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on 1 April 2027, in 5 months

Health Insurance Act

健康保険法（けんこうほけんほう）

Amended by

Act Partially Amending the Medical Care Act, etc.

医療法等の一部を改正する法律

The whole text as amended, on e-Gov

The same amending law also changes

4 provisions changed · 3 provisions added · 1 provision in the supplementary provisions

Each provision the amendment changes, before and after in one: words it removes are struck through, words it adds are highlighted. The Japanese is the law; the icon beside each English column says whose English it is.

Article 65 · (Designation of Medical Institutions and Pharmacies Providing Services Covered by Health Insurance)第六十五条（保険医療機関又は保険薬局の指定）

Read it in the amended law
  • ChangedArticle 65, paragraph (2)

    In the case of the preceding paragraph, if the application pertains to a hospital or to a clinic that has beds, the application is to be made by specifying the number of beds for each classification of bed prescribed in Article 7, paragraph (2) of the Medical Care Act (simply referred to as "bed classification" in paragraph (4), item (ii), and paragraph (1) of the following Article).

    前項の場合において、その申請が病院又は病床を有する診療所に係るものであるときは、当該申請は、医療法第七条第二項に規定する病床の種別（第四項第二号及び次条第一項において単に「病床の種別」という。）ごとにその数を定めて行うものとする。

  • ChangedArticle 65, paragraph (4), item (iii)

    it is found that the number of beds at a medical institution providing services covered by health insurance in a regional medical care vision area prescribed by Article 7-3, paragraph (1) of the Medical Care Act will, as a result of the designation pertaining to the application, exceed the number calculated as specified by the Minister of Health, Labour and Welfare in consideration of the required number of beds in the future specified in the medical care plan prescribed in Article 30-4, paragraph (1)if all of the same Act (including where that number is already exceeded)following apply, and the establisher or administrator of the hospital or clinic has received a recommendation from the prefectural governor pursuant to the provisions of Article 30-11, paragraph (1) of the same Medical Care Act butand does not comply with the recommendation; orit;

    医療法第七条の三第一項に規定する構想区域における保険医療機関の病床数が、当該申請に係る指定により同法第三十条の四第一項に規定する医療計画において定める将来の病床数の必要量を勘案して厚生労働大臣が定めるところにより算定した数を超えることになると認める場合（その数を既に超えている場合を含む。）次のいずれにも該当する場合であって、当該病院又は診療所の開設者又は管理者が同医療法第三十条の十一第一項の規定による都道府県知事の勧告を受け、これに従わないとき。

  • AddedArticle 65, paragraph (4), item (iii), (a)

    where it is found that, in accordance with the bed classification pertaining to the relevant application, the number of beds at medical institutions providing services covered by health insurance in the area prescribed in Article 7-2, paragraph (1) of the Medical Care Act would, as a result of the designation, fall short of the number calculated pursuant to the rules prescribed by the Minister of Health, Labour and Welfare taking into account the standard number of beds determined in the medical care plan prescribed in Article 30-4, paragraph (1) of that Act;

    当該申請に係る病床の種別に応じ、医療法第七条の二第一項に規定する地域における保険医療機関の病床数が、その指定により同法第三十条の四第一項に規定する医療計画において定める基準病床数を勘案して厚生労働大臣が定めるところにより算定した数に満たないことになると認める場合

  • AddedArticle 65, paragraph (4), item (iii), (b)

    where it is found that, in accordance with the bed classification pertaining to the relevant application, the number of beds at medical institutions providing services covered by health insurance in the vision area prescribed in Article 30-3-3, paragraph (2), item (ii) of the Medical Care Act would, as a result of the designation, exceed the number calculated pursuant to the rules prescribed by the Minister of Health, Labour and Welfare taking into account the required number of beds in the future (meaning the required number of beds in the future prescribed in item (iv) of that paragraph; the same applies in the following item) determined in the regional medical care vision prescribed in paragraph (1) of that Article (including where that number has already been exceeded);

    当該申請に係る病床の種別に応じ、医療法第三十条の三の三第二項第二号に規定する構想区域における保険医療機関の病床数が、その指定により同条第一項に規定する地域医療構想において定める将来の病床数の必要量（同条第二項第四号に規定する将来の病床数の必要量をいう。次号において同じ。）を勘案して厚生労働大臣が定めるところにより算定した数を超えることになると認める場合（その数を既に超えている場合を含む。）

  • ChangedArticle 65, paragraph (4), item (iv)

    it is found that , in accordance with the use of beds atbed classification pertaining to the hospital or clinic is significantly inappropriate forapplication, the number of beds at a medical institution providing services covered by health insurance from in a regional healthcare vision area prescribed in Article 30-3-3, paragraph (2), item (ii) of the viewpoint Medical Care Act will, as a result of efficiently providing appropriate the designation, exceed the number calculated as specified by the Minister of Health, Labour and Welfare in consideration of the required number of beds in the future specified in the regional medical care. vision prescribed in paragraph (1) of that Article (including where that number is already exceeded), and the establisher or administrator of the hospital or clinic has received a recommendation from the prefectural governor pursuant to the provisions of Article 30-11, paragraph (1) of the same Act but does not comply with the recommendation; or

    その他適正な医療の効率的な提供を図る観点から当該申請に係る病床の種別に応じ、医療法第三十条の三の三第二項第二号に規定する構想区域における保険医療機関の病床数が、その指定により同条第一項に規定する地域医療構想において定める将来の病床数の必要量を勘案して厚生労働大臣が定めるところにより算定した数を超えることになると認める場合（その数を既に超えている場合を含む。）であって、当該病院又は診療所の病床の利用に関し、保険医療機関として著しく不適当なところがあると認められる開設者又は管理者が同法第三十条の十一第一項の規定による都道府県知事の勧告を受け、これに従わないとき。

  • AddedArticle 65, paragraph (4), item (v)

    it is found that the use of beds at the hospital or clinic is significantly inappropriate for a medical institution providing services covered by health insurance from the viewpoint of efficiently providing appropriate medical care.

    その他適正な医療の効率的な提供を図る観点から、当該病院又は診療所の病床の利用に関し、保険医療機関として著しく不適当なところがあると認められるとき。

Article 205-4 · Delegation of Administration to the Infrastructure Organization, etc.第二百五条の四（基盤機構等への事務の委託）

Read it in the amended law
  • ChangedArticle 205-4, paragraph (2)

    When an insurer delegates the affairs listed in item (ii) or (iii) of the preceding paragraph pursuant to the provisions of that paragraph, the insurer is to delegate them jointly with other insurers prescribed in Article 1 of the Medical Information Infrastructure and Medical Fee Examination and Payment Organization Act, persons specified by Order of the Ministry of Health, Labour and Welfare as persons who provide perform affairs pertaining to benefits relating to medical care and perform other affairs pursuant to laws and regulations, and municipalities and special wards that operate long-term care insurance pursuant to the provisions of Article 3 of the Long-Term Care Insurance Act and other persons specified by Order of the Ministry of Health, Labour and Welfare.

    保険者は、前項の規定により同項第二号又は第三号に掲げる事務を委託する場合は、他の医療情報基盤・診療報酬審査支払機構法第一条に規定する保険者、法令の規定により医療に関する給付その他のに係る事務を行う者であっ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及び特別区その他厚生労働省令で定める者と共同して委託するものとする。

1 change in the supplementary provisions (附則)

Supplementary Provisions, Article 2 · Review附則第二条（検討）

Read it in the amended law
  • AddedSupplementary Provisions, Article 2, paragraph (3)

    In addition to the matters specified in the preceding two paragraphs, the government is to, with a target of five years after the enforcement of this Act, take into account the conditions of enforcement, etc. of each Act as amended by this Act (hereinafter referred to in this paragraph as the "respective Acts as amended"), and when it finds it necessary, review the provisions of the respective Acts as amended and take required measures based on the results.

    前二項に定める事項のほか、政府は、この法律の施行後五年を目途として、この法律による改正後のそれぞれの法律（以下この項において「改正後の各法律」という。）の施行の状況等を勘案し、必要があると認めるときは、改正後の各法律の規定について検討を加え、その結果に基づいて所要の措置を講ずるものとする。