insured or other person specified by Cabinet Order who is another Household Member of the household to which that person belongs, is not less than the amount specified by Cabinet Order that exceeds the amount specified by Cabinet Order in the preceding item: 30 percent.
当該療養の給付を受ける者又はその属する世帯の他の世帯員である被保険者その他政令で定める者について政令で定めるところにより算定した所得の額が前号の政令で定める額を超える政令で定める額以上である場合 百分の三十
A medical institution providing services covered by health insurance, etc. is to receive payment of the co-payment under the preceding paragraph (where a measure under Article 69, paragraph (1), item (i) has been taken, the reduced co-payment), and if, despite the medical institution providing services covered by health insurance, etc. having endeavored to receive that payment with the same care as a good administrator, the insured still fails to pay all or part of the co-payment, the Association of Medical Care Systems for the Elderly Aged 75 and older may, upon the request of that medical institution providing services covered by health insurance, etc., dispose of it in the same manner as money to be collected pursuant to the provisions of this Act.
保険医療機関等は、前項の一部負担金（第六十九条第一項第一号の措置が採られたときは、当該減額された一部負担金とする。）の支払を受けるべきものとし、保険医療機関等が善良な管理者と同一の注意をもつてその支払を受けることに努めたにもかかわらず、なお被保険者が当該一部負担金の全部又は一部を支払わないときは、後期高齢者医療広域連合は、当該保険医療機関等の請求に基づき、この法律の規定による徴収金の例によりこれを処分することができる。
第六十八条
In the case of making co-payment pursuant to the provisions of paragraph (1) of the preceding Article, if the amount of co-payment includes a fraction less than five yen, the fraction is to be rounded down, and if the amount includes a fraction not less than five yen but less than ten yen, the fraction is to be rounded up to the nearest ten yen.
前条第一項の規定により一部負担金を支払う場合においては、当該一部負担金の額に五円未満の端数があるときは、これを切り捨て、五円以上十円未満の端数があるときは、これを十円に切り上げるものとする。
第六十九条
The Association of Medical Care Systems for the Elderly Aged 75 and older may take the following measures with respect to an insured who has special circumstances, such as a disaster, specified by Order of the Ministry of Health, Labour and Welfare and who is found to have difficulty paying the co-payment under Article 67, paragraph (1) to a medical institution providing services covered by health insurance, etc.:
後期高齢者医療広域連合は、災害その他の厚生労働省令で定める特別の事情がある被保険者であつて、保険医療機関等に第六十七条第一項の規定による一部負担金を支払うことが困難であると認められるものに対し、次の措置を採ることができる。
to reduce the amount of co-payment;
一部負担金を減額すること。
exemption from co-payment;
一部負担金の支払を免除すること。
to decide to collect co-payment directly from the insured person in lieu of co-payment to the medical institution providing services covered by health insurance, etc., and to suspend such collection.
保険医療機関等に対する支払に代えて、一部負担金を直接に徴収することとし、その徴収を猶予すること。
Notwithstanding the provisions of Article 67, paragraph (1), in the case of an insured that has received the measures set forth in item (i) of the preceding paragraph, it is sufficient for the insured to pay the reduced amount of co-payment to the medical institution providing services covered by health insurance, etc., and in the case of an insured that has received the measures set forth in item (ii) or item (iii) of the preceding paragraph, it is not required to pay the co-payment to the medical institution providing services covered by health insurance, etc.
The provisions of the preceding Article apply mutatis mutandis to the payment of co-payment in the case referred to in the preceding paragraph.
A Association of Medical Care Systems for the Elderly Aged 75 and older is to pay expenses related to benefits for medical treatment to medical institutions providing services covered by health insurance, etc., and the amount of expenses which a medical institution providing services covered by health insurance, etc. may claim from a Association of Medical Care Systems for the Elderly Aged 75 and older related to benefits for medical treatment is the amount calculated by deducting the amount of co-payment to be paid to the relevant medical institution providing services covered by health insurance, etc. with respect to the relevant benefits for medical treatment from the amount of expenses required for benefits for medical treatment calculated in accordance with the standards for calculation of the amount of expenses required for benefits for medical treatment set forth in paragraph (1) of the following Article.
後期高齢者医療広域連合は、療養の給付に関する費用を保険医療機関等に支払うものとし、保険医療機関等が療養の給付に関し後期高齢者医療広域連合に請求することができる費用の額は、次条第一項の療養の給付に要する費用の額の算定に関する基準により算定した療養の給付に要する費用の額から、当該療養の給付に関して当該保険医療機関等に支払われるべき一部負担金に相当する額を控除した額とする。
A Association of Medical Care Systems for the Elderly Aged 75 and older may, with the authorization of the prefectural governor, specify otherwise in a contract with a medical institution providing services covered by health insurance, etc. with regard to the expenses required for the benefits for medical treatment set forth in the preceding paragraph pertaining to the benefits for medical treatment provided at the medical institution providing services covered by health insurance, etc., within the scope of the amount calculated pursuant to the provisions of the same paragraph.
後期高齢者医療広域連合は、都道府県知事の認可を受け、保険医療機関等との契約により、当該保険医療機関等において行われる療養の給付に関する前項の療養の給付に要する費用につき、同項の規定により算定される額の範囲内において、別段の定めをすることができる。
When a medical institution providing services covered by health insurance, etc. requests payment of expenses related to benefits for medical treatment, the Association of Medical Care Systems for the Elderly Aged 75 and older is to make payment after conducting an examination in light of the standards for treatment and responsibility for benefits for medical treatment as set forth in paragraph (1) of the following Article, the standards for calculation of the amount of expenses required for benefits for medical treatment, and the provisions of the preceding paragraph.
後期高齢者医療広域連合は、保険医療機関等から療養の給付に関する費用の請求があつたときは、次条第一項の療養の給付の取扱い及び担当に関する基準並びに療養の給付に要する費用の額の算定に関する基準及び前項の定めに照らして審査した上、支払うものとする。
The Association of Medical Care Systems for the Elderly Aged 75 and older may entrust affairs concerning the examination and payment under the provisions of the preceding paragraph to the Organization or the NHI federation.
後期高齢者医療広域連合は、前項の規定による審査及び支払に関する事務を機構又は国保連合会に委託することができる。
A federation of national health insurance associations that is entrusted pursuant to the provisions of the preceding paragraph may entrust the affairs concerning the examination entrusted thereto, which pertain to the examination of medical bills specified by the Minister of Health, Labour and Welfare, to a corporation designated by the Minister of Health, Labour and Welfare as prescribed in Article 45, paragraph (6) of the National Health Insurance Act (hereinafter referred to as a "designated corporation").
前項の規定による委託を受けた国保連合会は、当該委託を受けた審査に関する事務のうち厚生労働大臣の定める診療報酬請求書の審査に係るものを、国民健康保険法第四十五条第六項に規定する厚生労働大臣が指定する法人（以下「指定法人」という。）に委託することができる。
A designated corporation that has been entrusted with the affairs concerning the review of medical bills specified by the Minister of Health, Labour and Welfare pursuant to the provisions of the preceding paragraph must have the review of the medical bills conducted by a person who satisfies the requirements specified by Order of the Ministry of Health, Labour and Welfare.
Beyond what is provided for in each of the preceding paragraphs, necessary matters concerning claims for expenses incurred in providing medical treatment at medical institutions providing services covered by health insurance, etc. are specified by Order of the Ministry of Health, Labour and Welfare.
Article 71Standards for Benefits for Medical Treatment
第七十一条（療養の給付に関する基準）
The standards concerning the treatment and assignment of benefits for medical treatment and the standards concerning the calculation of the amount of expenses required for benefits for medical treatment are to be determined by the Minister of Health, Labour and Welfare after hearing the opinions of the Central Social Insurance Medical Council.
療養の給付の取扱い及び担当に関する基準並びに療養の給付に要する費用の額の算定に関する基準については、厚生労働大臣が中央社会保険医療協議会の意見を聴いて定めるものとする。
Notwithstanding the provisions of Article 2, paragraph (1) of the Social Insurance Medical Council Act (Act No. 47 of 1950), the Central Social Insurance Medical Council may deliberate on the particulars for which it has been asked for its opinion pursuant to the provisions of the preceding paragraph, and submit a report in writing, as well as make its own proposal in writing to the Minister of Health, Labour and Welfare with regard to the particulars prescribed in the same paragraph.
When the Minister of Health, Labour and Welfare or the prefectural governor finds it necessary in relation to benefits for medical treatment, the Minister or the governor may order a medical institution providing services covered by health insurance, etc., or a person who was an establisher or administrator of a medical institution providing services covered by health insurance, etc., a physician providing health insurance treatment, etc., or another employee (hereinafter referred to as a "former establisher, etc." in this paragraph) to make a report or to submit or present medical records and other books and documents, request the appearance of an establisher or administrator of a medical institution providing services covered by health insurance, etc., a physician providing health insurance treatment, etc., or another employee (including a former establisher, etc.), or have their official question the persons concerned or inspect the facilities, medical records, books and documents, and other articles of a medical institution providing services covered by health insurance, etc.
The provisions of Article 16-7, paragraph (2) and Article 66, paragraph (2) apply mutatis mutandis to questions and inspections pursuant to the provisions of the preceding paragraph, and the provisions of Article 16-7, paragraph (3) apply mutatis mutandis to the authority granted pursuant to the provisions of the preceding paragraph.
When the prefectural governor finds that a disposition under the provisions of Article 80 of the Health Insurance Act needs to be made with respect to a medical institution providing services covered by health insurance, etc. in relation to benefits for medical treatment under the provisions of this Act, or that a disposition under the provisions of Article 81 of the Health Insurance Act needs to be made with respect to a physician providing health insurance treatment, etc. in relation to medical care or dispensing under the provisions of this Act, the prefectural governor must notify the Minister of Health, Labour and Welfare to that effect, stating the reasons.
都道府県知事は、保険医療機関等につきこの法律の規定による療養の給付に関し健康保険法第八十条の規定による処分が行われる必要があると認めるとき、又は保険医等につきこの法律の規定による診療若しくは調剤に関し健康保険法第八十一条の規定による処分が行われる必要があると認めるときは、理由を付して、その旨を厚生労働大臣に通知しなければならない。
The provisions of Article 64 of the Health Insurance Act apply mutatis mutandis to benefits for medical treatment under the provisions of this Act.
健康保険法第六十四条の規定は、この法律の規定による療養の給付について準用する。
Article 74Dietary Treatment Expenses for Inpatients
第七十四条（入院時食事療養費）
The Association of Medical Care Systems for the Elderly Aged 75 and older pays dietary treatment expenses for inpatients to an insured (excluding an insured who receives long-term hospitalization and medical treatment (referred to as a "long-term inpatient insured" in paragraph (1) of the following Article); the same applies hereinafter in this Article) for the expenses required for dietary treatment received together with the benefits for medical treatment listed in Article 64, paragraph (1), item (v) at a medical institution providing services covered by health insurance, etc. (excluding pharmacies providing services covered by health insurance; the same applies hereinafter in this Article and the following Article) of the insured's own choosing; provided, however, that this does not apply while the insured is subject to the provisions of Article 82, paragraph (1) or the main clause of paragraph (2).
後期高齢者医療広域連合は、被保険者（長期入院療養を受ける被保険者（次条第一項において「長期入院被保険者」という。）を除く。以下この条において同じ。）が、保険医療機関等（保険薬局を除く。以下この条及び次条において同じ。）のうち自己の選定するものについて第六十四条第一項第五号に掲げる療養の給付と併せて受けた食事療養に要した費用について、当該被保険者に対し、入院時食事療養費を支給する。ただし、当該被保険者が第八十二条第一項又は第二項本文の規定の適用を受けている間は、この限りでない。
The amount of dietary treatment expenses for inpatients is the amount calculated by deducting the amount specified by the Minister of Health, Labour and Welfare in consideration of the status of food expenses for an average household budget and the average amount of expenses required to provide meals at a specified nursing care insurance facilities, etc. (meaning a specified facility, etc. for insured long-term care prescribed in Article 51-3, paragraph (1) of Long-Term Care Insurance Act) (for a person specified by Order of the Ministry of Health, Labour and Welfare in consideration of income status and other circumstances, a separately determined amount; hereinafter referred to as the "standard co-payment for dietary treatment") from the amount of expenses calculated based on the standards specified by the Minister of Health, Labour and Welfare in consideration of the average amount of expenses required for the dietary treatment (when the calculated amount exceeds the amount of expenses actually incurred in the dietary treatment, the amount of expenses actually incurred).
入院時食事療養費の額は、当該食事療養につき食事療養に要する平均的な費用の額を勘案して厚生労働大臣が定める基準により算定した費用の額（その額が現に当該食事療養に要した費用の額を超えるときは、当該現に食事療養に要した費用の額）から、平均的な家計における食費の状況及び特定介護保険施設等（介護保険法第五十一条の三第一項に規定する特定介護保険施設等をいう。）における食事の提供に要する平均的な費用の額を勘案して厚生労働大臣が定める額（所得の状況その他の事情をしん酌して厚生労働省令で定める者については、別に定める額。以下「食事療養標準負担額」という。）を控除した額とする。
If the circumstances pertaining to the matters to be taken into consideration have significantly changed after the Minister of Health, Labour and Welfare has determined the standard co-payment amount for dietary treatment, the Minister must promptly revise the amount.
厚生労働大臣は、食事療養標準負担額を定めた後に勘案又はしん酌すべき事項に係る事情が著しく変動したときは、速やかにその額を改定しなければならない。
A medical institution providing services covered by health insurance, etc. and a physician providing health insurance treatment, etc. (excluding pharmacists filling health insurance prescriptions; the same applies in paragraph (4) of the following Article) must handle or take charge of medical treatment pertaining to dietary treatment expenses for inpatients in accordance with the standards for the handling and taking charge of medical treatment pertaining to dietary treatment expenses for inpatients specified by the Minister of Health, Labour and Welfare.
When an insured has received dietary treatment at or from a medical institution providing services covered by health insurance, etc., the Association of Medical Care Systems for the Elderly Aged 75 and older may, on behalf of the insured, pay to the medical institution providing services covered by health insurance, etc. expenses incurred for the dietary treatment payable by the insured to the medical institution providing services covered by health insurance, etc., within the limit of the amount payable to the insured as expenses for dietary treatment for inpatients.
被保険者が保険医療機関等について食事療養を受けたときは、後期高齢者医療広域連合は、その被保険者が当該保険医療機関等に支払うべき食事療養に要した費用について、入院時食事療養費として被保険者に対し支給すべき額の限度において、被保険者に代わり、当該保険医療機関等に支払うことができる。
If a payment under the provisions of the preceding paragraph is made, it is deemed that dietary treatment expenses for inpatients are paid to the insured.
前項の規定による支払があつたときは、被保険者に対し入院時食事療養費の支給があつたものとみなす。
A medical institution providing services covered by health insurance, etc. must, when receiving payment of the expenses required for dietary treatment, issue a receipt to the insured who made the payment, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare.
The Minister of Health, Labour and Welfare must hear the opinions of the Central Social Insurance Medical Council in advance, when the Minister intends to establish standards under the provisions of paragraph (2) and standards concerning the treatment and taking charge of medical treatment pertaining to dietary treatment expenses for inpatients prescribed in paragraph (4).
The provisions of Article 71, paragraph (2) apply mutatis mutandis to the authority of the Central Social Insurance Medical Council concerning the particulars prescribed in the preceding paragraph.
The provisions of Article 64 of the Health Insurance Act and Article 64, paragraph (3), Article 66, Article 70, paragraphs (2) through (7), and Article 72 of this Act apply mutatis mutandis to dietary treatment received at or from a medical institution providing services covered by health insurance and to the payment of dietary treatment expenses for inpatients associated with that treatment. In such a case, Cabinet Order provides for the necessary technical replacement of terms in connection with these provisions.
健康保険法第六十四条並びに本法第六十四条第三項、第六十六条、第七十条第二項から第七項まで及び第七十二条の規定は、保険医療機関等について受けた食事療養及びこれに伴う入院時食事療養費の支給について準用する。この場合において、これらの規定に関し必要な技術的読替えは、政令で定める。
Article 75Living Support Expenses for Inpatients
第七十五条（入院時生活療養費）
With respect to expenses required for living support received by a long-term inpatient insured in combination with benefits for medical treatment listed in Article 64, paragraph (1), item (v) at or from a medical institution providing services covered by health insurance, etc. selected by the long-term inpatient insured, the Association of Medical Care Systems for the Elderly Aged 75 and older pays living support expenses for inpatients to the long-term inpatient insured; provided, however, that this does not apply during any period to which the provisions of Article 82, paragraph (1) or the main clause of paragraph (2) of the same Article apply to the long-term inpatient insured.
後期高齢者医療広域連合は、長期入院被保険者が、保険医療機関等のうち自己の選定するものについて第六十四条第一項第五号に掲げる療養の給付と併せて受けた生活療養に要した費用について、当該長期入院被保険者に対し、入院時生活療養費を支給する。ただし、当該長期入院被保険者が第八十二条第一項又は第二項本文の規定の適用を受けている間は、この限りでない。
The amount of living support expenses for inpatients is the amount calculated by deducting the amount specified by the Minister of Health, Labour and Welfare in consideration of the amount equivalent to the base cost for food expenses prescribed in Article 51-3, paragraph (2), item (i) of the Long-Term Care Insurance Act and the base cost for residence expenses prescribed in item (ii) of the same paragraph with regard to the status of food expenses and light, heating and water utility costs for an average household budget and the expenses required for living support at hospitals and clinics (for a person specified by the Order of the Ministry of Health, Labour and Welfare in consideration of the status of income, the degree of pathological condition, the content of treatment and other circumstances, a separately specified amount; hereinafter referred to as the "standard co-payment for living support") from the amount calculated based on the standards specified by the Minister of Health, Labour and Welfare in consideration of the average expenses required for the living support (when the calculated amount exceeds the amount of expenses actually incurred in the living support, the amount of expenses actually incurred in the living support).
入院時生活療養費の額は、当該生活療養につき生活療養に要する平均的な費用の額を勘案して厚生労働大臣が定める基準により算定した費用の額（その額が現に当該生活療養に要した費用の額を超えるときは、当該現に生活療養に要した費用の額）から、平均的な家計における食費及び光熱水費の状況並びに病院及び診療所における生活療養に要する費用について介護保険法第五十一条の三第二項第一号に規定する食費の基準費用額及び同項第二号に規定する居住費の基準費用額に相当する費用の額を勘案して厚生労働大臣が定める額（所得の状況、病状の程度、治療の内容その他の事情をしん酌して厚生労働省令で定める者については、別に定める額。以下「生活療養標準負担額」という。）を控除した額とする。
When the circumstances pertaining to the matters to be taken into consideration have significantly changed after the Minister of Health, Labour and Welfare has determined the standard co-payment amount for living support, the Minister must promptly revise the amount.
厚生労働大臣は、生活療養標準負担額を定めた後に勘案又はしん酌すべき事項に係る事情が著しく変動したときは、速やかにその額を改定しなければならない。
Medical institutions providing services covered by health insurance, etc. and physicians providing services covered by health insurance, etc. must handle or take charge of medical treatment pertaining to living support expenses for inpatients in accordance with the standards for handling and taking charge of medical treatment pertaining to living support expenses for inpatients specified by the Minister of Health, Labour and Welfare.
The Minister of Health, Labour and Welfare must hear the opinions of the Central Social Insurance Medical Council in advance, when the Minister intends to establish standards under the provisions of paragraph (2) and standards concerning the treatment and assignment of medical treatment pertaining to living support expenses for inpatients prescribed in the preceding paragraph.
The provisions of Article 71, paragraph (2) apply mutatis mutandis to the authority of the Central Social Insurance Medical Council concerning the particulars prescribed in the preceding paragraph.
The provisions of Article 64 of the Health Insurance Act and Article 64, paragraph (3), Article 66, Article 70, paragraphs (2) through (7), Article 72, and paragraphs (5) through (7) of the preceding Article of this Act apply mutatis mutandis to living support received at or from a medical institution providing services covered by health insurance and to the payment of living support expenses for inpatients associated with the living support. In such a case, Cabinet Order provides for the necessary technical replacement of terms in connection with these provisions.
健康保険法第六十四条並びに本法第六十四条第三項、第六十六条、第七十条第二項から第七項まで、第七十二条及び前条第五項から第七項までの規定は、保険医療機関等について受けた生活療養及びこれに伴う入院時生活療養費の支給について準用する。この場合において、これらの規定に関し必要な技術的読替えは、政令で定める。
When an insured receives evaluation treatment, patient-requested treatment, or selective treatment at or from a medical institution providing services covered by health insurance, etc. that it has selected, the Association of Medical Care Systems for the Elderly Aged 75 and older pays medical expenses combined with treatment outside insurance coverage to the insured for the expenses required for the treatment; provided, however, that this does not apply during any period to which the provisions of Article 82, paragraph (1) or the main clause of paragraph (2) of the same Article apply to the insured.
The amount of medical expenses combined with treatment outside insurance coverage is the amount listed in item (i) (if the medical treatment includes dietary treatment, the sum of the amount and the amount listed in item (ii), and if the medical treatment includes living support, the sum of the amount and the amount listed in item (iii)):
the amount calculated by deducting, from the amount of expenses calculated for the medical treatment (excluding dietary treatment and living support) in accordance with the standards specified by the Minister of Health, Labour and Welfare in consideration of the standards for calculation of the amount of expenses required for benefits for medical treatment prescribed in Article 71, paragraph (1) (when the amount exceeds the amount of expenses actually incurred in the medical treatment, the amount of expenses actually incurred in the medical treatment), the amount obtained by multiplying the amount of expenses by the applicable ratio specified in the items of Article 67, paragraph (1) in accordance with the categories of the cases listed in the items of the same paragraph (when the measures listed in the items of Article 69, paragraph (1) should be taken with respect to the co-payment set forth in the same paragraph for benefits for medical treatment, the amount calculated as if the measures were taken);
the amount calculated by deducting the amount of standard co-payment for dietary treatment from the amount of expenses calculated for the dietary treatment in accordance with the standards specified by the Minister of Health, Labour and Welfare pursuant to the provisions of Article 74, paragraph (2) (when the calculated amount exceeds the amount of expenses actually incurred in the dietary treatment, the amount of expenses actually incurred);
the amount calculated by deducting the amount of standard co-payment for living support from the amount of expenses calculated for the living support in accordance with the standards specified by the Minister of Health, Labour and Welfare pursuant to the provisions of paragraph (2) of the preceding Article (when the calculated amount exceeds the amount of expenses actually incurred in the living support, the amount of expenses actually incurred).
Medical institutions providing services covered by health insurance, etc. and physicians providing services covered by health insurance, etc. must handle or take charge of medical treatment covered by medical expenses combined with treatment outside insurance coverage in accordance with the standards for handling and taking charge of medical treatment covered by medical expenses combined with treatment outside insurance coverage specified by the Minister of Health, Labour and Welfare.
The Minister of Health, Labour and Welfare must hear the opinions of the Central Social Insurance Medical Council in advance, when the Minister intends to establish standards for evaluation treatment (excluding those pertaining to advanced medical care techniques prescribed in Article 64, paragraph (2), item (iii)), selective treatment, standards pursuant to the provisions of paragraph (2), item (i), and standards concerning treatment and taking charge of medical treatment pertaining to medical expenses combined with treatment outside insurance coverage prescribed in the preceding paragraph.
厚生労働大臣は、評価療養（第六十四条第二項第三号に規定する高度の医療技術に係るものを除く。）、選定療養、第二項第一号の規定による基準並びに前項に規定する保険外併用療養費に係る療養の取扱い及び担当に関する基準を定めようとするときは、あらかじめ中央社会保険医療協議会の意見を聴かなければならない。
The provisions of Article 71, paragraph (2) apply mutatis mutandis to the authority of the Central Social Insurance Medical Council concerning the particulars prescribed in the preceding paragraph.
The provisions of Article 64 of the Health Insurance Act and Article 64, paragraph (3), Article 66, Article 70, paragraphs (2) through (7), Article 72, and Article 74, paragraphs (5) through (7) of this Act apply mutatis mutandis to payment of evaluation treatment, patient-requested treatment, and selective treatment received at or from a medical institution providing services covered by health insurance, and medical expenses combined with treatment outside insurance coverage associated with the relevant treatment. In this case, the necessary technical replacement of terms in these provisions is specified by Cabinet Order.
健康保険法第六十四条並びに本法第六十四条第三項、第六十六条、第七十条第二項から第七項まで、第七十二条及び第七十四条第五項から第七項までの規定は、保険医療機関等について受けた評価療養、患者申出療養及び選定療養並びにこれらに伴う保険外併用療養費の支給について準用する。この場合において、これらの規定に関し必要な技術的読替えは、政令で定める。
The provisions of Article 68 apply mutatis mutandis to the payment of the amount calculated by deducting, from the amount of expenses calculated pursuant to the provisions of paragraph (2) for the medical treatment in the case set forth in Article 74, paragraph (5) as applied mutatis mutandis pursuant to the provisions of the preceding paragraph (when the amount exceeds the amount of expenses actually incurred in the medical treatment, the amount of expenses actually incurred), the amount payable as medical expenses combined with treatment outside insurance coverage with respect to the expenses incurred in the medical treatment.
第七十七条（療養費）
When a Association of Medical Care Systems for the Elderly Aged 75 and older finds it difficult to pay benefits for medical treatment, or expenses for dietary treatment for inpatients, living support expenses for inpatients, or medical expenses combined with treatment outside insurance coverage (hereinafter referred to as "benefits for medical treatment, etc." in this paragraph and the following paragraph), or when an insured has received any medical care, medication or treatment at or from hospitals, clinics, pharmacies or any other persons other than medical institutions providing services covered by health insurance, etc. and the Association of Medical Care Systems for the Elderly Aged 75 and older finds it unavoidable, it may pay medical expenses in lieu of benefits for medical treatment, etc.;provided, however, that this does not apply during any period for which the provisions of Article 82, paragraph (1) or the main clause of paragraph (2) of the same Article are applied to the insured.
後期高齢者医療広域連合は、療養の給付若しくは入院時食事療養費、入院時生活療養費若しくは保険外併用療養費の支給（以下この項及び次項において「療養の給付等」という。）を行うことが困難であると認めるとき、又は被保険者が保険医療機関等以外の病院、診療所若しくは薬局その他の者について診療、薬剤の支給若しくは手当を受けた場合において、後期高齢者医療広域連合がやむを得ないものと認めるときは、療養の給付等に代えて、療養費を支給することができる。ただし、当該被保険者が第八十二条第一項又は第二項本文の規定の適用を受けている間は、この限りでない。
When an insured has received medical care or medication from a medical institution providing services covered by health insurance, etc. without receiving confirmation of being an insured by electronic eligibility confirmation, etc., and the Association of Medical Care Systems for the Elderly Aged 75 and older finds that the failure to receive that confirmation was due to an emergency or other unavoidable reason, it is to pay medical expenses in lieu of benefits for medical treatment, etc.; provided, however, that this does not apply while the insured is subject to the provisions of Article 82, paragraph (1) or the main clause of paragraph (2).
The amount of medical expenses is determined by the Association of Medical Care Systems for the Elderly Aged 75 and older based on: (a) the amount calculated by deducting, from the amount calculated for the medical treatment (excluding dietary treatment and living support), the amount obtained by multiplying that amount by the applicable ratio specified in the items of Article 67, paragraph (1) in accordance with the categories of cases listed in the items of the same paragraph; and (b) the amount calculated by deducting, from the amount calculated for the dietary treatment or living support, the amount of standard co-payment for dietary treatment or standard co-payment for living support.
With regard to the calculation of the amount of expenses referred to in the preceding paragraph, the provisions of Article 71, paragraph (1) apply mutatis mutandis if benefits for medical treatment are to be received, the provisions of Article 74, paragraph (2) apply mutatis mutandis if dietary treatment expenses for inpatients are to be received, the provisions of Article 75, paragraph (2) apply mutatis mutandis if living support expenses for inpatients are to be received, and the provisions of paragraph (2) of the preceding Article apply mutatis mutandis if medical expenses combined with treatment outside insurance coverage are to be received; provided, however, that the amount may not exceed the amount of expenses actually incurred in the medical treatment.
Division 2 Payment of Medical Expenses for Home-Nursing
第二目 訪問看護療養費の支給
Article 78Medical Expenses for Home-Nursing
第七十八条（訪問看護療養費）
When an insured has received home-nursing (meaning care for medical treatment or necessary assistance with medical examination and treatment provided at the residence of an insured who is in a condition of continuously receiving medical treatment at home due to illness or injury (limited to an insured whom the attending physician has found to conform, as to the degree of necessity of the treatment, to the standards specified by Order of the Ministry of Health, Labour and Welfare) by a nurse or other person specified by Order of the Ministry of Health, Labour and Welfare; hereinafter referred to as "designated home-nursing") provided, by an office conducting the home-nursing business pertaining to the designation (meaning the home-nursing business prescribed in Article 88, paragraph (1) of the Health Insurance Act), from a designated home-nursing provider, the Association of Medical Care Systems for the Elderly Aged 75 and older pays the insured medical expenses for home-nursing for the expenses required for the designated home-nursing. However, this does not apply while the insured is subject to the application of Article 82, paragraph (1) or the main clause of paragraph (2).
後期高齢者医療広域連合は、被保険者が指定訪問看護事業者から当該指定に係る訪問看護事業（健康保険法第八十八条第一項に規定する訪問看護事業をいう。）を行う事業所により行われる訪問看護（疾病又は負傷により、居宅において継続して療養を受ける状態にある被保険者（主治の医師がその治療の必要の程度につき厚生労働省令で定める基準に適合していると認めたものに限る。）に対し、その者の居宅において看護師その他厚生労働省令で定める者が行う療養上の世話又は必要な診療の補助をいう。以下「指定訪問看護」という。）を受けたときは、当該被保険者に対し、当該指定訪問看護に要した費用について、訪問看護療養費を支給する。ただし、当該被保険者が第八十二条第一項又は第二項本文の規定の適用を受けている間は、この限りでない。
The medical expenses for home-nursing referred to in the preceding paragraph are to be paid only if the Association of Medical Care Systems for the Elderly Aged 75 and older finds it necessary pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare.
前項の訪問看護療養費は、厚生労働省令で定めるところにより、後期高齢者医療広域連合が必要と認める場合に限り、支給するものとする。
When an insured intends to receive designated home-nursing, the insured is to, as provided by Order of the Ministry of Health, Labour and Welfare, receive confirmation of being an insured from the designated home-nursing provider of the insured's choice by electronic eligibility confirmation, etc., and receive that designated home-nursing.
The amount of medical expenses for home-nursing is the amount calculated by deducting, from the amount calculated in accordance with the standards specified by the Minister of Health, Labour and Welfare in consideration of the average home-nursing expenses (meaning the average expenses required for designated home-nursing) for the relevant designated home-nursing, the amount obtained by multiplying the relevant amount by the applicable ratio specified in the items of Article 67, paragraph (1) in accordance with the categories of the cases listed in the items of the same paragraph (or, if any of the measures listed in the items of Article 69, paragraph (1) should be taken with respect to benefits for medical treatment, the amount calculated as if the relevant measures were taken).
When the Minister of Health, Labour and Welfare intends to specify the standards set forth in the preceding paragraph, the Minister must hear the opinions of the Central Social Insurance Medical Council in advance.
厚生労働大臣は、前項の基準を定めようとするときは、あらかじめ中央社会保険医療協議会の意見を聴かなければならない。
The provisions of Article 71, paragraph (2) apply mutatis mutandis to the authority of the Central Social Insurance Medical Council concerning the particulars prescribed in the preceding paragraph.
If a designated home-nursing provider requests payment of medical expenses for home-nursing, the Association of Medical Care Systems for the Elderly Aged 75 and older is to pay the expenses after conducting an examination in light of the standards specified by the Minister of Health, Labour and Welfare as set forth in paragraph (4) and the standards for business management of designated home-nursing as prescribed in paragraph (1) of the following Article (limited to the part regarding the treatment of designated home-nursing).
後期高齢者医療広域連合は、指定訪問看護事業者から訪問看護療養費の請求があつたときは、第四項の厚生労働大臣が定める基準及び次条第一項に規定する指定訪問看護の事業の運営に関する基準（指定訪問看護の取扱いに関する部分に限る。）に照らして審査した上、支払うものとする。
The provisions of Article 70, paragraphs (4) through (7) and Article 74, paragraphs (5) through (7) apply mutatis mutandis to designated home-nursing received at or from a designated home-nursing provider and to the payment of medical expenses for home-nursing associated with the relevant service. In such a case, Cabinet Order provides for the necessary technical replacement of terms in connection with these provisions.
第七十条第四項から第七項まで及び第七十四条第五項から第七項までの規定は、指定訪問看護事業者について受けた指定訪問看護及びこれに伴う訪問看護療養費の支給について準用する。この場合において、これらの規定に関し必要な技術的読替えは、政令で定める。
The provisions of Article 68 apply mutatis mutandis to the payment of the amount calculated by deducting, from the amount of expenses calculated pursuant to the provisions of paragraph (4) in the case referred to in Article 74, paragraph (5) as applied mutatis mutandis pursuant to the preceding paragraph, the amount payable as medical expenses for home-nursing with respect to expenses incurred in the relevant designated home-nursing.
Designated home-nursing is not to be included in any of the types of medical treatment listed in the items of Article 64, paragraph (1).
Beyond what is provided for in the preceding paragraphs, necessary matters concerning the application of the calculation method specified by the Minister of Health, Labour and Welfare as set forth in paragraph (4) and a claim for medical expenses for home-nursing by a designated home-nursing provider are specified by Cabinet Order.
Article 79Standards for Operations of Designated Home-Nursing Services
第七十九条（指定訪問看護の事業の運営に関する基準）
Standards for operations of a designated home-nursing provider are provided by the Minister of Health, Labour and Welfare.
指定訪問看護の事業の運営に関する基準については、厚生労働大臣が定める。
A designated home-nursing provider must, in accordance with the standards concerning the management of a business of designated home-nursing prescribed in the preceding paragraph, provide appropriate designated home-nursing according to the mental and physical condition, etc., of an elderly person, and always endeavor to provide designated home-nursing from the viewpoint of the person that receives the designated home-nursing by implementing self-evaluation of the quality of the designated home-nursing provided and other measures.
The Minister of Health, Labour and Welfare must hear the opinions of the Central Social Insurance Medical Council in advance, when the Minister intends to specify standards concerning the management of a business of designated home-nursing prescribed in paragraph (1) (limited to the part concerning the treatment of designated home-nursing).
The provisions of Article 71, paragraph (2) apply mutatis mutandis to the authority of the Central Social Insurance Medical Council concerning the particulars prescribed in the preceding paragraph.
Article 80Guidance by the Minister of Health, Labour and Welfare or Prefectural Governors
第八十条（厚生労働大臣又は都道府県知事の指導）
A designated home-nursing provider and nurses and other employees at the office to which the designation pertains must receive guidance from the Minister of Health, Labour and Welfare or the prefectural governor with regard to designated home-nursing.
第八十一条（報告等）
When the Minister of Health, Labour and Welfare or the prefectural governor finds it necessary in relation to the payment of medical expenses for home-nursing, the Minister or the governor may order a designated home-nursing provider, a person that was a designated home-nursing provider, or a person that was a nurse or other employee at the office relevant to the designation (hereinafter referred to as a "person that was a designated home-nursing provider, etc." in this paragraph) to make a report, submit or present books and documents, request the appearance of a designated home-nursing provider, a nurse or other employee at the office relevant to the designation, or a person that was a designated home-nursing provider, etc., or have their official question the persons concerned or inspect the books, documents, and other articles of the designated home-nursing provider at the office relevant to the designation.
厚生労働大臣又は都道府県知事は、訪問看護療養費の支給に関して必要があると認めるときは、指定訪問看護事業者又は指定訪問看護事業者であつた者若しくは当該指定に係る事業所の看護師その他の従業者であつた者（以下この項において「指定訪問看護事業者であつた者等」という。）に対し、報告若しくは帳簿書類の提出若しくは提示を命じ、指定訪問看護事業者若しくは当該指定に係る事業所の看護師その他の従業者若しくは指定訪問看護事業者であつた者等に対し出頭を求め、又は当該職員に関係者に対して質問させ、若しくは当該指定訪問看護事業者の当該指定に係る事業所について帳簿書類その他の物件を検査させることができる。
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.
If a prefectural governor finds it necessary for a designated home-nursing provider to be subject to a disposition under the provisions of Article 95 of the Health Insurance Act with regard to designated home-nursing under the provisions of this Act, the governor must notify the Minister of Health, Labour and Welfare to that effect by giving the reason therefor.
都道府県知事は、指定訪問看護事業者につきこの法律の規定による指定訪問看護に関し健康保険法第九十五条の規定による処分が行われる必要があると認めるときは、理由を付して、その旨を厚生労働大臣に通知しなければならない。
Division 3 Payment of Special Medical Expenses
第三目 特別療養費の支給
第八十二条
If an insured that is delinquent in the payment of insurance premiums (excluding an insured that is eligible to receive payment of general medical expenses for illness under the Act on Assistance for Atomic Bomb Victims (Act No. 117 of 1994) and other medical care benefits specified by Order of the Ministry of Health, Labour and Welfare (referred to as "payment, etc. of general medical expenses for illness caused by atomic bombs" in paragraph (4)); hereinafter referred to as a "person delinquent in payment of insurance premiums" in this Article) does not pay the insurance premiums during the period from the due date for payment of the insurance premiums until the expiration of the period specified by Order of the Ministry of Health, Labour and Welfare, even though a municipality has made efforts to encourage payment of the insurance premiums, to secure opportunities for consultation pertaining to the payment of the insurance premiums, and to contribute to the payment of the insurance premiums specified by Order of the Ministry of Health, Labour and Welfare (referred to as "encouragement, etc. of payment of insurance premiums" in the following paragraph and Article 92, paragraphs (1) and (2)), and when the person delinquent in payment of insurance premiums has received medical treatment from a medical institution providing services covered by health insurance, etc. or designated home-nursing from a designated home-nursing provider, the Association of Medical Care Systems for the Elderly Aged 75 and older pays to the person delinquent in payment of insurance premiums special medical expenses in lieu of benefits for medical treatment, or payment of dietary treatment expenses for inpatients, living support expenses for inpatients, medical expenses combined with treatment outside insurance coverage, medical expenses, or medical expenses for home-nursing (referred to as "benefits for medical treatment, etc." in the following paragraph, paragraph (4), and paragraph (5)), with regard to expenses required for the medical treatment or designated home-nursing, except when it is found that there are special circumstances specified by Cabinet Order.
後期高齢者医療広域連合は、保険料を滞納している被保険者（原子爆弾被爆者に対する援護に関する法律（平成六年法律第百十七号）による一般疾病医療費の支給その他厚生労働省令で定める医療に関する給付（第四項において「原爆一般疾病医療費の支給等」という。）を受けることができる被保険者を除く。以下この条において「保険料滞納者」という。）が、当該保険料の納期限から厚生労働省令で定める期間が経過するまでの間に、市町村が当該保険料の納付の勧奨及び当該保険料の納付に係る相談の機会の確保その他厚生労働省令で定める保険料の納付に資する取組（次項並びに第九十二条第一項及び第二項において「保険料納付の勧奨等」という。）を行つてもなお当該保険料を納付しない場合においては、当該保険料の滞納につき災害その他の政令で定める特別の事情があると認められる場合を除き、当該保険料滞納者が保険医療機関等から療養を受けたとき、又は指定訪問看護事業者から指定訪問看護を受けたときは、当該保険料滞納者に対し、その療養又は指定訪問看護に要した費用について、療養の給付又は入院時食事療養費、入院時生活療養費、保険外併用療養費、療養費若しくは訪問看護療養費の支給（次項、第四項及び第五項において「療養の給付等」という。）に代えて、特別療養費を支給する。
Even before the period specified by Order of the Ministry of Health, Labour and Welfare as prescribed in the preceding paragraph has elapsed, if a person delinquent in payment of insurance premiums still does not pay the insurance premiums even though a municipality has carried out encouragement of insurance premium payment, etc., and the person delinquent in payment of insurance premiums has received medical treatment from a medical institution providing services covered by health insurance, etc. or designated home-nursing from a designated home-nursing provider, the Association of Medical Care Systems for the Elderly Aged 75 and older may pay the person delinquent in payment of insurance premiums special medical expenses for the expenses required for the medical treatment or designated home-nursing, in lieu of benefits for medical treatment, etc. However, this does not apply if it is found that there are special circumstances specified by the Cabinet Order referred to in that paragraph.
When paying special medical expenses pursuant to the provisions of paragraph (1) or the main clause of the preceding paragraph, the Association of Medical Care Systems for the Elderly Aged 75 and older is to notify a person delinquent in insurance premiums to the effect that special medical expenses will be paid if the person delinquent in insurance premiums receives medical treatment at or from a medical institution providing services covered by health insurance, or receives designated home-nursing at or from a designated home-nursing provider, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare.
If a person delinquent in payment of insurance premiums who is subject to the provisions of paragraph (1) or the main clause of paragraph (2) completes payment of the delinquent insurance premiums, or it is found that the amount of delinquent payment pertaining to the person has significantly decreased, or there are special circumstances specified by Cabinet Order, such as disasters, or if the relevant insured has become eligible for the payment, etc. of medical expenses for atomic bomb-related general diseases, and the insured that falls under these cases has received medical treatment from a medical institution providing services covered by health insurance, etc. or designated home-nursing from a designated home-nursing provider, the Association of Medical Care Systems for the Elderly Aged 75 and older provides benefits for medical treatment, etc. to the relevant insured.
後期高齢者医療広域連合は、第一項又は第二項本文の規定の適用を受けている保険料滞納者が滞納している保険料を完納した場合若しくはその者に係る滞納額の著しい減少、災害その他の政令で定める特別の事情があると認められる場合又は当該被保険者が原爆一般疾病医療費の支給等を受けることができる者となつた場合において、これらの場合に該当する被保険者が保険医療機関等から療養を受けたとき、又は指定訪問看護事業者から指定訪問看護を受けたときは、当該被保険者に対し、療養の給付等を行う。
When the Association of Medical Care Systems for the Elderly Aged 75 and older is to provide benefits for medical treatment, etc. pursuant to the provisions of the preceding paragraph, it is to notify in advance, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, an insured who falls under the case prescribed in that paragraph that, when the insured receives medical treatment from a medical institution providing services covered by health insurance, etc. or designated home-nursing from a designated home-nursing provider, benefits for medical treatment, etc. will be provided.
The provisions of Article 64 of the Health Insurance Act and Article 64, paragraph (3), Article 65, Article 66, Article 70, paragraph (2), Article 72, Article 74, paragraph (7) (including as applied mutatis mutandis pursuant to Article 78, paragraph (8)), Article 76, paragraph (2), Article 78, paragraph (3), Article 79, paragraph (2), Article 80, and the preceding Article of this Act apply mutatis mutandis to medical treatment or designated home-nursing pertaining to special medical expenses received at or from a medical institution providing services covered by health insurance, etc. or a designated home-nursing provider, and to the payment of special medical expenses incidental thereto. In this case, any necessary technical replacement of terms is specified by Cabinet Order.
If a person delinquent in insurance premiums to whom the provisions of paragraph (1) or the main clause of paragraph (2) are applied would be subject to the provisions of Article 77, paragraph (1) if those provisions were not applied, the Association of Medical Care Systems for the Elderly Aged 75 and older may pay medical expenses to the person.
第一項又は第二項本文の規定の適用を受けている保険料滞納者がこれらの規定の適用を受けていないとすれば第七十七条第一項の規定が適用されることとなるときは、後期高齢者医療広域連合は、療養費を支給することができる。
When a person delinquent in payment of insurance premiums who is subject to the provisions of paragraph (1) or the main clause of paragraph (2) has received medical care or medication from a medical institution providing services covered by health insurance, etc. without receiving confirmation of being an insured by electronic eligibility confirmation, etc., and the Association of Medical Care Systems for the Elderly Aged 75 and older finds that the failure to receive that confirmation was due to an emergency or other unavoidable reason, the Association is to pay medical expenses.
The provisions of Article 77, paragraphs (3) and (4) apply mutatis mutandis to the medical expenses pursuant to the provisions of the preceding two paragraphs. In this case, the term "if the person is to receive" in paragraph (4) of the same Article is deemed to be replaced with "if the person is eligible to receive".
Division 4 Payment of Transport Expenses
第四目 移送費の支給
第八十三条
When an insured has been transferred to a hospital or clinic in order to receive medical treatment (including medical treatment covered by medical expenses combined with treatment outside insurance coverage and medical treatment covered by special medical expenses), the Association of Medical Care Systems for the Elderly Aged 75 and older pays, as transport expenses, an amount calculated pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare to the insured.
後期高齢者医療広域連合は、被保険者が療養の給付（保険外併用療養費に係る療養及び特別療養費に係る療養を含む。）を受けるため病院又は診療所に移送されたときは、当該被保険者に対し、移送費として、厚生労働省令で定めるところにより算定した額を支給する。
The transport expenses referred to in the preceding paragraph are to be paid only if the Association of Medical Care Systems for the Elderly Aged 75 and older finds it necessary pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare.
前項の移送費は、厚生労働省令で定めるところにより、後期高齢者医療広域連合が必要であると認める場合に限り、支給するものとする。
Subsection 3 Payment of High-Cost Medical Expenses and Sizable medical and nursing expenses
第三款 高額療養費及び高額介護合算療養費の支給
Article 84High-Cost Medical Expenses
第八十四条（高額療養費）
When the amount of co-payment prescribed in Article 67 with respect to benefits for medical treatment or the amount calculated by deducting, from the amount of expenses incurred in medical treatment (excluding dietary treatment and living support; hereinafter the same applies in this Article), the amount paid as medical expenses combined with treatment outside insurance coverage, medical expenses, medical expenses for home-nursing, or special medical expenses with respect to the expenses incurred in the medical treatment, or the amount equivalent to the difference paid pursuant to the provisions of Article 57, paragraph (2) (referred to as the "amount of co-payment, etc." in paragraph (1) of the following Article) is extremely large, the Association of Medical Care Systems for the Elderly Aged 75 and older pays high-cost medical expenses to the insured that received the benefits for medical treatment, or the payment of the medical expenses combined with treatment outside insurance coverage, medical expenses, medical expenses for home-nursing, or special medical expenses.
The requirements for payment and the amount of high-cost medical expenses and other necessary matters concerning the payment of high-cost medical expenses shall be prescribed by Cabinet Order by taking into consideration the impact of the burden of the expenses incurred in the relevant medical treatment on household finances, in particular the household finances of persons who continuously receive medical treatment over a long period, and the amount of expenses incurred in the medical treatment.
高額療養費の支給要件、支給額その他高額療養費の支給に関して必要な事項は、療養に必要な費用の負担の家計、とりわけ長期にわたつて継続的に療養を受ける者の家計に与える影響及び療養に要した費用の額を考慮して、政令で定める。
Article 85Sizable medical and nursing expenses
第八十五条（高額介護合算療養費）
When the sum of the amount of co-payment, etc. (when high-cost medical expenses set forth in paragraph (1) of the preceding Article are paid, the amount obtained by deducting the amount so paid) and the amount to be borne by a user of long-term care service as prescribed in Article 51, paragraph (1) of the Long-Term Care Insurance Act (when allowance for high-cost long-term care service set forth in the same paragraph is paid, the amount obtained by deducting the amount so paid) and the amount to be borne by a user of preventive long-term care service as prescribed in Article 61, paragraph (1) of the same Act (when High-Cost Long-Term Prevention Care Service Allowance set forth in the same paragraph is paid, the amount obtained by deducting the amount so paid) is extremely large, the Association of Medical Care Systems for the Elderly Aged 75 and older pays Sizable medical and nursing expenses to the insured that received benefits for medical treatment, or payment of medical expenses combined with treatment outside insurance coverage, medical expenses, medical expenses for home-nursing, or special medical expenses pertaining to the amount of co-payment, etc.
後期高齢者医療広域連合は、一部負担金等の額（前条第一項の高額療養費が支給される場合にあつては、当該支給額に相当する額を控除して得た額）並びに介護保険法第五十一条第一項に規定する介護サービス利用者負担額（同項の高額介護サービス費が支給される場合にあつては、当該支給額を控除して得た額）及び同法第六十一条第一項に規定する介護予防サービス利用者負担額（同項の高額介護予防サービス費が支給される場合にあつては、当該支給額を控除して得た額）の合計額が著しく高額であるときは、当該一部負担金等の額に係る療養の給付又は保険外併用療養費、療養費、訪問看護療養費若しくは特別療養費の支給を受けた被保険者に対し、高額介護合算療養費を支給する。
The provisions of paragraph (2) of the preceding Article apply mutatis mutandis to the payment of a Sizable medical and nursing expenses.
前条第二項の規定は、高額介護合算療養費の支給について準用する。
Subsection 4 Other Late-Stage medical care benefit for the Elderly
第四款 その他の後期高齢者医療給付
第八十六条
A Association of Medical Care Systems for the Elderly Aged 75 and older is to, pursuant to the provisions of its Ordinances, pay funeral expenses or provide funeral rites benefits with regard to the death of an insured; provided, however, that if there are special reasons, the payment or benefits may not be made in whole or in part.
後期高齢者医療広域連合は、被保険者の死亡に関しては、条例の定めるところにより、葬祭費の支給又は葬祭の給付を行うものとする。ただし、特別の理由があるときは、その全部又は一部を行わないことができる。
In addition to the benefits set forth in the preceding paragraph, the Association of Medical Care Systems for the Elderly Aged 75 and older may pay injury and sickness allowance and provide other medical care benefit for the old-old pursuant to the provisions of the ordinances of the Association of Medical Care Systems for the Elderly Aged 75 and older.
後期高齢者医療広域連合は、前項の給付のほか、後期高齢者医療広域連合の条例の定めるところにより、傷病手当金の支給その他の後期高齢者医療給付を行うことができる。
Subsection 5 Restrictions on Late-Stage medical care benefit for the Elderly
第五款 後期高齢者医療給付の制限
第八十七条
When an insured or a person who used to be an insured has suffered illness or injury intentionally or due to an intentional criminal act, benefits for medical treatment, or dietary treatment expenses for inpatients, living support expenses for inpatients, medical expenses combined with treatment outside insurance coverage, medical expenses, medical expenses for home-nursing, special medical expenses, or transport expenses pertaining to the illness or injury (hereinafter referred to as "benefits for medical treatment, etc." in this Subsection) are not paid.
被保険者又は被保険者であつた者が、自己の故意の犯罪行為により、又は故意に疾病にかかり、若しくは負傷したときは、当該疾病又は負傷に係る療養の給付又は入院時食事療養費、入院時生活療養費、保険外併用療養費、療養費、訪問看護療養費、特別療養費若しくは移送費の支給（以下この款において「療養の給付等」という。）は、行わない。
第八十八条
When an insured suffers illness or injury due to a conflict, state of drunkenness or extreme misconduct, benefits for medical treatment, etc. for such illness or injury may not be paid in whole or in part.
被保険者が闘争、泥酔又は著しい不行跡によつて疾病にかかり、又は負傷したときは、当該疾病又は負傷に係る療養の給付等は、その全部又は一部を行わないことができる。
第八十九条
If a person who is or was an insured is confined in a penal institution, workhouse, or any other facility equivalent thereto, no benefits for medical treatment, etc. are paid for the period during which the person is confined.
被保険者又は被保険者であつた者が、刑事施設、労役場その他これらに準ずる施設に拘禁された場合には、その期間に係る療養の給付等は、行わない。
第九十条
The Association of Medical Care Systems for the Elderly Aged 75 and older may refrain from providing part of the benefits for medical treatment, etc. when an insured or a person who used to be an insured fails, without justifiable grounds, to follow instructions concerning medical treatment.
後期高齢者医療広域連合は、被保険者又は被保険者であつた者が、正当な理由がなく療養に関する指示に従わないときは、療養の給付等の一部を行わないことができる。
第九十一条
When a person who is or was an insured or a person who receives an old-old medical care benefit fails to comply with an order pursuant to the provisions of Article 60 or refuses to answer questions or undergo a medical examination without justifiable grounds, the Association of Medical Care Systems for the Elderly Aged 75 and older may refrain from providing benefits for medical treatment, etc., in whole or in part.
後期高齢者医療広域連合は、被保険者若しくは被保険者であつた者又は後期高齢者医療給付を受ける者が、正当な理由がなく第六十条の規定による命令に従わず、又は答弁若しくは受診を拒んだときは、療養の給付等の全部又は一部を行わないことができる。
第九十二条
When an insured who is eligible to receive an old-old medical care benefit is delinquent in payment of insurance premiums and, during the period from the due date for payment of those insurance premiums until the period specified by Order of the Ministry of Health, Labour and Welfare has elapsed, still does not pay those insurance premiums even though a municipality has carried out encouragement of insurance premium payment, etc., the Association of Medical Care Systems for the Elderly Aged 75 and older is to temporarily suspend payment of all or part of the old-old medical care benefit, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, except where it is found that there are special circumstances specified by Cabinet Order, such as a disaster, regarding the delinquency in payment of those insurance premiums.
後期高齢者医療広域連合は、後期高齢者医療給付を受けることができる被保険者が保険料を滞納しており、かつ、当該保険料の納期限から厚生労働省令で定める期間が経過するまでの間に、市町村が保険料納付の勧奨等を行つてもなお当該保険料を納付しない場合においては、当該保険料の滞納につき災害その他の政令で定める特別の事情があると認められる場合を除き、厚生労働省令で定めるところにより、後期高齢者医療給付の全部又は一部の支払を一時差し止めるものとする。
Even if the period specified by Order of the Ministry of Health, Labour and Welfare as prescribed in the preceding paragraph has not elapsed, if an insured who is eligible to receive an old-old medical care benefit is still in arrears on insurance premiums even though a municipality has carried out encouragement of insurance premium payment, etc., the Association of Medical Care Systems for the Elderly Aged 75 and older may, as specified by Order of the Ministry of Health, Labour and Welfare, temporarily suspend payment of all or part of the old-old medical care benefit, except where it is found that there are special circumstances specified by Cabinet Order, such as a disaster, in respect of the arrears of those insurance premiums.
後期高齢者医療広域連合は、前項に規定する厚生労働省令で定める期間が経過しない場合においても、後期高齢者医療給付を受けることができる被保険者が、市町村が保険料納付の勧奨等を行つてもなお保険料を滞納している場合においては、当該保険料の滞納につき災害その他の政令で定める特別の事情があると認められる場合を除き、厚生労働省令で定めるところにより、後期高齢者医療給付の全部又は一部の支払を一時差し止めることができる。
If an insured to which the provisions of Article 82, paragraph (1) or the main clause of paragraph (2) are applied and for which the payment of the old-old medical care benefit has been temporarily suspended in whole or in part pursuant to the provisions of the preceding two paragraphs still does not pay the delinquent insurance premiums, the Association of Medical Care Systems for the Elderly Aged 75 and older may, pursuant to the provisions of the Order of the Ministry of Health, Labour and Welfare, deduct the amount of the insurance premiums that the insured is delinquent from the amount of the old-old medical care benefit pertaining to the temporary suspension, by giving notice to the insured in advance.
後期高齢者医療広域連合は、第八十二条第一項又は第二項本文の規定の適用を受けている被保険者であつて、前二項の規定による後期高齢者医療給付の全部又は一部の支払の一時差止がなされているものが、なお滞納している保険料を納付しない場合においては、厚生労働省令で定めるところにより、あらかじめ、当該被保険者に通知して、当該一時差止に係る後期高齢者医療給付の額から当該被保険者が滞納している保険料額を控除することができる。
Section 4 Expenses
第四節 費用等
Subsection 1 Bearing of Expenses
第一款 費用の負担
Article 93Expenses Borne by the State
第九十三条（国の負担）
The national government, pursuant to the provisions of Cabinet Order, bears, with respect to the Association of Medical Care Systems for the Elderly Aged 75 and older, an amount equivalent to 3/12 of the sum total (hereinafter referred to as the "total Amount Subject to Sharing") of the amount obtained by deducting the amount of expenses incurred in providing benefits for medical treatment, etc. pertaining to persons falling under the case listed in Article 67, paragraph (1), item (iii) (hereinafter referred to as the "amount of specified expenses") from the sum total (hereinafter referred to as the "amount of expenses incurred in providing benefits for medical treatment, etc.") of the amount obtained by deducting the amount equivalent to the co-payment for the benefits from the amount of expenses required for the benefits for medical treatment pertaining to insured and the amount of expenses required for payment of dietary treatment expenses for inpatients, living support expenses for inpatients, medical expenses combined with treatment outside insurance coverage, medical expenses, medical expenses for home-nursing, special medical expenses, transport expenses, high-cost medical expenses and sizable medical and nursing expenses (referred to as the "Amount Subject to Sharing" in item (i) of the following paragraph and Article 100, paragraph (1)), and the amount obtained by deducting, from the amount of the contribution for securing medical care in the early phase of an epidemic, the amount obtained by multiplying that amount by the ratio of the amount of specified expenses to the amount of expenses incurred in providing benefits for medical treatment, etc. (referred to as the "amount of specified contribution for securing medical care in the early phase of an epidemic" in Article 100, paragraph (1)) (referred to as the "contribution Amount Subject to Sharing" in Article 100, paragraph (1)).
国は、政令で定めるところにより、後期高齢者医療広域連合に対し、被保険者に係る療養の給付に要する費用の額から当該給付に係る一部負担金に相当する額を控除した額並びに入院時食事療養費、入院時生活療養費、保険外併用療養費、療養費、訪問看護療養費、特別療養費、移送費、高額療養費及び高額介護合算療養費の支給に要する費用の額の合計額（以下「療養の給付等に要する費用の額」という。）から第六十七条第一項第三号に掲げる場合に該当する者に係る療養の給付等に要する費用の額（以下「特定費用の額」という。）を控除した額（次項第一号及び第百条第一項において「負担対象額」という。）並びに流行初期医療確保拠出金の額から当該流行初期医療確保拠出金の額に療養の給付等に要する費用の額に占める特定費用の額の割合を乗じて得た額（第百条第一項において「特定流行初期医療確保拠出金の額」という。）を控除した額（第百条第一項において「負担対象拠出金額」という。）の合計額（以下「負担対象総額」という。）の十二分の三に相当する額を負担する。
The national government, beyond what is listed in the preceding paragraph, pursuant to the provisions of Cabinet Order, in order to achieve the financial stability of old-old medical care, bears, with respect to the Association of Medical Care Systems for the Elderly Aged 75 and older, an amount equivalent to 1/4 of the amount obtained by multiplying the sum total of the expenses required for benefits related to extremely expensive medical care that are not less than the amount calculated as specified by Cabinet Order as having a significant impact on the finances of old-old medical care due to the occurrence of benefits related to extremely expensive medical care, taking into consideration the ratio of benefits related to extremely expensive medical care to the amount of expenses required for all benefits related to medical care pertaining to insured and other factors, by the sum of the following rates (referred to as the "amount of high-cost medical expenses subject to sharing" in Article 96, paragraph (2)).
国は、前項に掲げるもののほか、政令で定めるところにより、後期高齢者医療広域連合に対し、後期高齢者医療の財政の安定化を図るため、被保険者に係る全ての医療に関する給付に要する費用の額に対する高額な医療に関する給付の割合等を勘案して、高額な医療に関する給付の発生による後期高齢者医療の財政に与える影響が著しいものとして政令で定めるところにより算定する額以上の高額な医療に関する給付に要する費用の合計額に次に掲げる率の合計を乗じて得た額（第九十六条第二項において「高額医療費負担対象額」という。）の四分の一に相当する額を負担する。
the rate obtained by dividing the amount equivalent to one twelfth of the Amount Subject to Sharing by the amount of expenses required for Benefits for Medical Treatment, etc.;
負担対象額の十二分の一に相当する額を療養の給付等に要する費用の額で除して得た率
the contribution rate for the old-old in Article 100, paragraph (1).
第百条第一項の後期高齢者負担率
Beyond what is provided for in the preceding two paragraphs, pursuant to the provisions of Cabinet Order, the national government is to grant two-thirds of the estimated total amount of special burden adjustment, etc. for the relevant fiscal year to the Organization each fiscal year; provided, however, that if the estimated total amount of special burden adjustment, etc. for the fiscal year before the previous fiscal year exceeds the total amount of special burden adjustment, etc. for the same fiscal year, the national government is to grant two-thirds of the amount obtained by subtracting the excess amount from the estimated total amount of special burden adjustment, etc. for the relevant fiscal year, and if the estimated total amount of special burden adjustment, etc. for the fiscal year before the previous fiscal year is less than the total amount of special burden adjustment, etc. for the same fiscal year, the national government is to grant two-thirds of the amount obtained by adding the less amount to the estimated total amount of special burden adjustment, etc. for the relevant fiscal year.
国は、前二項に定めるもののほか、政令で定めるところにより、年度ごとに、機構に対して当該年度の特別負担調整見込額の総額等の三分の二を交付する。ただし、前々年度の特別負担調整見込額の総額等が同年度の特別負担調整額の総額等を超えるときは、当該年度の特別負担調整見込額の総額等からその超える額を控除して得た額の三分の二を交付するものとし、前々年度の特別負担調整見込額の総額等が同年度の特別負担調整額の総額等に満たないときは、当該年度の特別負担調整見込額の総額等にその満たない額を加算して得た額の三分の二を交付するものとする。
Article 94Reduction of Treasury Share
第九十四条（国庫負担金の減額）
If a Association of Medical Care Systems for the Elderly Aged 75 and older unjustly fails to secure the revenue that it should have secured, the national government may reduce the amount to be borne by the Association of Medical Care Systems for the Elderly Aged 75 and older pursuant to the provisions of the preceding Article, pursuant to the provisions of Cabinet Order.
後期高齢者医療広域連合が確保すべき収入を不当に確保しなかつた場合においては、国は、政令で定めるところにより、前条の規定により当該後期高齢者医療広域連合に対して負担すべき額を減額することができる。
The amount to be reduced pursuant to the provisions of the preceding paragraph may not exceed the amount which was unjustly not secured.
前項の規定により減額する額は、不当に確保しなかつた額を超えることができない。
第九十五条（調整交付金）
The national government provides adjustment grants to a Association of Medical Care Systems for the Elderly Aged 75 and older pursuant to the provisions of a Cabinet Order in order to adjust the finances of medical care for the elderly.
国は、後期高齢者医療の財政を調整するため、政令で定めるところにより、後期高齢者医療広域連合に対して調整交付金を交付する。
The total amount of adjustment grants under the provisions of the preceding paragraph is the sum total of the amount equivalent to 1/12 of the total of the estimated amounts of the total amount subject to sharing and the amount equivalent to 1/120 of the estimated amount of the children and child-rearing support levy under the Act on Support for Children and Child-rearing (Act No. 65 of 2012) (hereinafter referred to as the "children and child-rearing support levy").
Article 96Expenses Borne by Prefectures
第九十六条（都道府県の負担）
A prefecture, pursuant to the provisions of Cabinet Order, bears an amount equivalent to one twelfth of the total amount subject to sharing by a Association of Medical Care Systems for the Elderly Aged 75 and older.
都道府県は、政令で定めるところにより、後期高齢者医療広域連合に対し、負担対象総額の十二分の一に相当する額を負担する。
Beyond what is set forth in the preceding paragraph, a prefecture is to bear an amount equivalent to one fourth of the amount subject to high medical care cost contribution to the Association of Medical Care Systems for the Elderly Aged 75 and older, pursuant to the provisions of Cabinet Order.
都道府県は、前項に掲げるもののほか、政令で定めるところにより、後期高齢者医療広域連合に対し、高額医療費負担対象額の四分の一に相当する額を負担する。
Article 97Reduction of Prefecture's Contribution
第九十七条（都道府県の負担金の減額）
If a Association of Medical Care Systems for the Elderly Aged 75 and older unjustly fails to secure the revenue it should have secured and the national government reduces the amount to be borne pursuant to the provisions of Article 94, the prefecture may reduce the amount to be borne by the Association of Medical Care Systems for the Elderly Aged 75 and older pursuant to the provisions of the preceding Article, pursuant to the provisions of Cabinet Order.
後期高齢者医療広域連合が確保すべき収入を不当に確保しなかつた場合において、国が第九十四条の規定により負担すべき額を減額したときは、都道府県は、政令で定めるところにより、前条の規定により当該後期高齢者医療広域連合に対して負担すべき額を減額することができる。
The amount to be reduced pursuant to the provisions of the preceding paragraph may not exceed the amount which was unjustly not secured.
前項の規定により減額する額は、不当に確保しなかつた額を超えることができない。
Article 98Burden on the General Account of a Municipality
第九十八条（市町村の一般会計における負担）
A Municipality, pursuant to the provisions of a Cabinet Order, is to bear an amount equivalent to one twelfth of the Total Amount Subject to Sharing with a Association of Medical Care Systems for the Elderly Aged 75 and older in its general account.
市町村は、政令で定めるところにより、後期高齢者医療広域連合に対し、その一般会計において、負担対象総額の十二分の一に相当する額を負担する。
Article 99Transfer to the Special Account of a Municipality
第九十九条（市町村の特別会計への繰入れ等）
A Municipality, pursuant to the provisions of a Cabinet Order, must transfer from the general account to the special account for medical care for the elderly of the Municipality the amount calculated, pursuant to the provisions of a Cabinet Order, based on the total amount of insurance premiums pertaining to the insured reduced based on the reduced assessment of insurance premiums for persons with small income pursuant to the provisions of the Ordinances of the Association of Medical Care Systems for the Elderly Aged 75 and older, by taking into consideration the financial status of medical care for the elderly and other circumstances.
市町村は、政令で定めるところにより、一般会計から、所得の少ない者について後期高齢者医療広域連合の条例の定めるところにより行う保険料の減額賦課に基づき被保険者に係る保険料につき減額した額の総額を基礎とし、後期高齢者医療の財政の状況その他の事情を勘案して政令で定めるところにより算定した額を市町村の後期高齢者医療に関する特別会計に繰り入れなければならない。
A municipality must, pursuant to the provisions of Cabinet Order, transfer from the general account to the special account of the municipality for old-old medical care, with respect to an insured who was a dependent under the provisions of the Health Insurance Act, the Mariners Insurance Act, the National Public Officers Mutual Aid Association Act (including as applied mutatis mutandis pursuant to other Acts) or the Local Public Officers, etc. Mutual Aid Association Act on the day before the day on which the insured came to fall under any of the items of Article 52, the amount calculated as specified by Cabinet Order, taking into consideration the financial status of old-old medical care and other circumstances, on the basis of the total amount of reduction where, limited to the period from the month containing the day on which the insured came to fall under any of the cases listed in the items of that Article until the month in which two years have elapsed, insurance premiums are reduced pursuant to a reduced assessment of insurance premiums made as provided by Ordinance of the Association.
市町村は、政令で定めるところにより、一般会計から、第五十二条各号のいずれかに該当するに至つた日の前日において健康保険法、船員保険法、国家公務員共済組合法（他の法律において準用する場合を含む。）又は地方公務員等共済組合法の規定による被扶養者であつた被保険者について、同条各号に掲げる場合のいずれかに該当するに至つた日の属する月以後二年を経過する月までの間に限り、条例の定めるところにより行う保険料の減額賦課に基づき保険料を減額した場合における当該減額した額の総額を基礎とし、後期高齢者医療の財政の状況その他の事情を勘案して政令で定めるところにより算定した額を、市町村の後期高齢者医療に関する特別会計に繰り入れなければならない。
A prefecture, pursuant to the provisions of Cabinet Order, bears an amount equivalent to three quarters of the amount to be transferred pursuant to the provisions of the preceding two paragraphs.
都道府県は、政令で定めるところにより、前二項の規定による繰入金の四分の三に相当する額を負担する。
第百条（後期高齢者交付金）
Among the expenses borne in the special account for old-old medical care of the Association of Medical Care Systems for the Elderly Aged 75 and older, the amount obtained by adding, to the sum total of the amount obtained by multiplying the Amount Subject to Sharing by the rate obtained by deducting the contribution rate for the old-old and 50 percent from one and the amount obtained by multiplying the amount of specified expenses by the rate obtained by deducting the contribution rate for the old-old from one (hereinafter referred to as the "amount subject to insurance payment" in this Section), the sum total of the amount obtained by multiplying the contribution Amount Subject to Sharing by the rate obtained by deducting the contribution rate for the old-old and 50 percent from one and the amount obtained by multiplying the amount of specified contribution for securing medical care in the early phase of an epidemic by the rate obtained by deducting the contribution rate for the old-old from one (referred to as the "total amount subject to insurance payment" in Article 121, paragraph (1)) is to be covered by the Old-Old Subsidy granted by the Organization to the Association of Medical Care Systems for the Elderly Aged 75 and older, pursuant to the provisions of Cabinet Order.
後期高齢者医療広域連合の後期高齢者医療に関する特別会計において負担する費用のうち、負担対象額に一から後期高齢者負担率及び百分の五十を控除して得た率を乗じて得た額並びに特定費用の額に一から後期高齢者負担率を控除して得た率を乗じて得た額の合計額（以下この節において「保険納付対象額」という。）に負担対象拠出金額に一から後期高齢者負担率及び百分の五十を控除して得た率を乗じて得た額並びに特定流行初期医療確保拠出金の額に一から後期高齢者負担率を控除して得た率を乗じて得た額の合計額を加えて得た額（第百二十一条第一項において「保険納付対象総額」という。）については、政令で定めるところにより、機構が後期高齢者医療広域連合に対して交付する後期高齢者交付金をもつて充てる。
The contribution rate for the old-old set forth in the preceding paragraph is specified by Cabinet Order every two years based on the rate obtained by multiplying the number set forth in item (i) by the rate set forth in item (ii) and then dividing the product by the number set forth in item (iii):
the number obtained by adding, to one half, a rate equivalent to one half of the ratio of the amount of specified expenses to the amount of expenses required for benefits for medical treatment, etc. in the relevant fiscal year.
二分の一に、当該年度における療養の給付等に要する費用の額に対する特定費用の額の割合の二分の一に相当する率を加えて得た数
The rate obtained by multiplying 11.72 percent by the rate obtained by dividing the prospective total number of insured pertaining to all Association of Medical Care Systems for the Elderly Aged 75 and older in the relevant fiscal year by the total number of insured pertaining to all Association of Medical Care Systems for the Elderly Aged 75 and older in fiscal year 2022.
百分の十一・七二に、当該年度における全ての後期高齢者医療広域連合に係る被保険者の見込総数を令和四年度における全ての後期高齢者医療広域連合に係る被保険者の総数で除して得た率を乗じて得た率
the number arrived at when the rate set forth in the preceding item is added to the rate arrived at when the rate set forth in (a) is multiplied by the rate set forth in (b):
前号に掲げる率に、イに掲げる率にロに掲げる率を乗じて得た率を加えて得た数
the rate obtained by dividing the amount subject to insurance payment in fiscal year 2022 by the amount of expenses required for benefits for medical treatment, etc. in the same fiscal year;
令和四年度における保険納付対象額を同年度における療養の給付等に要する費用の額で除して得た率
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 2022.
The Old-Old Subsidy referred to in paragraph (1) is to be covered by the aid for the old-old collected by the Organization pursuant to the provisions of Article 118, paragraph (1).
Article 101Reduction of Old-Old Subsidy
第百一条（後期高齢者交付金の減額）
If the Association of Medical Care Systems for the Elderly Aged 75 and older unjustly fails to secure the revenue that it should have secured or unjustly incurs expenses that it should not incur, the Minister of Health, Labour and Welfare may, pursuant to the provisions of Cabinet Order, order the Organization to reduce the amount of the Old-Old Subsidy referred to in the same paragraph that is granted to that Association pursuant to the provisions of paragraph (1) of the preceding Article.
厚生労働大臣は、後期高齢者医療広域連合が確保すべき収入を不当に確保しなかつた場合又は後期高齢者医療広域連合が支出すべきでない経費を不当に支出した場合においては、政令で定めるところにより、機構に対し、前条第一項の規定により当該後期高齢者医療広域連合に対して交付する同項の後期高齢者交付金の額を減額することを命ずることができる。
The amount to be reduced pursuant to the provisions of the preceding paragraph may not exceed the amount which has unjustly failed to be secured or the amount which has unjustly been expended.
前項の規定により減額する額は、不当に確保しなかつた額又は不当に支出した額を超えることができない。
Article 102Subsidies from the State
第百二条（国の補助）
In addition to what is provided for in Article 93, Articles 95 and 116, paragraph (6), the national government may subsidize part of the expenses required for medical care for elderly people within the scope of the budget.
第百三条（都道府県、市町村及び後期高齢者医療広域連合の補助及び貸付け）
Beyond what is provided for in Article 96, Article 98, Articles 99 and 116, paragraph (5), a prefecture, municipality, and Association of Medical Care Systems for the Elderly Aged 75 and older may provide subsidies or loans for expenses required for medical care for elderly persons.
都道府県、市町村及び後期高齢者医療広域連合は、第九十六条、第九十八条、第九十九条及び第百十六条第五項に規定するもののほか、後期高齢者医療に要する費用に対し、補助金を交付し、又は貸付金を貸し付けることができる。
第百四条（保険料）
A municipality must collect insurance premiums to cover the expenses required for old-old medical care (including expenses required for payment of the Fiscal Stability Fund contributions, the contributions and childbirth and childcare support benefits pursuant to the provisions of Article 117, paragraph (2), the contribution for securing medical care in the early phase of an epidemic, etc. pursuant to the provisions of the Act on the Prevention of Infectious Diseases and Medical Care for Patients with Infectious Diseases (referred to as the "contribution for securing medical care in the early phase of an epidemic, etc." in paragraph (3) and Article 116, paragraph (2)), and the children and child-rearing support levy).
市町村は、後期高齢者医療に要する費用（財政安定化基金拠出金、第百十七条第二項の規定による拠出金及び出産育児支援金、感染症の予防及び感染症の患者に対する医療に関する法律の規定による流行初期医療確保拠出金等（第三項及び第百十六条第二項において「流行初期医療確保拠出金等」という。）並びに子ども・子育て支援納付金の納付に要する費用を含む。）に充てるため、保険料を徴収しなければならない。
The insurance premiums referred to in the preceding paragraph are imposed by the Association of Medical Care Systems for the Elderly Aged 75 and older on an insured in the amount of insurance premiums calculated using the insurance premium rate calculated as provided by Ordinance of the Association of Medical Care Systems for the Elderly Aged 75 and older in accordance with the standards specified by Cabinet Order, such as the insurance premium rate being uniform throughout the entire area of the Association of Medical Care Systems for the Elderly Aged 75 and older; provided, however, that the insurance premiums of an insured who has an address in an area, within the area of the relevant Association of Medical Care Systems for the Elderly Aged 75 and older, such as a remote island, where securing medical care is extremely difficult and which falls under the standards specified by the Minister of Health, Labour and Welfare, may be imposed in the amount of insurance premiums calculated using an insurance premium rate separately calculated as provided by Ordinance of the Association of Medical Care Systems for the Elderly Aged 75 and older in accordance with the standards specified by Cabinet Order.
前項の保険料は、後期高齢者医療広域連合が被保険者に対し、後期高齢者医療広域連合の全区域にわたつて均一の保険料率であることその他の政令で定める基準に従い後期高齢者医療広域連合の条例で定めるところにより算定された保険料率によつて算定された保険料額によつて課する。ただし、当該後期高齢者医療広域連合の区域のうち、離島その他の医療の確保が著しく困難である地域であつて厚生労働大臣が定める基準に該当するものに住所を有する被保険者の保険料については、政令で定める基準に従い別に後期高齢者医療広域連合の条例で定めるところにより算定された保険料率によつて算定された保険料額によつて課することができる。
The insurance premiums rate referred to in the preceding paragraph must be able to maintain a balanced budget in general throughout two years in light of the estimated amount of expenses incurred in providing benefits for medical treatment, etc., the estimated amount of expenses required for payment of the Fiscal Stability Fund contributions, the contributions and childbirth and childcare support benefits pursuant to the provisions of Article 117, paragraph (2), the contribution for securing medical care in the early phase of an epidemic, etc., and the children and child-rearing support levy, the estimated amount of expenses required for redemption of borrowings from the prefecture pursuant to the provisions of Article 116, paragraph (1), item (ii), the estimated amount of expenses required for health services for the elderly provided for in Article 125, paragraph (1) and for the services provided for in paragraph (5) of the same Article, the status of distribution of income of insured and its prospects, the national treasury burden, and the amount of the Old-Old Subsidy, etc. in Article 100, paragraph (1).
前項の保険料率は、療養の給付等に要する費用の額の予想額、財政安定化基金拠出金、第百十七条第二項の規定による拠出金及び出産育児支援金、流行初期医療確保拠出金等並びに子ども・子育て支援納付金の納付に要する費用の予想額、第百十六条第一項第二号の規定による都道府県からの借入金の償還に要する費用の予定額、第百二十五条第一項に規定する高齢者保健事業及び同条第五項に規定する事業に要する費用の予定額、被保険者の所得の分布状況及びその見通し、国庫負担並びに第百条第一項の後期高齢者交付金等の額等に照らし、おおむね二年を通じ財政の均衡を保つことができるものでなければならない。
Article 105Payment of Insurance Premiums
第百五条（保険料等の納付）
A Municipality is to pay to a Association of Medical Care Systems for the Elderly Aged 75 and older the amount to be transferred pursuant to the provisions of Article 99, paragraphs (1) and (2) and insurance premiums and any other money to be collected pursuant to the provisions of this Chapter (limited to those collected by the Municipality) pursuant to the provisions of the constitution of the Association of Medical Care Systems for the Elderly Aged 75 and older, in order to cover the expenses required for the Old-Old Healthcare provided by the Association of Medical Care Systems for the Elderly Aged 75 and older.
市町村は、後期高齢者医療広域連合が行う後期高齢者医療に要する費用に充てるため、後期高齢者医療広域連合に対し、後期高齢者医療広域連合の規約で定めるところにより、第九十九条第一項及び第二項の規定による繰入金並びに保険料その他この章の規定による徴収金（市町村が徴収するものに限る。）を納付するものとする。
第百六条（賦課期日）
The assessment date for insurance premiums is the first day of the relevant fiscal year.
保険料の賦課期日は、当該年度の初日とする。
Article 107Method of Collecting Insurance Premiums
第百七条（保険料の徴収の方法）
The collection of the insurance premiums under Article 104 by a municipality must be done by the method of ordinary collection (meaning that a municipality collects insurance premiums by giving notice of payment pursuant to the provisions of Article 231 of the Local Autonomy Act (Act No. 67 of 1947) to an insured on whom the insurance premiums are imposed, to the head of the household to which that insured belongs, or to the spouse of that insured (including a person who has not filed a notification of marriage but is in a situation equivalent to a marital relationship in fact; the same applies hereinafter); the same applies hereinafter), except where it is done by the method of special collection (meaning that a municipality causes a person who pays Old Age, etc., pension benefits (hereinafter referred to as a "Pension Insurer") to collect insurance premiums from an insured who receives Old Age, etc., pension benefits (excluding persons specified by Cabinet Order) and to pay in the insurance premiums to be collected; the same applies hereinafter).
市町村による第百四条の保険料の徴収については、特別徴収（市町村が老齢等年金給付を受ける被保険者（政令で定める者を除く。）から老齢等年金給付の支払をする者（以下「年金保険者」という。）に保険料を徴収させ、かつ、その徴収すべき保険料を納入させることをいう。以下同じ。）の方法による場合を除くほか、普通徴収（市町村が、保険料を課せられた被保険者又は当該被保険者の属する世帯の世帯主若しくは当該被保険者の配偶者（婚姻の届出をしていないが、事実上婚姻関係と同様の事情にある者を含む。以下同じ。）に対し、地方自治法（昭和二十二年法律第六十七号）第二百三十一条の規定により納入の通知をすることによつて保険料を徴収することをいう。以下同じ。）の方法によらなければならない。
The Old Age, etc. pension benefit set forth in the preceding paragraph means the Old Age Basic Pension under the National Pension Act (Act No. 141 of 1959) and other pension benefits under the same Act or the Employee's Pension Insurance Act (Act No. 115 of 1954) for which the grounds for payment are old age, disability, or death, which are specified by Cabinet Order, and pension benefits similar to these pension benefits for which the grounds for payment are old age, retirement, disability, or death, which are specified by Cabinet Order.
前項の老齢等年金給付は、国民年金法（昭和三十四年法律第百四十一号）による老齢基礎年金その他の同法又は厚生年金保険法（昭和二十九年法律第百十五号）による老齢、障害又は死亡を支給事由とする年金たる給付であつて政令で定めるもの及びこれらの年金たる給付に類する老齢若しくは退職、障害又は死亡を支給事由とする年金たる給付であつて政令で定めるものをいう。
Article 108Obligation to Pay Insurance Premiums Pertaining to General Collection
第百八条（普通徴収に係る保険料の納付義務）
Insured must pay the insurance premiums when a Municipality intends to collect the person's insurance premiums by the method of general collection.
被保険者は、市町村がその者の保険料を普通徴収の方法によつて徴収しようとする場合においては、当該保険料を納付しなければならない。
When a Municipality intends to collect insurance premiums of an insured belonging to a household by the method of general collection, the Householder is liable to jointly and severally pay the insurance premiums.
世帯主は、市町村が当該世帯に属する被保険者の保険料を普通徴収の方法によつて徴収しようとする場合において、当該保険料を連帯して納付する義務を負う。
If a Municipality intends to collect insurance premiums of the other party that is an insured by the method of general collection, one of the spouses is liable to pay the insurance premiums jointly and severally.
配偶者の一方は、市町村が被保険者たる他方の保険料を普通徴収の方法によつて徴収しようとする場合において、当該保険料を連帯して納付する義務を負う。
Article 109Due Date of Insurance Premiums Pertaining to General Collection
第百九条（普通徴収に係る保険料の納期）
The due date of payment of insurance premiums collected by the method of general collection is specified by Municipal Ordinance.
普通徴収の方法によつて徴収する保険料の納期は、市町村の条例で定める。
The provisions of Articles 134 through 141-2, Long-Term Care Insurance Act apply mutatis mutandis to the special collection of insurance premiums conducted pursuant to the provisions of Article 107. In this case, the necessary technical replacement of terms is specified by Cabinet Order.
介護保険法第百三十四条から第百四十一条の二までの規定は、第百七条の規定により行う保険料の特別徴収について準用する。この場合において、必要な技術的読替えは、政令で定める。
Article 111Reduction and Exemption of Insurance Premiums
第百十一条（保険料の減免等）
The Association of Medical Care Systems for the Elderly Aged 75 and older may, pursuant to the provisions of its Ordinances, reduce or exempt insurance premiums or suspend the collection thereof for persons with special reasons.
後期高齢者医療広域連合は、条例で定めるところにより、特別の理由がある者に対し、保険料を減免し、又はその徴収を猶予することができる。
The provisions of Article 9, Article 13-2, Article 20, Article 20-2, and Article 20-4 of the Local Tax Act (Act No. 226 of 1950) apply mutatis mutandis to insurance premiums and any other money to be collected pursuant to the provisions of this Chapter (limited to those to be collected by municipalities and Association of Medical Care Systems for the Elderly Aged 75 and older).
保険料その他この章の規定による徴収金（市町村及び後期高齢者医療広域連合が徴収するものに限る。）については、地方税法（昭和二十五年法律第二百二十六号）第九条、第十三条の二、第二十条、第二十条の二及び第二十条の四の規定を準用する。
Article 113disposition to collect arrears
第百十三条（滞納処分）
Insurance premiums collected by a municipality, co-payment for which collection has been suspended and which is collected by a Association of Medical Care Systems for the Elderly Aged 75 and older, and any other money to be collected pursuant to the provisions of this Chapter are revenues specified by laws as prescribed in Article 231-3, paragraph (3) of the Local Autonomy Act.
市町村が徴収する保険料、後期高齢者医療広域連合が徴収する徴収猶予した一部負担金その他この章の規定による徴収金は、地方自治法第二百三十一条の三第三項に規定する法律で定める歳入とする。
Article 114Entrustment of Collection of Insurance Premiums
第百十四条（保険料の徴収の委託）
A Municipality may entrust the affairs of the collection of insurance premiums collected by the method of general collection to a person designated pursuant to the provisions of Article 243-2, paragraph (1) of the Local Autonomy Act, only when it is found that the entrustment will contribute to the assurance of revenue and the promotion of the benefits of the insured.
市町村は、普通徴収の方法によつて徴収する保険料の徴収の事務については、収入の確保及び被保険者の便益の増進に寄与すると認める場合に限り、地方自治法第二百四十三条の二第一項の規定により指定する者に委託することができる。
Article 115Delegation to Ordinance
第百十五条（条例等への委任）
Beyond what is provided for in this Subsection, the amount of insurance premiums to be imposed and other particulars concerning the imposition of insurance premiums are prescribed by Ordinance of the Association of Medical Care Systems for the Elderly Aged 75 and older in accordance with the standards specified by Cabinet Order.
この款に規定するもののほか、保険料の賦課額その他保険料の賦課に関する事項は、政令で定める基準に従つて後期高齢者医療広域連合の条例で定める。
Beyond what is provided for in this Subsection, the notification of the amount of insurance premiums and other matters concerning the collection of insurance premiums (excluding those concerning special collection) are specified by Municipal Ordinance in accordance with the standards specified by Cabinet Order, and necessary matters concerning special collection are specified by Cabinet Order or Municipal Ordinance in accordance with the standards specified by Cabinet Order.
この款に規定するもののほか、保険料の額の通知その他保険料の徴収に関する事項（特別徴収に関するものを除く。）は政令で定める基準に従つて市町村の条例で、特別徴収に関して必要な事項は政令又は政令で定める基準に従つて市町村の条例で定める。
Subsection 2 Fiscal Stability Funds
第二款 財政安定化基金
第百十六条
A prefecture, in order to contribute to the financial stability of medical care for the elderly, is to establish a financial stability fund to cover the expenses necessary for the following projects:
都道府県は、後期高齢者医療の財政の安定化に資するため財政安定化基金を設け、次に掲げる事業に必要な費用に充てるものとする。
a project to provide a Association of Medical Care Systems for the Elderly Aged 75 and older whose actual amount of insurance premiums received is expected to fall short of the estimated amount of insurance premiums received and whose amount of revenue subject to a fund project is expected to fall short of the amount of expenses subject to a fund project with an amount calculated pursuant to the provisions of Cabinet Order based on an amount equivalent to half of the amount listed in (a) below (if the amount listed in (a) below exceeds the amount listed in (b) below, the amount listed in (b) below) by taking into consideration the status of receipt of insurance premiums, etc. in the municipality that organizes the Association of Medical Care Systems for the Elderly Aged 75 and older, pursuant to the provisions of Cabinet Order:
実績保険料収納額が予定保険料収納額に不足すると見込まれ、かつ、基金事業対象収入額が基金事業対象費用額に不足すると見込まれる後期高齢者医療広域連合に対し、政令で定めるところにより、イに掲げる額（イに掲げる額がロに掲げる額を超えるときは、ロに掲げる額）の二分の一に相当する額を基礎として、当該後期高齢者医療広域連合を組織する市町村における保険料の収納状況等を勘案して政令で定めるところにより算定した額を交付する事業
the amount of insurance premiums actually received that is expected to be less than the amount of insurance premiums scheduled to be received;
the amount by which the Amount of Revenue Covered by the Fund Project is expected to be short of the Amount of Cost Covered by the Fund Project;
a project to provide a Association of Medical Care Systems for the Elderly Aged 75 and older whose total of the Revenue Subject to a Fund Project and the Amount Delivered by a Fund Project is expected to fall short of the Amount of Expenses Subject to a Fund Project with a loan, pursuant to the provisions of Cabinet Order, in an amount not exceeding the amount calculated pursuant to the provisions of Cabinet Order, based on the expected shortfall, by taking into consideration the status of collection of insurance premiums, etc. in the Municipality that organizes the Association of Medical Care Systems for the Elderly Aged 75 and older.
基金事業対象収入額及び基金事業交付額の合計額が、基金事業対象費用額に不足すると見込まれる後期高齢者医療広域連合に対し、政令で定めるところにより、当該不足すると見込まれる額を基礎として、当該後期高齢者医療広域連合を組織する市町村における保険料の収納状況等を勘案して政令で定めるところにより算定した額の範囲内の額を貸し付ける事業
Among the terms used in the preceding paragraph, the meanings of those set forth in the following items are as prescribed respectively in those items:
前項における用語のうち次の各号に掲げるものの意義は、当該各号に定めるところによる。
the estimated amount of insurance premiums received: the amount calculated pursuant to the provisions of Cabinet Order as the amount to be allocated to the amount of expenses incurred in providing benefits for medical treatment, etc., the amount of expenses required for payment of the Fiscal Stability Fund contributions, the contributions and childbirth and childcare support benefits pursuant to the provisions of paragraph (2) of the following Article, the contribution for securing medical care in the early phase of an epidemic, etc., and the children and child-rearing support levy, and the amount of expenses required for redemption of borrowings from the prefecture pursuant to the provisions of item (ii) of the preceding paragraph (hereinafter referred to as "Borrowings for Fund Project" in this paragraph), out of the total amount of insurance premiums that are expected to be received, during the specified period (meaning every two-fiscal-year period from fiscal year 2008, which is the first year; the same applies hereinafter in this paragraph), by the municipalities that organize the Association of Medical Care Systems for the Elderly Aged 75 and older in that Association;
予定保険料収納額 後期高齢者医療広域連合において特定期間（平成二十年度を初年度とする同年度以降の二年度ごとの期間をいう。以下この項において同じ。）中に当該後期高齢者医療広域連合を組織する市町村において収納が見込まれた保険料の額の合計額のうち、療養の給付等に要する費用の額、財政安定化基金拠出金、次条第二項の規定による拠出金及び出産育児支援金、流行初期医療確保拠出金等並びに子ども・子育て支援納付金の納付に要する費用の額並びに前項第二号の規定による都道府県からの借入金（以下この項において「基金事業借入金」という。）の償還に要する費用の額に充てるものとして政令で定めるところにより算定した額
the actual amount of insurance premiums received: the amount calculated pursuant to the provisions of Cabinet Order as the amount to be allocated to the sum total of the amount obtained by deducting the amount equivalent to the co-payment for the benefits from the amount of expenses spent on benefits for medical treatment and the amount of expenses spent on payment of dietary treatment expenses for inpatients, living support expenses for inpatients, medical expenses combined with treatment outside insurance coverage, medical expenses, medical expenses for home-nursing, special medical expenses, transport expenses, high-cost medical expenses and sizable medical and nursing expenses (hereinafter referred to as the "amount of costs spent on benefits for medical treatment, etc." in this paragraph), the amount of expenses spent on payment of the Fiscal Stability Fund contributions, the contributions and childbirth and childcare support benefits pursuant to the provisions of paragraph (2) of the following Article, the contribution for securing medical care in the early phase of an epidemic, etc., and the children and child-rearing support levy, and the amount of expenses spent on redemption of Borrowings for Fund Project, out of the total amount of insurance premiums received during the specified period by the municipalities that organize the Association of Medical Care Systems for the Elderly Aged 75 and older;
実績保険料収納額 後期高齢者医療広域連合を組織する市町村において特定期間中に収納した保険料の額の合計額のうち、療養の給付に要した費用の額から当該給付に係る一部負担金に相当する額を控除した額並びに入院時食事療養費、入院時生活療養費、保険外併用療養費、療養費、訪問看護療養費、特別療養費、移送費、高額療養費及び高額介護合算療養費の支給に要した費用の額の合計額（以下この項において「療養の給付等に要した費用の額」という。）、財政安定化基金拠出金、次条第二項の規定による拠出金及び出産育児支援金、流行初期医療確保拠出金等並びに子ども・子育て支援納付金の納付に要した費用の額並びに基金事業借入金の償還に要した費用の額に充てるものとして政令で定めるところにより算定した額
the amount of revenue subject to fund projects: the amount calculated pursuant to the provisions of Cabinet Order as the amount to be allocated to the amount of costs spent on benefits for medical treatment, etc., the amount of expenses spent on payment of the Fiscal Stability Fund contributions, the contributions and childbirth and childcare support benefits pursuant to the provisions of paragraph (2) of the following Article, the contribution for securing medical care in the early phase of an epidemic, etc., and the children and child-rearing support levy, and the amount of expenses spent on redemption of Borrowings for Fund Project, out of the total of the amounts received during the specified period in the special account for old-old medical care of the Association of Medical Care Systems for the Elderly Aged 75 and older (excluding the amount of grants for fund business set forth in item (v) and the amount of Borrowings for Fund Project);
基金事業対象収入額 後期高齢者医療広域連合の後期高齢者医療に関する特別会計において特定期間中に収入した金額（第五号の基金事業交付額及び基金事業借入金の額を除く。）の合計額のうち、療養の給付等に要した費用の額、財政安定化基金拠出金、次条第二項の規定による拠出金及び出産育児支援金、流行初期医療確保拠出金等並びに子ども・子育て支援納付金の納付に要した費用の額並びに基金事業借入金の償還に要した費用の額に充てるものとして政令で定めるところにより算定した額
the amount of expenses subject to fund projects: the amount calculated pursuant to the provisions of Cabinet Order as the sum total of the amount of costs spent on benefits for medical treatment, etc., the amount of expenses spent on payment of the Fiscal Stability Fund contributions, the contributions and childbirth and childcare support benefits pursuant to the provisions of paragraph (2) of the following Article, the contribution for securing medical care in the early phase of an epidemic, etc., and the children and child-rearing support levy, and the amount of expenses spent on redemption of Borrowings for Fund Project, during the specified period at the Association of Medical Care Systems for the Elderly Aged 75 and older;
基金事業対象費用額 後期高齢者医療広域連合において特定期間中に療養の給付等に要した費用の額、財政安定化基金拠出金、次条第二項の規定による拠出金及び出産育児支援金、流行初期医療確保拠出金等並びに子ども・子育て支援納付金の納付に要した費用の額並びに基金事業借入金の償還に要した費用の額の合計額として政令で定めるところにより算定した額
the amount of grants for fund business:the amount that a Association of Medical Care Systems for the Elderly Aged 75 and older has received pursuant to the provisions of item (i) of the preceding paragraph during the specified period.
基金事業交付額 後期高齢者医療広域連合が特定期間中に前項第一号の規定により交付を受けた額
A prefecture, pursuant to the provisions of Cabinet Order, is to collect Fiscal Stability Fund contributions from the Association of Medical Care Systems for the Elderly Aged 75 and older in order to allocate them to the Fiscal Stability Fund.
都道府県は、財政安定化基金に充てるため、政令で定めるところにより、後期高齢者医療広域連合から財政安定化基金拠出金を徴収するものとする。
The Association of Medical Care Systems for the Elderly Aged 75 and older is obliged to pay the Fiscal Stability Fund contribution pursuant to the provisions of the preceding paragraph.
後期高齢者医療広域連合は、前項の規定による財政安定化基金拠出金を納付する義務を負う。
A prefecture, pursuant to the provisions of Cabinet Order, must transfer an amount equivalent to three times the total amount of Fiscal Stability Fund contributions collected from the Association of Medical Care Systems for the Elderly Aged 75 and older pursuant to the provisions of paragraph (3) to the Fiscal Stability Fund.
都道府県は、政令で定めるところにより、第三項の規定により後期高齢者医療広域連合から徴収した財政安定化基金拠出金の総額の三倍に相当する額を財政安定化基金に繰り入れなければならない。
Pursuant to the provisions of Cabinet Order, the national government bears an amount equivalent to one third of the amount transferred by a prefecture pursuant to the provisions of the preceding paragraph.
国は、政令で定めるところにより、前項の規定により都道府県が繰り入れた額の三分の一に相当する額を負担する。
All revenues arising from the Fiscal Stability Fund must be appropriated to the Fiscal Stability Fund.
財政安定化基金から生ずる収入は、全て財政安定化基金に充てなければならない。
Subsection 3 Special high medical care cost Joint Enterprise
第三款 特別高額医療費共同事業
第百十七条
A designated corporation, pursuant to the provisions of Cabinet Order, in order to mitigate the impact of the occurrence of benefits related to extremely expensive medical care on the finances of medical care for the elderly, is to implement a project to provide Association of Medical Care Systems for the Elderly Aged 75 and older with grants related to benefits related to extremely expensive medical care pertaining to insured (hereinafter referred to as a "special joint high medical care cost project").
指定法人は、政令で定めるところにより、著しく高額な医療に関する給付の発生が後期高齢者医療の財政に与える影響を緩和するため、後期高齢者医療広域連合に対して被保険者に係る著しく高額な医療に関する給付に係る交付金を交付する事業（以下「特別高額医療費共同事業」という。）を行うものとする。
Designated Corporations, pursuant to the provisions of Cabinet Order, collect contributions from the Association of Medical Care Systems for the Elderly Aged 75 and older to cover the expenses required for the Special high medical care cost Joint Enterprise.
指定法人は、特別高額医療費共同事業に要する費用に充てるため、政令で定めるところにより、後期高齢者医療広域連合から拠出金を徴収する。
A Association of Medical Care Systems for the Elderly Aged 75 and older is liable to pay contributions pursuant to the provisions of the preceding paragraph.
後期高齢者医療広域連合は、前項の規定による拠出金を納付する義務を負う。
Subsection 4 Medical Care Assistance for the Elderly Aged 75 and over by Insurers
第四款 保険者の後期高齢者支援金等
第百十八条（後期高齢者支援金等の徴収及び納付義務）
The Organization collects aid for the old-old and contributions for administrative expenses related to the old-old (hereinafter referred to as "aid for the old-old, etc.") from Insurers (in the case of National Health Insurance, the prefecture; the same applies hereinafter in this Section) each fiscal year in order to cover the expenses required for the services listed in Article 139, paragraph (1), item (ii).
機構は、第百三十九条第一項第二号に掲げる業務に要する費用に充てるため、年度ごとに、保険者（国民健康保険にあつては、都道府県。以下この節において同じ。）から、後期高齢者支援金及び後期高齢者関係事務費拠出金（以下「後期高齢者支援金等」という。）を徴収する。
The amount of aid for the old-old to be collected from each Insurer pursuant to the provisions of paragraph (1) of the preceding Article is to be the estimated amount of aid for the old-old for the relevant fiscal year; provided, however, that when the estimated amount of aid for the old-old for the fiscal year before the previous fiscal year exceeds the fixed amount of aid for the old-old for that fiscal year, it is to be the amount obtained by deducting from the estimated amount of aid for the old-old for the relevant fiscal year the sum total of the excess amount and the old-old aid adjustment amount pertaining to the excess amount, and when the estimated amount of aid for the old-old for the fiscal year before the previous fiscal year is less than the fixed amount of aid for the old-old for that fiscal year, it is to be the amount obtained by adding to the estimated amount of aid for the old-old for the relevant fiscal year the sum total of the shortfall and the old-old aid adjustment amount pertaining to the shortfall.
The amount of adjustment for late-stage elderly as prescribed in the preceding paragraph is the amount calculated for each of the Insurers pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare by taking into consideration the interest arising from any excess or deficiency between the estimated amount of Medical Care Assistance for the Elderly Aged 75 and over and the amount of final Medical Care Assistance for the Elderly Aged 75 and over pertaining to all Insurers in the fiscal year before the previous fiscal year and any other circumstances.
The estimated amount of Medical Care Assistance for the Elderly Aged 75 and over referred to in paragraph (1) of the preceding Article is the amount specified in the relevant of the following items for the category of insurers set forth in that item:
Insurers of employee insurance, etc.: the amount obtained by multiplying the amount obtained by multiplying the amount obtained by dividing the total of the estimated amounts of the amounts subject to insurance payment of all Associations of Medical Care Systems for the Elderly Aged 75 and older in the relevant fiscal year by the estimated total number of participants pertaining to all Insurers in the same fiscal year, calculated as specified by Order of the Ministry of Health, Labour and Welfare, by the estimated number of participants pertaining to all Insurers of employee insurance, etc. in the same fiscal year, calculated as specified by Order of the Ministry of Health, Labour and Welfare, by the rate obtained by dividing the amount set forth in (a) by the amount set forth in (b) for the same fiscal year and the estimated old-old aid adjustment rate;
the estimated amount of the Total Amount of Standard Fees pertaining to the Insurer of employee insurance, etc.;
当該被用者保険等保険者に係る標準報酬総額の見込額
the sum of the estimated amounts of the total amount of standardized remunerations pertaining to all Insurers of employee insurance, etc.;
全ての被用者保険等保険者に係る標準報酬総額の見込額の合計額
Insurers other than Insurers of employee insurance, etc.: the amount obtained by multiplying the amount obtained by multiplying the amount obtained by dividing the total of the estimated amounts of the amounts subject to insurance payment of all Associations of Medical Care Systems for the Elderly Aged 75 and older in the relevant fiscal year by the estimated total number of participants pertaining to all Insurers in the same fiscal year, calculated as specified by Order of the Ministry of Health, Labour and Welfare, by the estimated number of participants pertaining to the relevant Insurer in the same fiscal year, calculated as specified by Order of the Ministry of Health, Labour and Welfare, by the estimated old-old aid adjustment rate.
The estimated Medical Care Assistance for the Elderly Aged 75 and over adjustment rate referred to in the items of the preceding paragraph is calculated pursuant to the provisions of Cabinet Order within the range of 90 percent to 110 percent by taking into consideration the degree of achievement of the particulars set forth in Article 18, paragraph (2), item (ii) and Article 19, paragraph (2), item (ii), the expected number of subscribers pertaining to the insurers, and other factors.
前項各号の概算後期高齢者支援金調整率は、第十八条第二項第二号及び第十九条第二項第二号に掲げる事項についての達成状況、保険者に係る加入者の見込数等を勘案し、百分の九十から百分の百十の範囲内で政令で定めるところにより算定する。
The amount of final Medical Care Assistance for the Elderly Aged 75 and over for Article 119, paragraph (1) is the amount specified in each of the following items in accordance with the category of insurers listed in the relevant item:
Insurers of employee insurance, etc.: the amount obtained by dividing the aggregate of the total amounts subject to insurance payment of all Associations of Medical Care Systems for the Elderly Aged 75 and older for the fiscal year before the previous fiscal year by the total number of participants for all Insurers in the same fiscal year calculated as specified by Order of the Ministry of Health, Labour and Welfare, multiplying the amount so obtained by the number of participants for all Insurers of employee insurance, etc. in the same fiscal year calculated as specified by Order of the Ministry of Health, Labour and Welfare, and further multiplying the amount so obtained by the rate obtained by dividing the amount set forth in (a) for the same fiscal year by the amount set forth in (b), and by the fixed old-old aid adjustment rate;
the total amount of standard compensation pertaining to the Insurer of employee insurance, etc.;
the sum of the Total Amount of Standard Fees pertaining to all Insurers of employee insurance, etc.;
Insurers other than Insurers of employee insurance, etc.: the amount obtained by multiplying the amount obtained by multiplying the amount obtained by dividing the total of the total amounts subject to insurance payment of all Associations of Medical Care Systems for the Elderly Aged 75 and older in the fiscal year before the previous fiscal year by the total number of participants pertaining to all Insurers in the same fiscal year, calculated as specified by Order of the Ministry of Health, Labour and Welfare, by the number of participants pertaining to the relevant Insurer in the same fiscal year, calculated as specified by Order of the Ministry of Health, Labour and Welfare, by the fixed old-old aid adjustment rate.
The fixed adjustment rate for the Medical Care Assistance for the Elderly Aged 75 and over referred to in the items of the preceding paragraph is calculated pursuant to the provisions of Cabinet Order within the range of 90 percent to 110 percent, in consideration of the degree of achievement of the particulars set forth in Article 18, paragraph (2), item (ii) and Article 19, paragraph (2), item (ii), the number of subscribers pertaining to insurers, and other factors.
前項各号の確定後期高齢者支援金調整率は、第十八条第二項第二号及び第十九条第二項第二号に掲げる事項についての達成状況、保険者に係る加入者の数等を勘案し、百分の九十から百分の百十の範囲内で政令で定めるところにより算定する。
Article 122Amount of Contributions for Office Expenses Related to Old-Old Age
第百二十二条（後期高齢者関係事務費拠出金の額）
The amount of contributions for administrative expenses related to the old-old to be collected from each Insurer pursuant to the provisions of Article 118, 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 (ii) in the relevant fiscal year, in accordance with the estimated number of participants pertaining to each Insurer.
第百二十三条（通知）
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.
後期高齢者医療広域連合は、厚生労働省令で定めるところにより、機構に対し、各年度における保険納付対象額その他厚生労働省令で定める事項を通知しなければならない。
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.
後期高齢者医療広域連合は、前項の規定による通知の事務を国保連合会に委託することができる。
Article 124Application Mutatis Mutandis
第百二十四条（準用）
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.
第四十一条及び第四十三条から第四十六条までの規定は、後期高齢者支援金等について準用する。
Subsection 5 Childbirth and Childcare Support Benefits of a Association of Medical Care Systems for the Elderly Aged 75 and older
第五款 後期高齢者医療広域連合の出産育児支援金等
Article 124-2Collection and Payment Obligation of Childbirth and Childcare Support Benefits
第百二十四条の二（出産育児支援金の徴収及び納付義務）
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).
機構は、第百三十九条第一項第三号に掲げる業務に要する費用に充てるため、年度ごとに、後期高齢者医療広域連合から、出産育児支援金を徴収する。
A Association of Medical Care Systems for the Elderly Aged 75 and older is liable to pay childbirth and childcare support benefits.
後期高齢者医療広域連合は、出産育児支援金を納付する義務を負う。
Article 124-3Amount of Childbirth and Childcare Support Benefits
第百二十四条の三（出産育児支援金の額）
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.
前条第一項の規定により各後期高齢者医療広域連合から徴収する出産育児支援金の額は、医療保険各法の規定による出産育児一時金、家族出産育児一時金、出産費及び家族出産費の支給に要する費用（次条第一項及び第百二十四条の七第一項において「出産育児一時金等の支給に要する費用」という。）の額の総額を基礎として厚生労働省令で定めるところにより算定した額に、出産育児支援金率及び全ての後期高齢者医療広域連合に係る被保険者の総数に対する当該後期高齢者医療広域連合に係る被保険者の数の割合を乗じて得た額とする。
The childbirth and childcare support rate referred to in the preceding paragraph for fiscal year 2024 and fiscal year 2025 is 7 / 100.
令和六年度及び令和七年度における前項の出産育児支援金率は、百分の七とする。
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;
百分の七に、当該年度における全ての後期高齢者医療広域連合に係る被保険者の見込総数を令和六年度における全ての後期高齢者医療広域連合に係る被保険者の総数で除して得た率を乗じて得た率
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.
Article 124-4Childbirth and Childcare Grants
第百二十四条の四（出産育児交付金）
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.
機構は、出産育児一時金等の支給に要する費用の一部に充てるため、保険者に対して、出産育児交付金を交付する。
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).
前項の出産育児交付金は、第百二十四条の二第一項の規定により機構が徴収する出産育児支援金をもつて充てる。
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.
第百二十四条の五（出産育児関係事務費拠出金の徴収及び納付義務）
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).
機構は、第百三十九条第一項第三号に掲げる業務に関する事務の処理に要する費用に充てるため、年度ごとに、保険者から、出産育児関係事務費拠出金を徴収する。
An insurer is liable to pay contributions for childbirth and childcare related office expenses.
保険者は、出産育児関係事務費拠出金を納付する義務を負う。
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.
第百二十四条の七（通知）
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.
保険者は、厚生労働省令で定めるところにより、機構に対し、各年度における当該保険者に係る出産育児一時金等の支給に要する費用の額その他厚生労働省令で定める事項を通知しなければならない。
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.
後期高齢者医療広域連合は、厚生労働省令で定めるところにより、機構に対し、各年度における当該後期高齢者医療広域連合に係る被保険者の数その他厚生労働省令で定める事項を通知しなければならない。
Article 124-8Application Mutatis Mutandis
第百二十四条の八（準用）
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.
第四十一条及び第四十三条から第四十六条までの規定は、出産育児支援金及び出産育児関係事務費拠出金について準用する。この場合において、必要な技術的読替えは、政令で定める。
Subsection 6 Miscellaneous Provisions
第六款 雑則
第百二十四条の九
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.
第百条第一項の規定により機構が各後期高齢者医療広域連合に対して交付する後期高齢者交付金と第百二十四条の二第一項の規定により機構が各後期高齢者医療広域連合から徴収する出産育児支援金は、相殺するものとする。
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.
第百十八条第一項及び第百二十四条の五第一項の規定により機構が各保険者から徴収する後期高齢者支援金等及び出産育児関係事務費拠出金と第百二十四条の四第一項の規定により機構が各保険者に対して交付する出産育児交付金は、相殺するものとする。
Section 5 Healthcare Services for the Elderly
第五節 高齢者保健事業
Article 125Healthcare Services for the Elderly
第百二十五条（高齢者保健事業）
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.
後期高齢者医療広域連合は、高齢者の心身の特性に応じ、健康教育、健康相談、健康診査及び保健指導並びに健康管理及び疾病の予防に係る被保険者の自助努力についての支援その他の被保険者の健康の保持増進のために必要な事業（以下「高齢者保健事業」という。）を行うように努めなければならない。
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.
後期高齢者医療広域連合は、高齢者保健事業を行うに当たつては、医療保険等関連情報を活用し、適切かつ有効に行うものとする。
In providing health services for the elderly, a Association of Medical Care Systems for the Elderly Aged 75 and older is to, in coordination with municipalities and insurers, and in light of the physical, mental and social characteristics of elderly persons, provide health services for the elderly in an integrated manner with the services provided by municipalities according to the mental and physical characteristics of elderly persons as prescribed in Article 82, paragraph (5) of the National Health Insurance Act (referred to as "national health insurance health services" in paragraph (1) of the following Article) and the community support projects provided by the Long-Term Care Insurance Act Article 115-45, paragraphs (1) through (3) (referred to as "community support projects" in paragraph (1) of the following Article), in order to provide health services for the elderly in an effective, efficient and meticulous manner according to the circumstances of the insured, in coordination with municipalities.
後期高齢者医療広域連合は、高齢者保健事業を行うに当たつては、市町村及び保険者との連携を図るとともに、高齢者の身体的、精神的及び社会的な特性を踏まえ、高齢者保健事業を効果的かつ効率的で被保険者の状況に応じたきめ細かなものとするため、市町村との連携の下に、市町村が実施する国民健康保険法第八十二条第五項に規定する高齢者の心身の特性に応じた事業（次条第一項において「国民健康保険保健事業」という。）及び介護保険法第百十五条の四十五第一項から第三項までに規定する地域支援事業（次条第一項において「地域支援事業」という。）と一体的に実施するものとする。
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.
後期高齢者医療広域連合は、高齢者保健事業を行うに当たつては、効果的かつ効率的で被保険者の状況に応じたきめ細かな高齢者保健事業の実施が推進されるよう、地方自治法第二百九十一条の七に規定する広域計画（次条第一項において「広域計画」という。）に、後期高齢者医療広域連合における市町村との連携に関する事項を定めるよう努めなければならない。
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.
後期高齢者医療広域連合は、被保険者の療養のために必要な用具の貸付けその他の被保険者の療養環境の向上のために必要な事業、後期高齢者医療給付のために必要な事業、被保険者の療養のための費用に係る資金の貸付けその他の必要な事業を行うことができる。
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.
厚生労働大臣は、第一項の規定により後期高齢者医療広域連合が行う高齢者保健事業に関して、その適切かつ有効な実施を図るため、指針の公表、情報の提供その他の必要な支援を行うものとする。
The guidelines referred to in the preceding paragraph are to provide for the following particulars:
前項の指針においては、次に掲げる事項を定めるものとする。
basic matters concerning the effective and efficient implementation of health services for the elderly;
高齢者保健事業の効果的かつ効率的な実施に関する基本的事項
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;
高齢者保健事業の効果的かつ効率的な実施に向けた後期高齢者医療広域連合及び次条第一項前段の規定により委託を受けた市町村が行う取組に関する事項
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;
高齢者保健事業の効果的かつ効率的な実施に向けた後期高齢者医療広域連合及び次条第一項前段の規定により委託を受けた市町村に対する支援に関する事項
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;
高齢者保健事業の効果的かつ効率的な実施に向けた後期高齢者医療広域連合と市町村との連携に関する事項
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;
高齢者保健事業の効果的かつ効率的な実施に向けた後期高齢者医療広域連合と地域の関係機関及び関係団体との連携に関する事項
other matters to be taken into consideration for the effective and efficient implementation of health services for the elderly.
その他高齢者保健事業の効果的かつ効率的な実施に向けて配慮すべき事項
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.
第六項の指針は、健康増進法第九条第一項に規定する健康診査等指針、国民健康保険法第八十二条第十一項に規定する指針及び介護保険法第百十六条第一項に規定する基本指針と調和が保たれたものでなければならない。
Article 125-2Entrustment of Health Services for the Elderly to Municipalities
第百二十五条の二（高齢者保健事業の市町村への委託）
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.
後期高齢者医療広域連合は、当該後期高齢者医療広域連合の広域計画に基づき、高齢者保健事業の一部について、当該後期高齢者医療広域連合に加入する市町村に対し、その実施を委託することができるものとし、当該委託を受けた市町村は、被保険者に対する高齢者保健事業の効果的かつ効率的な実施を図る観点から、その実施に関し、国民健康保険保健事業及び地域支援事業との一体的な実施の在り方を含む基本的な方針を定めるものとする。この場合において、後期高齢者医療広域連合は、当該委託を受けた市町村に対し、委託した高齢者保健事業の実施に必要な範囲内において、自らが保有する被保険者に係る療養に関する情報又は健康診査若しくは保健指導に関する記録の写しその他高齢者保健事業を効果的かつ効率的に実施するために必要な情報として厚生労働省令で定めるものを提供することができる。
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.
Article 125-3Provision of Information on Health Services for the Elderly
第百二十五条の三（高齢者保健事業に関する情報の提供）
An Association of Medical Care Systems for the Elderly Aged 75 and older and a Municipality which has been entrusted by the Association of Medical Care Systems for the Elderly Aged 75 and older pursuant to the provisions of the first sentence of paragraph (1) of the preceding Article may, when there is a person who has obtained eligibility as an insured of the Association of Medical Care Systems for the Elderly Aged 75 and older (limited to a person who had belonged to an Insurer), request the Insurer to which the insured belonged to provide a copy of records concerning Special health examinations or Specific Health Guidance pertaining to the insured preserved by the Insurer.
後期高齢者医療広域連合及び前条第一項前段の規定により当該後期高齢者医療広域連合から委託を受けた市町村は、当該後期高齢者医療広域連合の被保険者の資格を取得した者（保険者に加入していたことがある者に限る。）があるときは、当該被保険者が加入していた保険者に対し、当該保険者が保存している当該被保険者に係る特定健康診査又は特定保健指導に関する記録の写しを提供するよう求めることができる。
If a Association of Medical Care Systems for the Elderly Aged 75 and older conducts an inventory and analysis of the physical, mental, and social conditions of each insured and finds it necessary for the effective and efficient implementation of health and welfare services for the elderly in each insured, it may request a Municipality and other Association of Medical Care Systems for the Elderly Aged 75 and older to provide information, etc. concerning medical care and long-term care pertaining to the insured (meaning information concerning medical treatment, a copy of records concerning health checkups or health guidance, or a copy of records concerning Special health examinations or specified health guidance pertaining to the insured, information concerning medical treatment under the provisions of the National Health Insurance Act, or information concerning health and medical services or welfare services under the provisions of the Long-Term Care Insurance Act; hereinafter the same applies in this Article and the following Article) and other information specified by Order of the Ministry of Health, Labour and Welfare as necessary for the effective and efficient implementation of health and welfare services for the elderly.
後期高齢者医療広域連合は、被保険者ごとの身体的、精神的及び社会的な状態の整理及び分析を行い、被保険者に対する高齢者保健事業の効果的かつ効率的な実施を図る観点から、必要があると認めるときは、市町村及び他の後期高齢者医療広域連合に対し、当該被保険者に係る医療及び介護に関する情報等（当該被保険者に係る療養に関する情報若しくは健康診査若しくは保健指導に関する記録の写し若しくは特定健康診査若しくは特定保健指導に関する記録の写し、国民健康保険法の規定による療養に関する情報又は介護保険法の規定による保健医療サービス若しくは福祉サービスに関する情報をいう。以下この条及び次条において同じ。）その他高齢者保健事業を効果的かつ効率的に実施するために必要な情報として厚生労働省令で定めるものの提供を求めることができる。
If a municipality is entrusted with elderly health services provided by a Association of Medical Care Systems for the Elderly Aged 75 and older pursuant to the provisions of the first sentence of paragraph (1) of the preceding Article, and finds it necessary from the viewpoint of organizing and analyzing the physical, mental, and social conditions of each insured and implementing elderly health services for the insured in an effective and efficient manner, the municipality may request other municipalities and the Association of Medical Care Systems for the Elderly Aged 75 and older to provide information, etc. concerning medical care and nursing care pertaining to the insured and other information specified by Order of the Ministry of Health, Labour and Welfare as necessary for implementing elderly health services in an effective and efficient manner.
市町村は、前条第一項前段の規定により、後期高齢者医療広域連合が行う高齢者保健事業の委託を受けた場合であつて、被保険者ごとの身体的、精神的及び社会的な状態の整理及び分析を行い、被保険者に対する高齢者保健事業の効果的かつ効率的な実施を図る観点から、必要があると認めるときは、他の市町村及び後期高齢者医療広域連合に対し、当該被保険者に係る医療及び介護に関する情報等その他高齢者保健事業を効果的かつ効率的に実施するために必要な情報として厚生労働省令で定めるものの提供を求めることができる。
Insurers, municipalities, and Association of Medical Care Systems for the Elderly Aged 75 and older that have been requested to provide a copy of records or data pursuant to the provisions of the preceding three paragraphs must provide a copy of the records or data pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare.
前三項の規定により、記録の写し又は情報の提供を求められた保険者並びに市町村及び後期高齢者医療広域連合は、厚生労働省令で定めるところにより、当該記録の写し又は情報を提供しなければならない。
A Municipality which has been entrusted pursuant to the provisions of the first sentence of paragraph (1) of the preceding Article may, in order to provide Health Services for the Elderly in an effective and efficient manner and in a meticulous manner that corresponds to the circumstances of the insured, utilize, in addition to copies of records or information provided pursuant to the provisions of the preceding paragraph, records that it holds concerning Special health examinations or Specific Health Guidance pertaining to the insured, information concerning medical treatment under the provisions of the National Health Insurance Act, or information concerning health and medical services or welfare services under the provisions of the Long-Term Care Insurance Act.
Article 125-4Entrustment of Health Services for the Elderly to Relevant Organizations or Groups
第百二十五条の四（高齢者保健事業の関係機関又は関係団体への委託）
An Association of Medical Care Systems for the Elderly Aged 75 and older may entrust part of its health services for the elderly to a relevant organization or group (excluding a prefecture or municipality; hereinafter the same applies in this Article) that is found to be capable of implementing health services for the elderly appropriately and reliably. In this case, the Association of Medical Care Systems for the Elderly Aged 75 and older may provide to the entrusted relevant organization or group, within the scope necessary for implementing the entrusted health services for the elderly, information, etc. concerning medical care and nursing care for the insured which it possesses or which it has received pursuant to the provisions of paragraph (4) of the preceding Article, and any other information specified by Order of the Ministry of Health, Labour and Welfare as necessary for implementing health services for the elderly effectively and efficiently.
後期高齢者医療広域連合は、高齢者保健事業の一部について、高齢者保健事業を適切かつ確実に実施することができると認められる関係機関又は関係団体（都道府県及び市町村を除く。以下この条において同じ。）に対し、その実施を委託することができる。この場合において、後期高齢者医療広域連合は、当該委託を受けた関係機関又は関係団体に対し、委託した高齢者保健事業の実施に必要な範囲内において、自らが保有する、又は前条第四項の規定により提供を受けた被保険者に係る医療及び介護に関する情報等その他高齢者保健事業を効果的かつ効率的に実施するために必要な情報として厚生労働省令で定めるものを提供することができる。
A Municipality that has been entrusted pursuant to the provisions of the first sentence of Article 125-2, paragraph (1) may entrust part of the entrusted health services for the elderly to a Relevant Organization or Group that is found to be capable of implementing the health services for the elderly appropriately and reliably. In this case, the Municipality may provide the entrusted Relevant Organization or Group, to the extent necessary to implement the entrusted health services for the elderly, with the Information, etc. on medical care and nursing care for the insured which it possesses or which it has been provided pursuant to the provisions of the second sentence of the same paragraph or paragraph (4) of the preceding Article, and any other Information specified by Order of the Ministry of Health, Labour and Welfare as necessary for implementing the health services for the elderly effectively and efficiently.
第百二十五条の二第一項前段の規定により委託を受けた市町村は、当該委託を受けた高齢者保健事業の一部について、高齢者保健事業を適切かつ確実に実施することができると認められる関係機関又は関係団体に対し、その実施を委託することができる。この場合において、市町村は、当該委託を受けた関係機関又は関係団体に対し、委託した高齢者保健事業の実施に必要な範囲内において、自らが保有する、又は同項後段若しくは前条第四項の規定により提供を受けた被保険者に係る医療及び介護に関する情報等その他高齢者保健事業を効果的かつ効率的に実施するために必要な情報として厚生労働省令で定めるものを提供することができる。
It is prohibited for the current or former officer or employee of a relevant organization or group entrusted pursuant to the first sentence of paragraph (1) or the first sentence of the preceding paragraph to divulge any individual confidential information learned in the course of implementing elderly health services, without a legitimate reason for doing so.
Section 6 Examination Committee for Medical Fees for Old-Old Healthcare
第六節 後期高齢者医療診療報酬審査委員会
第百二十六条（審査委員会）
A Medical Fee Review Committee for Old-Old Healthcare is established within the NHI Federations in order to review medical bills as entrusted pursuant to the provisions of Article 70, paragraph (4).
Notwithstanding the provisions of the preceding paragraph, a NHI federation with a review committee as prescribed in Article 87 of the National Health Insurance Act may have the review committee review medical bills pertaining to medical care for the elderly.
前項の規定にかかわらず、国民健康保険法第八十七条に規定する審査委員会を置く国保連合会は、当該審査委員会において後期高齢者医療に係る診療報酬請求書の審査を行うことができる。
The provisions of Articles 88 through 90 of the National Health Insurance Act apply mutatis mutandis to the Examination Committee for Old-Old Medical Treatment Fees.
国民健康保険法第八十八条から第九十条までの規定は、後期高齢者医療診療報酬審査委員会について準用する。
Section 7 Request for Examination
第七節 審査請求
Article 128Request for Examination
第百二十八条（審査請求）
A person who is dissatisfied with a disposition concerning a medical care benefit for the old-old (including a disposition concerning a request pursuant to the provisions of Article 54, paragraphs (3) and (5)) or a disposition concerning insurance premiums or any other money to be collected pursuant to the provisions of this Chapter (limited to those collected by a Municipality and a Association of Medical Care Systems for the Elderly Aged 75 and older) may make a request for examination to the Certification Committee for Old-Old Healthcare.
後期高齢者医療給付に関する処分（第五十四条第三項及び第五項の規定による求めに対する処分を含む。）又は保険料その他この章の規定による徴収金（市町村及び後期高齢者医療広域連合が徴収するものに限る。）に関する処分に不服がある者は、後期高齢者医療審査会に審査請求をすることができる。
With regard to postponement of expiry of prescription period and renewal of prescription period, the request for examination referred to in the preceding paragraph is deemed to be a demand by litigation.
前項の審査請求は、時効の完成猶予及び更新に関しては、裁判上の請求とみなす。
Article 129Establishment of the Review Board
第百二十九条（審査会の設置）
The Certification Committee for Old-Old Healthcare is established in each prefecture.
後期高齢者医療審査会は、各都道府県に置く。
The provisions of Articles 93 through 103 of the National Health Insurance Act apply mutatis mutandis to the Certification Committee for Old-Old Healthcare. In this case, the necessary technical replacement of terms is specified by Cabinet Order.
国民健康保険法第九十三条から第百三条までの規定は、後期高齢者医療審査会について準用する。この場合において、必要な技術的読替えは、政令で定める。
Section 8 Assistance for Healthcare Services for the Elderly
第八節 高齢者保健事業等に関する援助等
Article 131Assistance for Healthcare Services for the Elderly
第百三十一条（高齢者保健事業等に関する援助等）
The NHI federation and designated corporations, in order to ensure the stability of the operation of Old-old Medical Care, in addition to conducting research and study on health services for the elderly conducted by an Association of Medical Care Systems for the Elderly Aged 75 and older, the services prescribed in Article 125, paragraph (5), services for the optimization of expenses required for old-old medical care benefit, and other services (hereinafter referred to as "health services for the elderly, etc." in this Article), and liaison and coordination among the Associations in relation to the implementation of health services for the elderly, etc. (in the case of the NHI federation, including between an Association and a municipality entrusted by that Association pursuant to the provisions of the first sentence of Article 125-2, paragraph (1), and among municipalities so entrusted), must endeavor to dispatch persons with specialized technology or knowledge, provide information, analyze and evaluate the status of implementation of health services for the elderly, etc., and provide other necessary assistance in relation to health services for the elderly, etc.
国保連合会及び指定法人は、後期高齢者医療の運営の安定化を図るため、後期高齢者医療広域連合が行う高齢者保健事業及び第百二十五条第五項に規定する事業、後期高齢者医療給付に要する費用の適正化のための事業その他の事業（以下この条において「高齢者保健事業等」という。）に関する調査研究及び高齢者保健事業等の実施に係る後期高齢者医療広域連合間（国保連合会においては、後期高齢者医療広域連合と当該後期高齢者医療広域連合から第百二十五条の二第一項前段の規定により委託を受けた市町村との間及び当該委託を受けた市町村間を含む。）の連絡調整を行うとともに、高齢者保健事業等に関し、専門的な技術又は知識を有する者の派遣、情報の提供、高齢者保健事業等の実施状況の分析及び評価その他の必要な援助を行うよう努めなければならない。
Article 132Measures by the State and Local Governments
第百三十二条（国及び地方公共団体の措置）
The national government and local governments must endeavor to give advice, provide information, and take other measures necessary to promote the services provided by NHI federations and designated corporations pursuant to the provisions of the preceding Article.
Section 9 Miscellaneous Provisions
第九節 雑則
Article 133Advice of Prefectures
第百三十三条（都道府県の助言等）
A prefecture is to provide a Association of Medical Care Systems for the Elderly Aged 75 and older or a municipality with necessary advice and appropriate assistance so that the operation of the medical insurance system for the elderly is carried out soundly and smoothly.
都道府県は、後期高齢者医療広域連合又は市町村に対し、後期高齢者医療制度の運営が健全かつ円滑に行われるように、必要な助言及び適切な援助をするものとする。
If a Association of Medical Care Systems for the Elderly Aged 75 and older intends to provide the benefits set forth in Article 56, item (iii) or in other cases specified by Cabinet Order, it must consult with the prefectural governor in advance.
後期高齢者医療広域連合は、第五十六条第三号に掲げる給付を行おうとする場合その他の政令で定める場合においては、あらかじめ、都道府県知事に協議しなければならない。
Article 134Collection of Reports
第百三十四条（報告の徴収等）
The Minister of Health, Labour and Welfare or the prefectural governor may, when they find it necessary for the enforcement of this Act with regard to a Association of Medical Care Systems for the Elderly Aged 75 and older or a municipality, collect reports on the status of its services and assets, or have the relevant officials inspect the status on site.
厚生労働大臣又は都道府県知事は、後期高齢者医療広域連合又は市町村について、この法律を施行するために必要があると認めるときは、その事業及び財産の状況に関する報告を徴し、又は当該職員に実地にその状況を検査させることができる。
If the Minister of Health, Labour and Welfare or the prefectural governor finds it necessary for the calculation of the amount of Young-Old Payments, etc., Medical Care Assistance for the Elderly Aged 75 and over, etc., and contributions for childbirth and childcare related office expenses, the Minister of Health, Labour and Welfare or the prefectural governor may collect reports on the services from Insurers (or prefectures in the case of national health insurance programs) or have the relevant officials inspect the situation on site.
The provisions of Article 16-7, paragraph (2) apply mutatis mutandis to the inspection pursuant to the provisions of the preceding two paragraphs, and the provisions of paragraph (3) of the same Article apply mutatis mutandis to the authority pursuant to the provisions of the preceding two paragraphs.
Article 135Reporting on the Status of Operations
第百三十五条（事業状況の報告）
An Association of Medical Care Systems for the Elderly Aged 75 and older or the NHI federation must, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, report the status of services pertaining to Old-old Medical Care (in the case of an Association, including the status of services reported by a Municipality pursuant to the provisions of the following paragraph to the head of the Association (in the case of an Association that has a board of directors in place of a head pursuant to the provisions of Article 287-3, paragraph (2) of the Local Autonomy Act as applied mutatis mutandis pursuant to Article 291-13 of that Act, the board of directors; the same applies in the following paragraph)) to the Prefectural Governor.
後期高齢者医療広域連合又は国保連合会は、厚生労働省令で定めるところにより、後期高齢者医療に係る事業の状況（後期高齢者医療広域連合にあつては、次項の規定により後期高齢者医療広域連合の長（地方自治法第二百九十一条の十三において準用する同法第二百八十七条の三第二項の規定により長に代えて理事会を置く後期高齢者医療広域連合にあつては、理事会。次項において同じ。）が市町村から報告を受ける事業の状況を含む。）を都道府県知事に報告しなければならない。
A Municipality, pursuant to the provisions of an Order of the Ministry of Health, Labour and Welfare, must report the status of its services pertaining to Old-Old Healthcare to the head of an Association of Medical Care Systems for the Elderly Aged 75 and older.
市町村は、厚生労働省令で定めるところにより、後期高齢者医療に係る事業の状況を後期高齢者医療広域連合の長に報告しなければならない。
Article 136Free Certification Concerning Family Registers
第百三十六条（戸籍に関する無料証明）
The mayor of a municipality (including the head of a special ward and, in the case of a designated city under Article 252-19, paragraph (1) of the Local Autonomy Act, a ward head or a general ward head) may, pursuant to the provisions of the Municipal Ordinance of the municipality, certify free of charge, to an Association of Medical Care Systems for the Elderly Aged 75 and older or a person who receives old-old medical care benefit, matters concerning the family register of the insured or a person who was insured.
市町村長（特別区の区長を含むものとし、地方自治法第二百五十二条の十九第一項の指定都市にあつては、区長又は総合区長とする。）は、後期高齢者医療広域連合又は後期高齢者医療給付を受ける者に対し、当該市町村の条例で定めるところにより、被保険者又は被保険者であつた者の戸籍に関し、無料で証明を行うことができる。
Article 137Investigation of insured
第百三十七条（被保険者等に関する調査）
If the Association of Medical Care Systems for the Elderly Aged 75 and older finds it necessary in relation to eligibility as an insured, a medical care benefit for the old-old, and insurance premiums, it may order the insured, the spouse of the insured, or the householder or any other member or former member of the household to which the insured belongs to submit or present a document or any other item, or may have its official ask them questions.
後期高齢者医療広域連合は、被保険者の資格、後期高齢者医療給付及び保険料に関して必要があると認めるときは、被保険者、被保険者の配偶者若しくは被保険者の属する世帯の世帯主その他その世帯に属する者又はこれらであつた者に対し、文書その他の物件の提出若しくは提示を命じ、又は当該職員に質問させることができる。
A Municipality, when it finds it necessary in relation to the collection of insurance premiums, may order the insured, the spouse of the insured, or the householder or any other member or former member of the household to which the insured belongs to submit or present a document or any other article, or may have its personnel question such person.
市町村は、保険料の徴収に関して必要があると認めるときは、被保険者、被保険者の配偶者若しくは被保険者の属する世帯の世帯主その他その世帯に属する者又はこれらであつた者に対し、文書その他の物件の提出若しくは提示を命じ、又は当該職員に質問させることができる。
The provisions of Article 16-7, paragraph (2) apply mutatis mutandis to questions pursuant to the provisions of the preceding two paragraphs, and the provisions of paragraph (3) of the same Article apply mutatis mutandis to the authority granted pursuant to the provisions of the preceding two paragraphs.
Article 138Provision of Materials
第百三十八条（資料の提供等）
When an Association of Medical Care Systems for the Elderly Aged 75 and older finds it necessary in relation to the qualifications of insured, old-old medical care benefit, and insurance premiums, it may request a Municipality or other public agencies or Pension Insurers to provide access to necessary documents or to provide necessary materials, or may request banks, trust companies, other institutions, employers of the insured, or other relevant persons to make a report, with regard to the matters necessary to confirm that the grounds on which the insured received old-old medical care benefit arose from the act of a third party, the status of assets or income of the insured, the spouse of the insured, or the head of the household to which the insured belongs or other members of that household, or the status of payment of an Old Age, etc., pension benefit prescribed in Article 107, paragraph (2) to the insured.
後期高齢者医療広域連合は、被保険者の資格、後期高齢者医療給付及び保険料に関して必要があると認めるときは、被保険者の後期高齢者医療給付を受けた事由が第三者の行為によつて生じたものであることを確認するために必要な事項、被保険者、被保険者の配偶者若しくは被保険者の属する世帯の世帯主その他その世帯に属する者の資産若しくは収入の状況又は被保険者に対する第百七条第二項に規定する老齢等年金給付の支給状況につき、市町村その他の官公署若しくは年金保険者に対し必要な文書の閲覧若しくは資料の提供を求め、又は銀行、信託会社その他の機関若しくは被保険者の雇用主その他の関係人に報告を求めることができる。
If a Association of Medical Care Systems for the Elderly Aged 75 and older finds it necessary in relation to eligibility as an insured, it may request other Association of Medical Care Systems for the Elderly Aged 75 and older and insurers (or municipalities in the case of national health insurance programs) to provide necessary materials, including the names and addresses of the insured and subscribers of medical care for the elderly provided by other Association of Medical Care Systems for the Elderly Aged 75 and older (or the insured domiciled within the area of the relevant municipality in the case of national health insurance programs), and the name and location of the applicable place of business as prescribed in Article 3, paragraph (3) of the Health Insurance Act.
後期高齢者医療広域連合は、被保険者の資格に関し必要があると認めるときは、他の後期高齢者医療広域連合及び保険者（国民健康保険にあつては、市町村）に対し、他の後期高齢者医療広域連合が行う後期高齢者医療の被保険者及び加入者（国民健康保険にあつては、当該市町村の区域内に住所を有する被保険者）の氏名及び住所、健康保険法第三条第三項に規定する適用事業所の名称及び所在地その他の必要な資料の提供を求めることができる。
A Municipality, when it finds it necessary in relation to the collection of insurance premiums, may request public agencies or Pension Insurers to provide access to necessary documents or to provide necessary materials, or may request a report from banks, trust companies, other institutions, employers of the insured, or other relevant persons, with regard to the status of assets or income of the insured, the spouses of the insured, or the head of the household or other members of the household to which the insured belongs, or the status of payment of an Old Age, etc., pension benefit as prescribed by the Article 107, paragraph (2) to the insured.
Chapter V Operations of the Medical Information Infrastructure and Medical Fee Examination and Payment Organization Related to the Medical Care System for the Elderly
第五章 医療情報基盤・診療報酬審査支払機構の高齢者医療制度関係業務
Article 139Operations of the Organization
第百三十九条（機構の業務）
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;
保険者から後期高齢者支援金等を徴収し、後期高齢者医療広域連合に対し後期高齢者交付金を交付する業務及びこれに附帯する業務
operations to collect childbirth and childcare support benefits from Associations of Medical Care Systems for the Elderly Aged 75 and older, to collect contributions for childbirth and childcare related office expenses from Insurers, and to provide childbirth and childcare grants to Insurers, and operations incidental thereto.
後期高齢者医療広域連合から出産育児支援金を徴収し、保険者から出産育児関係事務費拠出金を徴収し、及び保険者に対し出産育児交付金を交付する業務並びにこれに附帯する業務
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.
前二項に規定する業務は、高齢者医療制度関係業務という。
Article 140Entrustment of Operations
第百四十条（業務の委託）
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.
Article 141Operational Method Statement
第百四十一条（業務方法書）
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.
機構は、高齢者医療制度関係業務に関し、当該業務の開始前に、業務方法書を作成し、厚生労働大臣の認可を受けなければならない。これを変更するときも、同様とする。
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.
前項の業務方法書に記載すべき事項は、厚生労働省令で定める。
第百四十二条（報告等）
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 childbirth and childcare related office expenses 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 and childcare support benefits 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.
機構は、後期高齢者医療広域連合に対し、第百三十九条第一項第三号に規定する後期高齢者医療広域連合から出産育児支援金を徴収する業務に関し必要があると認めるときは、文書その他の物件の提出を求めることができる。
Article 143Separate Accounting
第百四十三条（区分経理）
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.
機構は、高齢者医療制度関係業務に係る経理については、第百三十九条第一項第一号に掲げる業務、同項第二号及び第三号に掲げる業務並びに同条第二項に規定する業務ごとに、その他の業務に係る経理と区分して、特別の会計を設けて行わなければならない。
Article 144Approval of Budgets
第百四十四条（予算等の認可）
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.
機構は、高齢者医療制度関係業務に関し、毎事業年度、予算、事業計画及び資金計画を作成し、当該事業年度の開始前に、厚生労働大臣の認可を受けなければならない。これを変更するときも、同様とする。
Article 145Financial Statements
第百四十五条（財務諸表等）
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.
機構は、高齢者医療制度関係業務に関し、毎事業年度、財産目録、貸借対照表及び損益計算書（以下「財務諸表」という。）を作成し、当該事業年度の終了後三月以内に厚生労働大臣に提出し、その承認を受けなければならない。
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.
Article 146Handling of Profits and Losses
第百四十六条（利益及び損失の処理）
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 and childcare 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.
機構は、予算をもつて定める金額に限り、第一項の規定による積立金を第百三十九条第一項第一号に規定する保険者に対し前期高齢者交付金を交付する業務、同項第二号に規定する後期高齢者医療広域連合に対し後期高齢者交付金を交付する業務及び同項第三号に規定する保険者に対し出産育児交付金を交付する業務又は同条第二項の規定により認可を受けて行う業務に要する費用に充てることができる。
Article 147Borrowings and Bonds
第百四十七条（借入金及び債券）
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.
機構は、高齢者医療制度関係業務に関し、厚生労働大臣の認可を受けて、長期借入金若しくは短期借入金をし、又は債券を発行することができる。
The long-term borrowings and bond certificates under the preceding paragraph must be redeemed within two years.
前項の規定による長期借入金及び債券は、二年以内に償還しなければならない。
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.
第一項の規定による短期借入金は、当該事業年度内に償還しなければならない。ただし、資金の不足のため償還することができないときは、その償還することができない金額に限り、厚生労働大臣の認可を受けて、これを借り換えることができる。
Short-term borrowings that have been refinanced pursuant to the proviso to the preceding paragraph must be repaid within one year.
前項ただし書の規定により借り換えた短期借入金は、一年以内に償還しなければならない。
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).
前項の先取特権の順位は、民法（明治二十九年法律第八十九号）の規定による一般の先取特権に次ぐものとする。
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.
会社法（平成十七年法律第八十六号）第七百五条第一項及び第二項並びに第七百九条の規定は、前項の規定により委託を受けた銀行又は信託会社について準用する。
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.
Article 148Government Guarantee
第百四十八条（政府保証）
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 and childcare 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.
Article 149Investment of Surplus Funds
第百四十九条（余裕金の運用）
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:
機構は、次の方法によるほか、高齢者医療制度関係業務に係る業務上の余裕金を運用してはならない。
holding of Japanese government bonds and other securities designated by the Minister of Health, Labour and Welfare;
国債その他厚生労働大臣が指定する有価証券の保有
making deposits with banks and other financial institutions designated by the Minister of Health, Labour and Welfare;
銀行その他厚生労働大臣が指定する金融機関への預金
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)).
信託業務を営む金融機関（金融機関の信託業務の兼営等に関する法律（昭和十八年法律第四十三号）第一条第一項の認可を受けた金融機関をいう。）への金銭信託
第百五十条（協議）
The Minister of Health, Labour and Welfare must consult with the Minister of Finance in advance in any of the following cases:
厚生労働大臣は、次の場合には、あらかじめ、財務大臣に協議しなければならない。
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.
この章に定めるもののほか、高齢者医療制度関係業務に係る機構の財務及び会計に関し必要な事項は、厚生労働省令で定める。
Article 152Collection of Reports
第百五十二条（報告の徴収等）
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.
The provisions of Article 16-7, paragraph (2) apply mutatis mutandis to the inspection under the provisions of the preceding paragraph, and the provisions of paragraph (3) of the same Article apply mutatis mutandis to the authority under the provisions of the preceding paragraph.
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.
都道府県知事は、機構につき高齢者医療制度関係業務に関し医療情報基盤・診療報酬審査支払機構法第三十九条の規定による処分が行われる必要があると認めるとき、又は機構の役員につき高齢者医療制度関係業務に関し同法第十四条第三項若しくは第四項の規定による処分が行われる必要があると認めるときは、理由を付して、その旨を厚生労働大臣に通知しなければならない。
第百五十三条（医療情報基盤・診療報酬審査支払機構法の適用の特例）
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.
第百一条第一項に規定する命令は、医療情報基盤・診療報酬審査支払機構法第十四条第三項及び第四項の規定の適用については、同法第三十九条に規定する命令とみなし、高齢者医療制度関係業務は、同法第四十三条第二項の規定の適用については、同法第十八条に規定する業務とみなす。
Article 154Request for Examination
第百五十四条（審査請求）
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).
Chapter VI Medical Services for the Elderly by the National Health Insurance Federation
第六章 国民健康保険団体連合会の高齢者医療関係業務
Article 155Operations of NHI Federations
第百五十五条（国保連合会の業務）
In addition to the operations under the provisions of the National Health Insurance Act, a Federation of National Health Insurance Associations performs the operations of examination and payment of claims for expenses required for benefits for medical treatment provided based on entrustment from an Association of Medical Care Systems for the Elderly Aged 75 and older pursuant to the provisions of Article 70, paragraph (4) (including as applied mutatis mutandis pursuant to Article 74, paragraph (10), Article 75, paragraph (7), Article 76, paragraph (6), and Article 78, paragraph (8)), as well as dietary treatment expenses for inpatients, living support expenses for inpatients, medical expenses combined with treatment outside insurance coverage, and medical expenses for home-nursing.
In addition to the operations prescribed in the preceding paragraph, a NHI federation may conduct the following operations in order to contribute to the smooth operation of medical care for elderly persons:
affairs of collecting or receiving compensation for damage from a third party, conducted upon entrustment from the Association of Medical Care Systems for the Elderly Aged 75 and older pursuant to the provisions of Article 58, paragraph (3);
第五十八条第三項の規定により後期高齢者医療広域連合から委託を受けて行う第三者に対する損害賠償金の徴収又は収納の事務
beyond what is set forth in the preceding item, a project that contributes to the smooth operation of Old-Old Healthcare.
前号に掲げるもののほか、後期高齢者医療の円滑な運営に資する事業
Article 156Special Provisions for Voting Rights
第百五十六条（議決権の特例）
With regard to the business conducted by NHI federations pursuant to the provisions of the preceding Article (hereinafter referred to as "medical services for the elderly"), notwithstanding the provisions of Article 29 of the National Health Insurance Act as applied mutatis mutandis pursuant to Article 86 of the same Act, as specified by Order of the Ministry of Health, Labour and Welfare, special provisions concerning voting rights may be established by the constitution.
国保連合会が前条の規定により行う業務（以下「高齢者医療関係業務」という。）については、国民健康保険法第八十六条において準用する同法第二十九条の規定にかかわらず、厚生労働省令で定めるところにより、規約をもつて議決権に関する特別の定めをすることができる。
Article 157Separate Accounting
第百五十七条（区分経理）
A NHI federation must separate its accounting for medical services for the elderly from its other accounting.
Chapter VII Miscellaneous Provisions
第七章 雑則
第百五十七条の二（保険者協議会）
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.
保険者及び後期高齢者医療広域連合は、共同して、加入者の高齢期における健康の保持及び医療費適正化のために必要な事業の推進並びに高齢者医療制度の円滑な運営及び当該運営への協力のため、都道府県ごとに、保険者協議会を組織する。
The insurer council referred to in the preceding paragraph performs the following services:
前項の保険者協議会は、次に掲げる業務を行う。
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;
保険者に対する必要な助言又は援助
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;
医療に要する費用その他の厚生労働省令で定める事項に関する情報についての調査及び分析
investigation and analysis concerning the evaluation of the performance of the prefectural plan for regulating medical expenses.
都道府県医療費適正化計画の実績の評価に関する調査及び分析
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.
厚生労働大臣は、保険者協議会が前項各号に掲げる業務を円滑に行うため必要な支援を行うものとする。
Article 158Promotion of Research and Development
第百五十八条（研究開発の推進）
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.
Article 159Order of Statutory Liens
第百五十九条（先取特権の順位）
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.
保険料その他この法律の規定による徴収金の先取特権の順位は、国税及び地方税に次ぐものとする。
第百六十条（時効）
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.
保険料その他この法律の規定による徴収金を徴収し、又はその還付を受ける権利及び後期高齢者医療給付を受ける権利は、これらを行使することができる時から二年を経過したときは、時効によつて消滅する。
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.
保険料その他この法律の規定による徴収金の徴収の告知又は督促は、時効の更新の効力を生ずる。
Article 160-2Time Limits for Assessment Decisions
第百六十条の二（賦課決定の期間制限）
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.
Article 161Calculation of Period
第百六十一条（期間の計算）
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.
この法律又はこの法律に基づく命令に規定する期間の計算については、民法の期間に関する規定を準用する。
Article 161-2Restrictions on the Use of insured Numbers
第百六十一条の二（被保険者番号等の利用制限等）
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.
厚生労働大臣、後期高齢者医療広域連合、保険医療機関等、指定訪問看護事業者その他の後期高齢者医療の事業又は当該事業に関連する事務の遂行のため被保険者番号等（保険者番号（厚生労働大臣が後期高齢者医療の事業において後期高齢者医療広域連合を識別するための番号として、後期高齢者医療広域連合ごとに定めるものをいう。）及び被保険者番号（後期高齢者医療広域連合が被保険者の資格を管理するための番号として、被保険者ごとに定めるものをいう。）をいう。以下この条において同じ。）を利用する者として厚生労働省令で定める者（以下この条において「厚生労働大臣等」という。）は、当該事業又は事務の遂行のため必要がある場合を除き、何人に対しても、その者又はその者以外の者に係る被保険者番号等を告知することを求めてはならない。
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:
何人も、次に掲げる場合を除き、その者が業として行う行為に関し、その者に対し売買、貸借、雇用その他の契約（以下この項において「契約」という。）の申込みをしようとする者若しくは申込みをする者又はその者と契約の締結をした者に対し、当該者又は当該者以外の者に係る被保険者番号等を告知することを求めてはならない。
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):
何人も、次に掲げる場合を除き、業として、被保険者番号等の記録されたデータベース（その者以外の者に係る被保険者番号等を含む情報の集合物であつて、それらの情報を電子計算機を用いて検索することができるように体系的に構成したものをいう。）であつて、当該データベースに記録された情報が他に提供されることが予定されているもの（以下この項において「提供データベース」という。）を構成してはならない。
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.
厚生労働大臣は、前二項の規定に違反する行為が行われた場合において、当該行為をした者が更に反復してこれらの規定に違反する行為をするおそれがあると認めるときは、当該行為をした者に対し、当該行為を中止することを勧告し、又は当該行為が中止されることを確保するために必要な措置を講ずることを勧告することができる。
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.
厚生労働大臣は、前項の規定による勧告を受けた者がその勧告に従わないときは、その者に対し、期限を定めて、当該勧告に従うべきことを命ずることができる。
Article 161-3Reports and Inspections
第百六十一条の三（報告及び検査）
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.
Article 162Supervision of NHI Federations
第百六十二条（国保連合会に対する監督）
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))".
国保連合会について国民健康保険法第百六条及び第百八条の規定を適用する場合において、これらの規定中「事業」とあるのは、「事業（高齢者の医療の確保に関する法律（昭和五十七年法律第八十号）第百五十六条に規定する高齢者医療関係業務を含む。）」とする。
Article 163Delegation of Authority
第百六十三条（権限の委任）
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.
この法律に規定する厚生労働大臣の権限は、厚生労働省令で定めるところにより、地方厚生局長に委任することができる。
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.
前項の規定により地方厚生局長に委任された権限は、厚生労働省令で定めるところにより、地方厚生支局長に委任することができる。
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.
厚生労働大臣又は都道府県知事がこの法律に規定する事務を行うときは、相互に密接な連携の下に行うものとする。
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 (6), and Article 82, paragraph (6)) 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 (6), and Article 82, paragraph (6)), 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 (6), and Article 82, paragraph (6)), Article 80, and Article 81, paragraphs (1) and (3) (including as applied mutatis mutandis pursuant to Article 82, paragraph (6)), 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.
第四十四条第四項（第百二十四条、第百二十四条の八及び附則第十条において準用する場合を含む。）、第六十一条第一項及び第二項、第六十六条第一項（第七十四条第十項、第七十五条第七項、第七十六条第六項及び第八十二条第六項において準用する場合を含む。）及び第二項（第七十二条第二項、第七十四条第十項、第七十五条第七項、第七十六条第六項及び第八十二条第六項において準用する場合を含む。）、第七十条第二項並びに第七十二条第一項及び第三項（これらの規定を第七十四条第十項、第七十五条第七項、第七十六条第六項及び第八十二条第六項において準用する場合を含む。）、第八十条並びに第八十一条第一項及び第三項（これらの規定を第八十二条第六項において準用する場合を含む。）、第百三十三条第二項、第百三十四条第二項（附則第十条において準用する場合を含む。）、第百五十二条第一項及び第三項（これらの規定を附則第十一条第二項において準用する場合を含む。）並びに第百二十七条の規定において準用する国民健康保険法第八十八条及び第八十九条第一項の規定により都道府県が処理することとされている事務は、地方自治法第二条第九項第一号に規定する第一号法定受託事務とする。
Article 165-2Entrustment of Affairs to the Organization, etc.
第百六十五条の二（機構等への事務の委託）
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 (6) 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 provide benefits related to medical care or conduct other affairs 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.
後期高齢者医療広域連合は、前項の規定により同項各号に掲げる事務を委託する場合は、他の後期高齢者医療広域連合及び保険者、法令の規定により医療に関する給付その他の事務を行う者であつて厚生労働省令で定めるもの並びに介護保険法第三条の規定により介護保険を行う市町村と共同して委託するものとする。
Article 165-3Coordination and Cooperation among Relevant Persons
第百六十五条の三（関係者の連携及び協力）
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.
国、後期高齢者医療広域連合及び保険医療機関等その他の関係者は、電子資格確認の仕組みの導入その他手続における情報通信の技術の利用の推進により、医療保険各法、この法律その他医療に関する給付を定める法令の規定により行われる事務が円滑に実施されるよう、相互に連携を図りながら協力するものとする。
Article 166Implementation Provisions
第百六十六条（実施規定）
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.
この法律に特別の規定があるものを除くほか、この法律の実施のための手続その他その執行について必要な細則は、厚生労働省令で定める。
Chapter VIII Penal Provisions
第八章 罰則
第百六十七条
A person who divulges any secret in violation of the provisions of Article 30, Article 125-2, paragraph (2) or Article 125-4, paragraph (3) is punished by imprisonment for not more than one year or a fine of not more than 1,000,000 yen.
第三十条、第百二十五条の二第二項又は第百二十五条の四第三項の規定に違反して秘密を漏らした者は、一年以下の拘禁刑又は百万円以下の罰金に処する。
If a person as set forth in one of the following items divulges confidential information learned in connection with the performance of duties based on the provisions of this Act without legitimate grounds for doing so, that person is subject to imprisonment for not more than one year or a fine of not more than 1,000,000 yen:
次の各号のいずれかに掲げる者が、この法律の規定に基づく職務の執行に関して知り得た秘密を正当な理由がなく漏らしたときは、一年以下の拘禁刑又は百万円以下の罰金に処する。
a current or former official of a Association of Medical Care Systems for the Elderly Aged 75 and older;
後期高齢者医療広域連合の職員又はその職にあつた者
a member of the Examination Committee for Old-Old Medical Treatment Fees or the Examination Board for Old-Old Medical Treatment, an officer or employee of the NHI Federations, or a person who was formerly in those positions;
後期高齢者医療診療報酬審査委員会若しくは後期高齢者医療審査会の委員、国保連合会の役員若しくは職員又はこれらの職にあつた者
a person who is or was an officer or employee of a designated corporation that conducts a review of medical bills specified by the Minister of Health, Labour and Welfare pursuant to the provisions of Article 70, paragraph (5) (including as applied mutatis mutandis pursuant to Article 74, paragraph (10), Article 75, paragraph (7), Article 76, paragraph (6), and Article 78, paragraph (8));
a person who conducts or used to conduct a review of medical bills specified by the Minister of Health, Labour and Welfare pursuant to the provisions of Article 70, paragraph (6) (including as applied mutatis mutandis pursuant to Article 74, paragraph (10), Article 75, paragraph (7), Article 76, paragraph (6), and Article 78, paragraph (8)).
第百六十七条の二
A person who falls under any of the following items is punished by imprisonment for not more than one year or by a fine of not more than 500,000 yen, or both:
次の各号のいずれかに該当する者は、一年以下の拘禁刑若しくは五十万円以下の罰金に処し、又はこれを併科する。
a person who, in violation of the provisions of Article 16-6, has disclosed the content of anonymized medical data related to medical insurance, etc. acquired in relation to the use of the anonymized medical data related to medical insurance, etc. to another person without justifiable grounds, or used the information for an unjust purpose;
第十六条の六の規定に違反して、匿名医療保険等関連情報の利用に関して知り得た匿名医療保険等関連情報の内容をみだりに他人に知らせ、又は不当な目的に利用した者
a person who has violated an order issued under the provisions of Article 16-8.
第十六条の八の規定による命令に違反した者
第百六十七条の三
A person who has violated an order issued under the provisions of Article 161-2, paragraph (6) is punished by imprisonment for not more than one year or a fine of not more than 500,000 yen.
第百六十一条の二第六項の規定による命令に違反した者は、一年以下の拘禁刑又は五十万円以下の罰金に処する。
第百六十八条
Officers, liquidators, or employees of a Japan Health Insurance Association, health insurance society, national health insurance society, mutual aid association, or the Promotion and Mutual Aid Corporation for Private Schools of Japan are punished by a fine of not more than 500000 yen if they fall under any of the following items:
全国健康保険協会、健康保険組合、国民健康保険組合、共済組合又は日本私立学校振興・共済事業団の役員、清算人又は職員が次の各号のいずれかに該当するときは、五十万円以下の罰金に処する。
when the person has failed to make a report under the provisions of Article 134, paragraph (2) or has made a false report, or has refused, obstructed, or evaded an inspection under the provisions of the same paragraph;
if the person has failed to submit a report, document, or any other item pursuant to the provisions of Article 142, paragraph (1), or has submitted a false report or document including a false entry.
第百四十二条第一項の規定による報告若しくは文書その他の物件の提出をせず、又は虚偽の報告をし、若しくは虚偽の記載をした文書を提出したとき。
When an officer or employee of the Organization or an entrusted party has failed to make a report under the provisions of Article 152, paragraph (1) or has made a false report, or has refused, obstructed, or evaded an inspection under the provisions of the same paragraph, the officer or employee is punished by a fine of not more than 500,000 yen.
A person who fails to make a report or submit or present books and documents under the provisions of Article 16-7, paragraph (1), or makes a false report or submits or presents false books and documents, or fails to answer or gives a false answer to the questions under the provisions of the same paragraph, or refuses, interferes with, or evades the on-site inspection under the provisions of the same paragraph is punished by a fine of not more than 500000 yen.
第百六十九条
A person who has committed any of the following violations is punished by a fine of not more than 300000 yen:
次の各号のいずれかに該当する場合には、その違反行為をした者は、三十万円以下の罰金に処する。
when the requestor for review or relevant persons, or a physician or dental practitioner has failed to appear, failed to make a statement, failed to make a report, or made a false statement or report, or failed to make a diagnosis or examination, in violation of the disposition under the provisions of Article 101, paragraph (1) of the National Health Insurance Act as applied mutatis mutandis pursuant to the provisions of Article 130, without justifiable grounds (excluding cases pertaining to the requestor in the procedure of review conducted by the Certification Committee for Old-Old Healthcare, or a Association of Medical Care Systems for the Elderly Aged 75 and older or other interested persons who has received a notification pursuant to the provisions of Article 100 of the same Act as applied mutatis mutandis pursuant to the provisions of Article 130);
審査請求人若しくは関係者又は医師若しくは歯科医師が、正当な理由がなく第百三十条の規定において準用する国民健康保険法第百一条第一項の規定による処分に違反して、出頭せず、陳述をせず、報告をせず、若しくは虚偽の陳述若しくは報告をし、又は診断若しくは検案をしなかつたとき（後期高齢者医療審査会の行う審査の手続における請求人又は第百三十条の規定において準用する同法第百条の規定により通知を受けた後期高齢者医療広域連合その他の利害関係人に係る場合を除く。）。
when an insured or a person who used to be an insured fails to comply with an order to make a report issued pursuant to the provisions of Article 61, paragraph (2) without justifiable grounds, or fails to answer a question asked by the relevant official pursuant to the provisions of the same paragraph without justifiable grounds or gives a false answer;
when the person has failed to make a report under the provisions of Article 161-3, paragraph (1) or has made a false report without justifiable grounds, has failed to answer or given a false answer to the questions asked by the relevant official under the provisions of the same paragraph without justifiable grounds, or has refused, obstructed, or avoided the inspection under the provisions of the same paragraph without justifiable grounds.
正当な理由がなく第百六十一条の三第一項の規定による報告をせず、若しくは虚偽の報告をし、又は同項の規定による当該職員の質問に対して、正当な理由がなく答弁せず、若しくは虚偽の答弁をし、若しくは正当な理由がなく同項の規定による検査を拒み、妨げ、若しくは忌避したとき。
第百六十九条の二
The crimes of Article 167-2 also apply to persons who commit the crimes referred to in the same Article outside of Japan.
第百六十九条の三
If the representatives of a corporation (including an association or foundation that is not a corporation but for which a representative or an administrator has been designated (hereinafter referred to as an "association or foundation without legal personality" in this Article); hereinafter the same applies in this paragraph) (including the administrator of an association or foundation without legal personality) or the agents, employees, or other workers of a corporation or individual commit a violation of Article 167-2, Article 167-3, Article 168, paragraph (3) or Article 169, item (iii) in connection with the business of the corporation or individual, in addition to the offender being subject to punishment, the corporation or individual is subject to the fine referred to in the relevant Article.
Where the provisions of the preceding paragraph apply to an association or foundation without juridical personality, its representatives or administrators represent the association or foundation without juridical personality with respect to its procedural act, and the provisions of laws concerning criminal procedure that are applicable in the case where a corporation is accused or suspected apply mutatis mutandis.
第百七十条
If an officer of the Organization falls under any of the following items, the officer is punished by a civil fine of not more than 200,000 yen:
機構の役員が次の各号のいずれかに該当するときは、二十万円以下の過料に処する。
failure to obtain the approval or recognition of the Minister of Health, Labour and Welfare when such approval or recognition is required pursuant to this Act;
この法律により厚生労働大臣の認可又は承認を受けなければならない場合において、その認可又は承認を受けなかつたとき。
when the surplus funds in the course of business have been invested in violation of the provisions of Article 149.
第百四十九条の規定に違反して業務上の余裕金を運用したとき。
When a medical practitioner, dental practitioner, pharmacist, or person who has provided medical care or their employer fails to comply with an order to make a report or to present medical records, books and documents, or any other articles under the provisions of Article 61, paragraph (1) without justifiable grounds, or fails to answer a question asked by the relevant official under the provisions of the same paragraph without justifiable grounds, or gives a false answer, the person is punished by a civil fine of not more than 100,000 yen.
第百七十一条
The Association of Medical Care Systems for the Elderly Aged 75 and older may, by its Ordinance, establish provisions to impose a civil fine of not more than 100,000 yen when a insured fails to make a notification under the provisions of Article 54, paragraph (1) (excluding cases where the notification has been made by the householder of the household to which the insured belongs pursuant to the provisions of paragraph (2) of the same Article) or makes a false notification.
後期高齢者医療広域連合は、条例で、被保険者が第五十四条第一項の規定による届出をしないとき（同条第二項の規定により当該被保険者の属する世帯の世帯主から届出がなされたときを除く。）又は虚偽の届出をしたときは、十万円以下の過料を科する規定を設けることができる。
If a person who is or was a insured, the spouse of a insured, the householder of a household to which a insured belongs, or any other member of the household fails to comply with an order to submit or present a document or any other article issued pursuant to the provisions of the Article 137, paragraph (1) without justifiable grounds, or fails to answer or gives a false answer to a question asked by the relevant official under the provisions of the same paragraph, the Association of Medical Care Systems for the Elderly Aged 75 and older may establish provisions in its Ordinances to impose a civil fine of not more than 100,000 yen.
後期高齢者医療広域連合は、条例で、被保険者、被保険者の配偶者若しくは被保険者の属する世帯の世帯主その他その世帯に属する者又はこれらであつた者が正当な理由がなく第百三十七条第一項の規定により文書その他の物件の提出若しくは提示を命ぜられてこれに従わず、又は同項の規定による当該職員の質問に対して答弁せず、若しくは虚偽の答弁をしたときは、十万円以下の過料を科する規定を設けることができる。
A municipality may, by Municipal Ordinance, establish provisions to impose a civil fine of not more than 100,000 yen if an insured, the spouse of an insured, the head of the household to which an insured belongs or any other member of that household, or a person who was any of these, fails without justifiable grounds to comply with an order to submit or present a document or any other article under the provisions of Article 137, paragraph (2), or fails to answer or gives a false answer to a question asked by the relevant official under the provisions of the same paragraph.
A Association of Medical Care Systems for the Elderly Aged 75 and older may establish provisions in its Ordinance to impose a civil fine on a person who has evaded the collection of money to be collected related to co-payment whose collection has been suspended and other money to be collected pursuant to the provisions of Chapter IV (limited to money to be collected by the Association of Medical Care Systems for the Elderly Aged 75 and older) by deception or other wrongful acts, in an amount not exceeding the amount equivalent to five times the amount evaded.
後期高齢者医療広域連合は、条例で、偽りその他不正の行為により徴収猶予した一部負担金に係る徴収金その他第四章の規定による徴収金（後期高齢者医療広域連合が徴収するものに限る。）の徴収を免れた者に対し、その徴収を免れた金額の五倍に相当する金額以下の過料を科する規定を設けることができる。
A Municipality may, in its Municipal Ordinance, establish provisions to impose on a person who has evaded the collection of insurance premiums or any other money to be collected pursuant to the provisions of Chapter IV (limited to those collected by the Municipality) by deception or other wrongful acts, a civil fine of not more than the amount equivalent to five times the amount evaded.
市町村は、条例で、偽りその他不正の行為により保険料その他第四章の規定による徴収金（市町村が徴収するものに限る。）の徴収を免れた者に対し、その徴収を免れた金額の五倍に相当する金額以下の過料を科する規定を設けることができる。
The provisions of Article 255-3 of the Local Autonomy Act apply mutatis mutandis to the disposition of a civil fine under the provisions of the preceding paragraphs.
地方自治法第二百五十五条の三の規定は、前各項の規定による過料の処分について準用する。