Act on Assurance of Medical Care for Elderly People
高齢者の医療の確保に関する法律
Every term this law . Its definitions bind only this law — each entry says where the definition applies and links to the sentence that settles it. 347 terms: 60 with the Ministry of Justice's English, 287 in our translation, marked as such.
保険者
In this Act, the bodies that provide medical care benefits under the Medical Insurance Acts (医療保険各法): the Japan Health Insurance Association (全国健康保険協会), health insurance societies (健康保険組合), prefectures (都道府県) and municipalities (市町村), National Health Insurance Societies (国民健康保険組合), mutual aid associations (共済組合) and the Promotion and Mutual Aid Corporation for Private Schools of Japan (日本私立学校振興・共済事業団).
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
The wide-area union (広域連合) that, under Article 48, all the municipalities (市町村) in each prefecture's area join to handle the work of late-stage elderly medical care (後期高齢者医療), other than collecting insurance premiums and the work a Cabinet Order (政令) names as serving insured persons' convenience.
The fiscal year, from 1 April to 31 March of the following year.
毎年四月一日から翌年三月三十一日まで
The Medical Information Infrastructure and Medical Fee Examination and Payment Organization (医療情報基盤・診療報酬審査支払機構), set up under Act No. 129 of 1948; under this Act it collects the young-old payments, etc. (前期高齢者納付金等) and the aid for the old-old, etc. (後期高齢者支援金等) from insurers and pays grants, among other work (Article 139).
加入者
Here a participant as defined in Article 7, paragraph (4), used in defining a young-old participant (前期高齢者である加入者): a participant from the month after the month in which they reach age 65 (or from that month, where that day is the first of the month) up to the month in which they reach age 75, and others a Ministry of Health, Labour and Welfare Order (厚生労働省令) names.
六十五歳に達する日の属する月の翌月（その日が月の初日であるときは、その日の属する月）以後である加入者であつて、七十五歳に達する日の属する月以前であるものその他厚生労働省令で定めるもの
A hospital or clinic (保険医療機関) or a pharmacy (保険薬局) designated by the Minister of Health, Labour and Welfare under Article 63, paragraph (3), item (i) of the Health Insurance Act, from which insured persons of late-stage elderly medical care (後期高齢者医療) receive benefits for medical treatment (療養の給付).
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
An insurer (保険者) other than the Japan Health Insurance Association (全国健康保険協会) as insurer under Article 123, paragraph (1) of the Health Insurance Act, prefectures, municipalities (市町村) and national health insurance societies (国民健康保険組合), together with any national health insurance society the Minister of Health, Labour and Welfare designates whose members are people who, with approval under Article 3, paragraph (1), item (viii) of the Health Insurance Act, are not insured under that Act.
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
後期高齢者医療給付
The benefits this Act provides for insured persons: benefits for medical treatment (療養の給付) and the payment of inpatient dietary treatment expenses, inpatient living support expenses, medical expenses combined with treatment outside insurance coverage, medical expenses, medical expenses for home-nursing, special medical expenses and transport expenses; the payment of high-cost medical expenses and high-cost medical and long-term care expenses; and other benefits an Association of Medical Care Systems for the Elderly Aged 75 and older (後期高齢者医療広域連合) provides under its bylaws (条例).
This Act as amended by Article 3 of Act No. 102 of 2002.
Health education, health consultations, health checkups and health guidance, support for insured persons' own efforts at health management and disease prevention, and other work needed to maintain and improve their health, which an Association of Medical Care Systems for the Elderly Aged 75 and older (後期高齢者医療広域連合) must try to carry out in a way suited to the physical and mental characteristics of older people.
七十五歳以上の加入者等
In Articles 14 to 17 of the supplementary provisions (附則) of Act No. 102 of 2002, a participant aged 75 or over, etc. as defined in Article 25, paragraph (1) of this Act as Article 3 of that Act amended it (新老健法), including a participant (加入者) whom Article 9 of those supplementary provisions treats as aged 75 or over.
指定訪問看護
Home-visit nursing (訪問看護) given by a designated home-nursing provider (指定訪問看護事業者) at its place of business covered by the designation, for which insured persons receive medical expenses for home-nursing (訪問看護療養費).
前期高齢者納付金等
The young-old payment (前期高齢者納付金) and the young-old administrative expense contribution (前期高齢者関係事務費拠出金) that the Medical Information Infrastructure and Medical Fee Examination and Payment Organization (機構) collects from insurers each fiscal year under Article 36, paragraph (1), to meet the cost of the work in Article 139, paragraph (1), item (i) and of administering it.
The plan each prefecture draws up every six years, for a six-year period, in line with the basic policies for the optimization of medical expenses (医療費適正化基本方針), to promote the optimization of medical expenses (医療費適正化) in the prefecture (Article 9, paragraph (1)).
指定訪問看護事業者
A provider the Minister of Health, Labour and Welfare has designated to run a home-visit nursing business: nursing care or help with medical treatment given at home by nurses and others a Ministry of Health, Labour and Welfare Order (厚生労働省令) names to people under continuing treatment at home for an illness or injury whom their doctor finds meet the Order's standard.
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
A health checkup for diabetes and other lifestyle-related diseases (生活習慣病) that a Cabinet Order (政令) specifies.
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
国保連合会
A federation of national health insurance associations (国民健康保険団体連合会) as provided in Article 45, paragraph (5) of the National Health Insurance Act, to which, under Article 17, paragraph (1), the Minister of Health, Labour and Welfare may entrust all or part of the work of surveying and analysing medical insurance-related information (医療保険等関連情報) under Article 16, paragraph (1) and of using or providing anonymized medical data (匿名医療保険等関連情報) under Article 16-2, paragraph (1).
加入者
In this Act, any of the persons Article 7, paragraph (4) lists: insured persons under the Health Insurance Act other than day-labourer insured persons (日雇特例被保険者); insured persons of mariners' insurance (船員保険) and of national health insurance (国民健康保険); members of the mutual aid associations (共済組合) for national and local public officers and of the private school personnel mutual aid scheme; dependants (被扶養者) under the health insurance, mariners' insurance and public officers' mutual aid schemes, other than dependants of day-labourer insured persons; and a person issued a day-labourer insured person's handbook (日雇特例被保険者手帳) under Article 126 of the Health Insurance Act, until it has no space left for health insurance stamps, with that person's dependants, with the exceptions item (vii) lists.
次に掲げる者
Special health examinations (特定健康診査) and specified health guidance (特定保健指導) together.
医療保険各法
The Health Insurance Act, the Mariners Insurance Act, the National Health Insurance Act, the National Public Officers Mutual Aid Association Act, the Local Public Officers, etc. Mutual Aid Association Act and the Private School Personnel Mutual Aid Association Act.
次に掲げる法律
Health guidance given by a person a Ministry of Health, Labour and Welfare Order (厚生労働省令) names as having expert knowledge and skills in health guidance, to people the Order names as needing to work at keeping healthy in light of the results of their special health examination (特定健康診査).
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
This Act as amended by Article 1 of Act No. 106 of 1986.
This Act as amended by Article 1 of Act No. 89 of 1991.
The wide-area union (広域連合) that, under Article 48, all the municipalities (市町村) in each prefecture's area join to handle the work of late-stage elderly medical care (後期高齢者医療), other than collecting insurance premiums and the work a Cabinet Order (政令) names as serving insured persons' convenience.
The optimization of medical expenses: keeping the expenses required for medical care (医療に要する費用) appropriate, which, to secure appropriate medical care for people in their old age, the Minister of Health, Labour and Welfare promotes comprehensively and systematically through the basic policies for the optimization of medical expenses (医療費適正化基本方針) and the national plan for the optimization of medical expenses (全国医療費適正化計画).
The date Act No. 89 of 1991, the amending Act these supplementary provisions (附則) belong to, comes into effect.
The plan for promoting the optimization of medical expenses (医療費適正化) that the Minister of Health, Labour and Welfare draws up under Article 8, paragraph (1) every six years, each plan covering six years.
前期高齢者に係る後期高齢者支援金の概算額
For an insurer, its estimated aid for the old-old (概算後期高齢者支援金) under Article 119, paragraph (1) for the fiscal year, divided by its estimated aid adjustment rate (概算後期高齢者支援金調整率) under Article 120, paragraph (1), and multiplied by a rate worked out for each insurer from the expected share of young-old participants (前期高齢者である加入者) among its participants (加入者); it counts in working out the insurer's estimated young-old subsidy (概算前期高齢者交付金) and estimated young-old payment (概算前期高齢者納付金).
前期高齢者に係る後期高齢者支援金の確定額
For an insurer, its fixed aid for the old-old (確定後期高齢者支援金) under Article 119, paragraph (1) for the fiscal year before last, divided by its fixed aid adjustment rate (確定後期高齢者支援金調整率) under Article 121, paragraph (1), and multiplied by a rate worked out for each insurer from the share of young-old participants (前期高齢者である加入者) among its participants (加入者) that year; it counts in working out the insurer's fixed young-old subsidy (確定前期高齢者交付金) and fixed young-old payment (確定前期高齢者納付金).
In the supplementary provisions (附則) of Act No. 102 of 2002, medical care (医療, including the payment of medical expenses) under this Act as Article 3 of that Act amended it (新老健法), and the payment of inpatient dietary treatment expenses (入院時食事療養費) and specified medical expenses (特定療養費) (each including the payment of medical expenses), of elderly home-nursing medical expenses (老人訪問看護療養費), of transport expenses (移送費) and of high-cost medical expenses (高額医療費).
The national health insurance that a prefecture (都道府県) carries out together with the municipalities (市町村) in it under the National Health Insurance Act.
Meals provided as treatment together with inpatient care at a hospital or clinic (the treatment in Article 64, paragraph (1), item (v)), other than with long-term hospitalization and medical treatment (長期入院療養): hospitalization in a sanatorium ward (療養病床) under Article 7, paragraph (2), item (iv) of the Medical Care Act, with the care and nursing that go with it.
前期高齢者に係る流行初期医療確保拠出金の額
For an insurer, the part of its contribution for securing medical care in the early phase of an epidemic (流行初期医療確保拠出金) under the Act on the Prevention of Infectious Diseases and Medical Care for Patients with Infectious Diseases for the fiscal year before last that relates to its young-old participants (前期高齢者である加入者), as a Ministry of Health, Labour and Welfare Order (厚生労働省令) calculates it; it counts in working out the insurer's fixed young-old subsidy (確定前期高齢者交付金) and fixed young-old payment (確定前期高齢者納付金).
匿名医療保険等関連情報
Medical insurance-related information (医療保険等関連情報) processed, to standards a Ministry of Health, Labour and Welfare Order (厚生労働省令) sets, so that the specific insured persons and others it concerns (本人) cannot be identified and the information it was made from cannot be restored; under Article 16-2 the Minister of Health, Labour and Welfare may use it, and may provide it for work of considerable public interest to other national bodies and local governments, universities and other research institutions, and private businesses and others the Order names.
医療保険等関連情報に係る特定の被保険者その他の厚生労働省令で定める者（次条において「本人」という。）を識別すること及びその作成に用いる医療保険等関連情報を復元することができないようにするために厚生労働省令で定める基準に従い加工した医療保険等関連情報
保険者の給付に要する費用
The cost of an insurer's benefits (for National Health Insurance (国民健康保険), the benefits of the municipalities in the prefecture) that are medical care benefits under the Medical Insurance Acts (医療保険各法), other than the other benefits of Article 53 of the Health Insurance Act and their equivalents, of the kinds a Ministry of Health, Labour and Welfare Order (厚生労働省令) names; the young-old subsidy (前期高齢者交付金) and payment (前期高齢者納付金) are worked out from it.
生活療養
Meals, and a suitable care environment as to temperature, lighting and water supply, provided as treatment together with long-term hospitalization and medical treatment (長期入院療養) — the stay in a sanatorium ward (療養病床), with its care, that is part of the inpatient treatment in Article 64, paragraph (1), item (v).
The sickbed conversion promotion services each prefecture is to run, until a date a Cabinet Order (政令) sets, to promote the optimization of medical expenses (医療費適正化) in the prefecture: subsidizing a hospital or clinic covered by health insurance, set up by a medical corporation (医療法人) or another person a Ministry of Health, Labour and Welfare Order (厚生労働省令) names, for the cost of converting beds — cutting beds of kinds the Order names among those listed in Article 7, paragraph (2) of the Medical Care Act and, within that number, adding places in a newly built or enlarged long-term care medical facility (介護医療院) under Article 8, paragraph (29) of the Long-Term Care Insurance Act or another facility the Order names.
The basic policies on measures for the optimization of medical expenses (医療費適正化) that the Minister of Health, Labour and Welfare sets under Article 8, paragraph (1); they set the standards and other basic matters for the targets of the prefectural plans for the optimization of medical expenses (都道府県医療費適正化計画), basic matters on evaluating how far those plans are achieved and on surveying and analysing the expenses required for medical care, and other important matters for promoting the optimization of medical expenses.
Short name, in the supplementary provisions (附則) of Act No. 102 of 2002, for the law on health services for the elderly (老人保健法) as it stood before Article 3 of that Act amended it.
This Act as amended by Article 7 of Act No. 83 of 2006.
In the supplementary provisions (附則) of Act No. 35 of 2010, an insurer of employee insurance, etc. as defined in Article 10, paragraph (1) of the supplementary provisions of the National Health Insurance Act as that Act amended it (改正後国保法).
改正後国保法附則第十条第一項に規定する被用者保険等保険者
Short name, in the supplementary provisions (附則) of Act No. 62 of 2012, for the Act on Assurance of Medical Care for Elderly People (Act No. 80 of 1982).
This Act as amended by Article 9 of Act No. 31 of 2015.
The adjustment among insurers of the sharing of costs for the young-old (前期高齢者) under Chapter III, together with the medical insurance system for the old-old (後期高齢者医療制度) under Chapter IV.
第三章に規定する前期高齢者に係る保険者間の費用負担の調整及び第四章に規定する後期高齢者医療制度
A person who is provided with anonymized medical data (匿名医療保険等関連情報) under Article 16-2, paragraph (1) and uses it, and who must not try to identify the people it concerns, by obtaining the descriptions deleted from the information it was made from or information on how it was processed, or by matching it with other information.
The basic guidelines for special health examinations, etc.: the guidelines the Minister of Health, Labour and Welfare sets for carrying out special health examinations (特定健康診査) and specified health guidance (特定保健指導) properly and effectively.
The implementation plan for special health examinations, etc.: the plan each insurer (保険者) — for national health insurance, each municipality (市町村) — draws up every six years, for a six-year period, in line with the basic guidelines for special health examinations, etc. (特定健康診査等基本指針), for carrying out special health examinations (特定健康診査) and specified health guidance (特定保健指導).
A physician or dentist registered with the Minister of Health, Labour and Welfare to give medical care under health insurance at a medical institution providing services covered by health insurance (保険医), or a pharmacist so registered to dispense at a pharmacy providing services covered by health insurance (保険薬剤師), as provided in Article 64 of the Health Insurance Act; under Article 65 they must handle or give the benefits for medical treatment (療養の給付) of late-stage elderly medical care (後期高齢者医療) by the standards under Article 71, paragraph (1).
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
A general incorporated association or general incorporated foundation that the Minister of Health, Labour and Welfare designates under Article 45, paragraph (6) of the National Health Insurance Act as meeting the requirements a Ministry of Health, Labour and Welfare Order (厚生労働省令) sets for its review organization and as able to do the work properly and reliably, to which a Federation of National Health Insurance Associations (国保連合会) may entrust the review of the medical bills the Minister specifies; under Article 117 it also runs the special joint high medical care cost project (特別高額医療費共同事業).
The total, for insured persons, of the cost of benefits for medical treatment (療養の給付) less the co-payments (一部負担金) on them, and the cost of paying dietary treatment expenses for inpatients (入院時食事療養費), living support expenses for inpatients (入院時生活療養費), medical expenses combined with treatment outside insurance coverage (保険外併用療養費), medical expenses (療養費), medical expenses for home-nursing (訪問看護療養費), special medical expenses (特別療養費), transport expenses (移送費), high-cost medical expenses (高額療養費) and high-cost combined medical and long-term care expenses (高額介護合算療養費).
子ども・子育て支援納付金
The children and child-rearing support levy under the Act on Support for Children and Child-rearing (Act No. 65 of 2012); under Article 95, paragraph (2), one 120th of its expected amount, with one twelfth of the expected total amount subject to the burden (負担対象総額), makes up the total of the adjustment grants (調整交付金) the State gives Associations of Medical Care Systems for the Elderly Aged 75 and older (後期高齢者医療広域連合).
後期高齢者支援金等
The aid for the old-old (後期高齢者支援金) and the old-old administrative expense contribution (後期高齢者関係事務費拠出金) that the Medical Information Infrastructure and Medical Fee Examination and Payment Organization (機構) collects each fiscal year from insurers (for National Health Insurance (国民健康保険), prefectures) under Article 118, paragraph (1), to meet the cost of the work in Article 139, paragraph (1), item (ii).
This Act as amended by Article 4 of Act No. 56 of 1994.
保険者の給付に要する費用
In Article 14, paragraph (1) and Articles 15 to 17 of the supplementary provisions (附則) of Act No. 102 of 2002, the cost of an insurer's medical-related benefits (医療関連給付) — medical care benefits under the Medical Insurance Acts as referred to in Article 6, paragraph (1) of this Act as Article 3 of that Act amended it (新老健法), other than the other benefits of Article 53 of the Health Insurance Act and their equivalents — of the kinds a Ministry of Health, Labour and Welfare Order (厚生労働省令) names, including the cost of paying the day-labourer contribution (日雇拠出金) of Article 173, paragraph (2) of the Health Insurance Act and the medical treatment benefit contribution, etc. (療養給付費等拠出金) of Article 81-2, paragraph (1) of the National Health Insurance Act.
医療関連給付
In Article 14 and Articles 15 to 17 of the supplementary provisions (附則) of Act No. 102 of 2002, an insurer's medical care benefits under the Medical Insurance Acts as referred to in Article 6, paragraph (1) of this Act as Article 3 of that Act amended it (新老健法), other than the other benefits of Article 53 of the Health Insurance Act and their equivalents.
平成二十年四月改正前老健法
Short name, in Articles 37 and 38 of the supplementary provisions (附則) of Act No. 83 of 2006, for the Act on Assurance of Medical Care for Elderly People, then titled 老人保健法 (the law on health care for the elderly), as it stood before Article 7 of that Act amended it with effect from 1 April 2008.
改正後高齢者医療確保法
This Act as amended by Article 3 of Act No. 35 of 2010.
In Articles 51 to 51-7 of the supplementary provisions (附則) of Act No. 62 of 2012, an insurer of employee insurance, etc. as defined in Article 10, paragraph (1) of the supplementary provisions of the National Health Insurance Act (Act No. 192 of 1958) as it stood before Article 3 of the Act Partially Amending the National Health Insurance Act, etc. to Establish a Sustainable Medical Insurance System (Act No. 31 of 2015) amended it, other than the Japan Health Insurance Association (全国健康保険協会) as insurer under Article 123, paragraph (1) of the Health Insurance Act.
持続可能な医療保険制度を構築するための国民健康保険法等の一部を改正する法律（平成二十七年法律第三十一号。以下「国保法等一部改正法」という。）第三条の規定による改正前の国民健康保険法（昭和三十三年法律第百九十二号）附則第十条第一項に規定する被用者保険等保険者（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を除く。）
Short name, in Article 51-2 of the supplementary provisions (附則) of Act No. 62 of 2012, for the Act on Assurance of Medical Care for Elderly People (Act No. 80 of 1982) as it stood before Article 27 of that Act amended it.
This Act as it stood before Article 10 of Act No. 31 of 2015 amended it.
Information as defined in Article 16, paragraph (1) of the Act on Assurance of Medical Care for Elderly People: information on medical costs by region, age or illness, on the changing number of hospital beds by region and on other matters a Ministry of Health, Labour and Welfare Order (厚生労働省令) names, which the Minister of Health, Labour and Welfare surveys, analyses and publishes to help draw up, carry out and evaluate the national and prefectural plans for keeping medical costs appropriate.
Medical treatment using advanced medical technology that the Minister of Health, Labour and Welfare designates as needing evaluation, at the request of the person who wishes to receive it, of whether it should be covered by the benefits for medical treatment (療養の給付), with a view to providing appropriate medical care efficiently.
In Article 82, an insured person who is behind with their insurance premiums (保険料), other than one who can receive the payment of general medical expenses (一般疾病医療費) under the Atomic Bomb Survivors' Assistance Act or another medical benefit a Ministry of Health, Labour and Welfare Order (厚生労働省令) names; if such a person still has not paid by the end of the period the Order sets after the due date, even after the municipality's encouragement of insurance premium payment, etc. (保険料納付の勧奨等), the Association of Medical Care Systems for the Elderly Aged 75 and older (後期高齢者医療広域連合) pays special medical expenses (特別療養費) in place of benefits for medical treatment, etc. (療養の給付等), unless a disaster or other special circumstance a Cabinet Order (政令) names applies.
The contribution for securing medical care in the early phase of an epidemic (流行初期医療確保拠出金) and the related administrative expense contribution (流行初期医療確保関係事務費拠出金), which insurers (保険者) and Associations of Medical Care Systems for the Elderly Aged 75 and older (後期高齢者医療広域連合) must pay under Article 36-14 of the Act on the Prevention of Infectious Diseases and Medical Care for Patients with Infectious Diseases; Article 104 counts paying them among the costs municipalities (市町村) collect insurance premiums (保険料) to cover.
A municipality's (市町村) collecting insurance premiums (保険料) by sending a payment notice, under Article 231 of the Local Autonomy Act, to the insured person charged with them, the householder (世帯主) of their household or their spouse, including a partner in an unregistered marriage; premiums must be collected this way unless they are collected by special collection (特別徴収).
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
In Article 161-2, the Minister of Health, Labour and Welfare, Associations of Medical Care Systems for the Elderly Aged 75 and older (後期高齢者医療広域連合), medical institutions providing services covered by health insurance, etc. (保険医療機関等), designated home-nursing providers (指定訪問看護事業者) and the others a Ministry of Health, Labour and Welfare Order (厚生労働省令) names as using insured person numbers, etc. (被保険者番号等) — the number the Minister sets to identify each union and the number each union sets for each insured person — to carry out late-stage elderly medical care or related work; they may not ask anyone to disclose those numbers except where that work needs it.
被保険者番号等
In Article 161-2, the insurer number (保険者番号) the Minister of Health, Labour and Welfare sets for each Association of Medical Care Systems for the Elderly Aged 75 and older (後期高齢者医療広域連合) to identify it in late-stage elderly medical care (後期高齢者医療), and the insured person number (被保険者番号) each wide-area union sets for each insured person to manage their eligibility.
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。）
Short name, in the supplementary provisions (附則) of Act No. 106 of 1986, for the law on health services for the elderly (老人保健法) as it stood before Article 1 of that Act amended it.
下限割合
In Articles 14 to 17 of the supplementary provisions (附則) of Act No. 102 of 2002, the rate a Cabinet Order (政令) sets under Article 55, paragraph (2) of this Act as Article 3 of that Act amended it (新老健法); where an insurer's share of participants aged 75 or over, etc. (七十五歳以上の加入者等) among its participants (加入者) for a period is below it, its participant adjustment rate for that period is worked out with this rate instead.
新老健法第五十五条第二項の政令で定める割合
病床の機能
The functions of hospital beds as defined in Article 30-3, paragraph (2), item (vi) of the Medical Care Act: the kind of medical care, suited to patients' condition, provided in the beds of a hospital or clinic.
同法第三十条の三第二項第六号に規定する病床の機能
For an insurer, the part of its expected expenses required for benefits by insurers (保険者の給付に要する費用) for the fiscal year that relates to its young-old participants (前期高齢者である加入者), as a Ministry of Health, Labour and Welfare Order (厚生労働省令) calculates it; the insurer's estimated young-old subsidy (概算前期高齢者交付金) is worked out from it.
前期高齢者給付費額
For an insurer, the part of its expenses required for benefits by insurers (保険者の給付に要する費用) for a fiscal year that relates to its young-old participants (前期高齢者である加入者), as a Ministry of Health, Labour and Welfare Order (厚生労働省令) calculates it; the insurer's fixed young-old subsidy (確定前期高齢者交付金) is worked out from it.
In Article 38, an insurer whose estimated amount equivalent to young-old payments before burden adjustment (負担調整前概算前期高齢者納付金相当額) for the fiscal year is above zero, for which the total in paragraph (1), item (ii), (a) — that amount plus its estimated aid for the old-old (概算後期高齢者支援金) divided by its adjustment rate for that aid — exceeds the amount in (b): that total plus the expected costs of its benefits (保険者の給付に要する費用等), multiplied by the fiscal year's special burden adjustment base rate (特別負担調整基準率), and whose expected financial strength for the year, worked out as a Cabinet Order (政令) provides, falls short of a standard the Cabinet Order sets.
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が零を超える保険者のうち、イに掲げる合計額がロに掲げる額を超える者であつて、政令で定めるところにより算定した同年度における当該保険者の財政力の見込みが政令で定める基準に満たないもの
In Chapter IV, Section 3, Subsection 5 (Articles 87 to 92), on restricting late-stage elderly medical care benefits (後期高齢者医療給付), benefits for medical treatment (療養の給付) and the payment of dietary treatment expenses for inpatients (入院時食事療養費), living support expenses for inpatients (入院時生活療養費), medical expenses combined with treatment outside insurance coverage (保険外併用療養費), medical expenses (療養費), medical expenses for home-nursing (訪問看護療養費), special medical expenses (特別療養費) and transport expenses (移送費).
In Chapter IV, Section 4 (costs), the part of the costs borne by the special account (特別会計) of an Association of Medical Care Systems for the Elderly Aged 75 and older (後期高齢者医療広域連合) for that care that is to be met from insurers: the amount subject to the burden (負担対象額) multiplied by the rate left after taking the old-old contribution rate (後期高齢者負担率) and 50 percent from one, plus the specified costs (特定費用) multiplied by one minus the old-old contribution rate.
特定期間
In Article 116, paragraph (2), each successive two-fiscal-year period beginning with fiscal 2008 (fiscal 2008 and 2009, then 2010 and 2011, and so on).
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
The bed conversion support payment (病床転換支援金) and the contribution toward the administrative costs of bed conversion grants (病床転換助成関係事務費拠出金) that the Medical Information Infrastructure and Medical Fee Examination and Payment Organization (機構) collects each fiscal year from insurers — for national health insurance, the prefectures — to pay for its work under Article 11, paragraph (1) of the supplementary provisions (附則): collecting them and paying prefectures bed conversion grants (病床転換助成交付金).
Short name, in the supplementary provisions (附則) of Act No. 89 of 1991, for the law on health services for the elderly (老人保健法) as it stood before Article 1 of that Act amended it.
新平成七年改正法
Short name, in the supplementary provisions (附則) of Act No. 109 of 1998, for the Act Partially Amending the National Health Insurance Act, etc. (Act No. 53 of 1995) as amended by Article 3 of Act No. 109 of 1998.
新全国計画
In the supplementary provisions (附則) of Act No. 31 of 2015, the national plan for the optimization of medical expenses (全国医療費適正化計画) that the State is to draw up promptly on or after 1 April 2016, when the provisions listed in Article 1, item (ii) of those supplementary provisions came into effect, under the Act on Assurance of Medical Care for Elderly People as amended by Article 9 of that Act.
新都道府県計画
In the supplementary provisions (附則) of Act No. 31 of 2015, the prefectural plan for the optimization of medical expenses (都道府県医療費適正化計画) that each prefecture is to draw up promptly on or after 1 April 2016, when the provisions listed in Article 1, item (ii) of those supplementary provisions came into effect, under the Act on Assurance of Medical Care for Elderly People as amended by Article 9 of that Act.
This Act as amended by Article 6 of Act No. 31 of 2023.
子ども・子育て支援納付金
In Article 47 of the supplementary provisions (附則) of Act No. 47 of 2024, the children and child-rearing support levy provided for in Article 71-3, paragraph (1) of the Act on Support for Children and Child-rearing as that Act amended it, which the government collects every fiscal year from fiscal 2026 from health insurers and similar bodies (健康保険者等).
施行日新支援法第七十一条の三第一項に規定する子ども・子育て支援納付金
標準報酬総額の見込額
An insurer's total standard remuneration (標準報酬総額) for the fiscal year as estimated in the way a Ministry of Health, Labour and Welfare Order (厚生労働省令) provides.
The contribution for securing medical care in the early phase of an epidemic (流行初期医療確保拠出金) that the Organization (基盤機構) named in the Act on the Prevention of Infectious Diseases and Medical Care for Patients with Infectious Diseases collects, under Article 36-14 of that Act, from insurers (保険者) — for national health insurance, the prefectures — and from Associations of Medical Care Systems for the Elderly Aged 75 and older (後期高齢者医療広域連合), for each month in which measures to secure medical care early in an outbreak (流行初期医療確保措置) were carried out, in the period running from the month an outbreak of a novel influenza or similar infectious disease is announced to the month in which a period a Cabinet Order (政令) sets ends.
The total standard remuneration as provided in Article 34, paragraph (8): for each fiscal year, the total of the standard remuneration of an insurer's insured persons or members — standard monthly remuneration and standard bonus amounts (標準賞与額), for mutual aid associations (共済組合) standard monthly remuneration and standard term-end allowances (標準期末手当等), and for a national health insurance society (国民健康保険組合) amounts a Ministry of Health, Labour and Welfare Order (厚生労働省令) sets as equivalent — adjusted as a Cabinet Order (政令) provides.
前条第八項に規定する標準報酬総額
In Article 38, an insurer whose estimated amount equivalent to young-old payments before burden adjustment (負担調整前概算前期高齢者納付金相当額) for the fiscal year is above zero and for which the total in paragraph (1), item (i), (a) — that amount plus its estimated aid for the old-old (概算後期高齢者支援金) divided by its adjustment rate for that aid — exceeds the amount in (b): that total plus the expected costs of its benefits (保険者の給付に要する費用等), multiplied by the fiscal year's burden adjustment base rate (負担調整基準率); an insurer exceeding the special estimated burden adjustment standard (特別概算負担調整基準超過保険者) is not included.
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が零を超える保険者のうち、イに掲げる合計額がロに掲げる額を超える者（次号の特別概算負担調整基準超過保険者を除く。）
In Article 38, paragraphs (1) and (3), for an insurer exceeding the estimated burden adjustment standard (概算負担調整基準超過保険者), the total in paragraph (1), item (i), (a) less the amount in (b), but no more than its estimated amount equivalent to young-old payments before burden adjustment (負担調整前概算前期高齢者納付金相当額); it is deducted from that amount in working out the insurer's estimated young-old payments (概算前期高齢者納付金).
イに掲げる合計額からロに掲げる額を控除して得た額（当該額が負担調整前概算前期高齢者納付金相当額を上回るときは、負担調整前概算前期高齢者納付金相当額とする。）
In Article 39, paragraphs (1) and (3), for an insurer exceeding the fixed burden adjustment standard (確定負担調整基準超過保険者), the total in paragraph (1), item (i), (a) less the amount in (b), but no more than its fixed amount equivalent to young-old payments before burden adjustment (負担調整前確定前期高齢者納付金相当額); it is deducted from that amount in working out the insurer's fixed young-old payments (確定前期高齢者納付金).
イに掲げる合計額からロに掲げる額を控除して得た額（当該額が負担調整前確定前期高齢者納付金相当額を上回るときは、負担調整前確定前期高齢者納付金相当額とする。）
In Article 39, an insurer whose fixed amount equivalent to young-old payments before burden adjustment (負担調整前確定前期高齢者納付金相当額) for the fiscal year before last is above zero, for which the total in paragraph (1), item (ii), (a) — that amount plus its fixed aid for the old-old (確定後期高齢者支援金) for that year divided by its adjustment rate for that aid — exceeds the amount in (b): that total plus the costs of its benefits (保険者の給付に要する費用等) and its contribution for securing medical care in the early phase of an epidemic (流行初期医療確保拠出金) for that year, multiplied by that year's special burden adjustment base rate (特別負担調整基準率) under Article 38, paragraph (1), item (ii), (b), and whose financial strength for that year, worked out as a Cabinet Order (政令) provides, falls short of a standard the Cabinet Order sets.
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が零を超える保険者のうち、イに掲げる合計額がロに掲げる額を超える者であつて、政令で定めるところにより算定した同年度における当該保険者の財政力が政令で定める基準に満たないもの
In Article 55, any of the stays its paragraph (1) lists: admission to a hospital or clinic; admission to a support facility for persons with disabilities (障害者支援施設) or another facility named by ministerial order (主務省令), or to the facility of the Nozominosono national center for persons with severe intellectual disabilities; admission to a nursing home or special nursing home for the elderly (養護老人ホーム, 特別養護老人ホーム) where placed there by the admission measures (入所措置) the item names; and moving into a specified facility (特定施設) or admission to a long-term care insurance facility (介護保険施設) under the Long-Term Care Insurance Act.
In Article 55, a hospital or clinic, or one of the facilities listed in paragraph (1), items (ii) to (v) — a support facility for persons with disabilities (障害者支援施設) or another facility a ministerial order (主務省令) sets, as item (ii) provides, a facility set up by the National Center for Persons with Severe Intellectual Disabilities, Nozominosono, a home for the elderly (養護老人ホーム) or special nursing home for the elderly (特別養護老人ホーム) entered under a placement measure (入所措置), or a specified facility (特定施設) or long-term care insurance facility (介護保険施設) under the Long-Term Care Insurance Act — entering which moves a person's address there.
従前住所地後期高齢者医療広域連合
In Article 55-2, the Association of Medical Care Systems for the Elderly Aged 75 and older (後期高齢者医療広域連合) that the municipality of the previous domicile (従前住所地市町村) belongs to; an insured person of National Health Insurance (国民健康保険) whom Article 116-2 of the National Health Insurance Act treats as having their address in that municipality, but who lives in another union's area, becomes an insured person of this union on reaching age 75 or, if aged 65 to 74, on being certified by this union as having a disability of the degree a Cabinet Order (政令) sets.
A hospital or clinic designated by the Minister of Health, Labour and Welfare under Article 63, paragraph (3), item (i) of the Health Insurance Act (not counting any beds left out of its designation under Article 65 of that Act), where insured persons of late-stage elderly medical care (後期高齢者医療) receive benefits for medical treatment (療養の給付).
Treatment using advanced medical technology that the Minister of Health, Labour and Welfare specifies, and other treatment the Minister specifies as needing to be evaluated, with a view to providing appropriate medical care efficiently, for whether it should be covered by medical treatment benefits (療養の給付) — other than patient-requested treatment (患者申出療養).
A special hospital room the insured person chooses, and other treatment the Minister of Health, Labour and Welfare specifies — one of the kinds of treatment Article 64, paragraph (2) leaves out of benefits for medical treatment (療養の給付).
Electronic eligibility confirmation (電子資格確認) or another method a Ministry of Health, Labour and Welfare Order (厚生労働省令) sets, by which an insured person seeking the benefits for medical treatment (療養の給付) of Article 64, paragraph (1) is confirmed as insured by the medical institution or pharmacy covered by health insurance (保険医療機関等) of their choice.
The amount the Minister of Health, Labour and Welfare sets, in view of average household spending on food and the average cost of meals at specified long-term care insurance facilities (特定介護保険施設等), that is deducted from the cost of dietary treatment (食事療養) in working out inpatient dietary treatment expenses (入院時食事療養費); a separate amount applies to persons a Ministry of Health, Labour and Welfare Order (厚生労働省令) specifies in view of their income and other circumstances.
The amount the Minister of Health, Labour and Welfare sets, taking account of average household spending on food, heating, lighting and water and of the base costs of meals and accommodation under Article 51-3, paragraph (2) of the Long-Term Care Insurance Act, which is deducted from the cost of living support (生活療養) to give the living support expenses for inpatients (入院時生活療養費); a different amount applies to people a Ministry of Health, Labour and Welfare Order (厚生労働省令) specifies in view of their income, condition, treatment and other circumstances.
In Article 82, paragraph (2) and Article 92, paragraphs (1) and (2), what a municipality (市町村) does to get unpaid insurance premiums (保険料) paid: urging payment, making sure there are opportunities to consult on paying, and the other steps a Ministry of Health, Labour and Welfare Order (厚生労働省令) names.