Health Insurance Act

payment of injury and sickness allowancedelivery expenses;

payment of burial chargesinjury and sickness allowance;

payment of lump-sum allowance for childbirth and childcareburial charges;

payment of childbirthlump-sum allowance at childbirth;

payment of dependent's medical expenses, dependent's medical expenses for home-nursing, and dependent's transport expenseschildbirth allowance;

payment of dependent's burial chargesmedical expenses, dependent's medical expenses for home-nursing, and dependent's transport expenses;

lump-sum allowance forpayment of dependent's childbirth and childcare; anddelivery expenses;

payment of high-cost medical expenses and expenses for high-cost medical treatment combined with long-term caredependent's burial charges;

payment of lump-sum allowance at dependent's childbirth; and

payment of high-cost medical expenses and expenses for high-cost medical treatment combined with long-term care.

Dependent's medical expenses (including medical expenses paid pursuant to the provisions of Article 87, paragraph (1) as applied mutatis mutandis pursuant to Article 110, paragraph (7)), dependent's medical expenses for home-nursing, dependent's transport expenses, dependent's delivery expenses (including an amount equivalent to the cost required for delivery care paid pursuant to the provisions of Article 98-2, paragraph (10) as applied mutatis mutandis pursuant to Article 112-2, paragraph (3); the same applies in paragraph (4) of the following Article and Article 60, paragraph (2)), dependent's burial charges, or lump-sum allowance forat dependent's childbirth and childcare (including the difference paid pursuant to the provisions of Article 101, paragraph (3) as applied mutatis mutandis pursuant to Article 114, paragraph (2); the same applies in Article 56, paragraph (1)) in relation to an insured person are not paid to that extent if the insured person has received medical , for the same sickness, injury, death, or childbirth, pursuant to the provisions of the following Chapter, benefits for medical treatment, or dietary treatment expenseexpenses for inpatients, living support expenses for inpatients, medical expenses combined with treatment outside insurance coverage, medical expenses, medical expenses for home-nursing, transport expenses, burial charges, or lump-sum allowance for childbirth and childcare delivery expenses (including an amount equivalent to the cost required for delivery care paid pursuant to the same sickness, injury, deathprovisions of Article 134-2, paragraph (6) or (7)), burial charges, or lump-sum allowance at childbirth (including the difference paid pursuant to the provisions of the following ChapterArticle 101, paragraph (3) as applied mutatis mutandis pursuant to Article 149).

Benefits for medical treatment, or expenses for dietary treatment for inpatients, living support expenses for inpatients, medical expenses combined with treatment outside insurance coverage, medical expenses, medical expenses for home-nursing, transport expenses, delivery expenses (including an amount equivalent to the cost required for delivery care paid pursuant to the provisions of Article 98-2, paragraph (10) (including when applied mutatis mutandis to Article 98-24, paragraph (2)); the same applies in Article 60, paragraph (2)), dependent's medical expenses, dependent's medical expenses for home-nursing, dependent's transport expenses, or dependent's transportdelivery expenses in relation to an insured person are not paid to that extent if the insured person has received , for the same sickness, injury, or childbirth, medical treatment or payment of medical expenses for the same sickness or injury from, or delivery care, at the expense of the national government or a local government pursuant to the provisions of other laws and regulations.

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, transport expenses, delivery expenses, injury and sickness allowance, burial charges, lump-sum allowance forat childbirth and childcare, (including the difference paid pursuant to the provisions of Article 101, paragraph (3) (including when applied mutatis mutandis to Article 106, paragraph (2))), childbirth allowance, dependent's medical expenses, dependent's medical expenses for home-nursing, dependent's transport expenses, dependent's delivery expenses, dependent's burial charges, and lump-sum allowance forat dependent's childbirth and childcare must be paid on each occasion. This also applies to the payment of an amount equivalent to the cost ofrequired for delivery care pursuant to the provisions of Article 98-2, paragraph (10) (including when applied mutatis mutandis to Article 98-24, paragraph (2) and Article 112-2, paragraph (3)) and an amount equivalent to the cost required for burial pursuant to the provisions of Article 100, paragraph (2) (including when applied mutatis mutandis to Article 105, paragraph (2)).

If a medical institution providing services covered by health insurance or a pharmacy providing services covered by health insurance as prescribed in Article 63, paragraph (3), item (i) or, a designated home-nursing provider as prescribed in Article 88, paragraph (1) , or a medical institution providing services covered by health insurance as prescribed in that item (limited to one that handles delivery; hereinafter referred to as a "delivery-handling medical institution providing services covered by health insurance") or a designated birthing center as prescribed in Article 98-2, paragraph (1), item (i) receives, by means of deception or other wrongful conduct, any payment of expenses relating to benefits for medical treatment or any payment pursuant to the provisions of Article 85, paragraph (5) (including when applied mutatis mutandis to Article 85-2, paragraph (5) or Article 86, paragraph (5)), or Article 110, paragraph (4), any payment pursuant to the provisions of Article 88, paragraph (6) (including when applied mutatis mutandis to Article 111, paragraph (3)), or any payment pursuant to the provisions of Article 11098-2, paragraph (4), 3) (including when applied mutatis mutandis to Article 98-24, paragraph (2) and Article 112-2, paragraph (3)) or Article 101, paragraph (2) (including when applied mutatis mutandis to Article 106, paragraph (2) and Article 114, paragraph (2)), the relevant insurer may cause the medical institution, or pharmacy, orthe designated home-nursing provider, or the delivery-handling medical institution providing services covered by health insurance or designated birthing center to refund the amount so paid and to pay, in addition, an amount obtained by multiplying the amount to be refunded by four-tenths.

If the Minister of Health, Labour and Welfare finds it necessary in relation to the payment of insurance benefits, the Minister may order a physician, dentist, pharmacist , midwife or person who provided medical care or a person who employs any of these to make a report or to present medical records, birth records, record books, and other documents or other objects concerning the provided medical care, provision of drugs, or medical treatment, or delivery care, or may order the ministry's official to ask the person questions.

If the Minister of Health, Labour and Welfare finds it necessary, the Minister may order a person who is or was an insured person and who received payment of benefits for medical treatment, or expenses for dietary treatment for inpatients, living support expenses for inpatients, medical expenses combined with treatment outside insurance coverage, medical expenses, medical expenses for home-nursing, delivery expenses, dependent's medical expenses, or dependent's medical expenses for home-nursing , or dependent's delivery expenses to make a report on or have the Ministry's official ask questions about the medical care or, prescription pertaining to the insurance benefits, or , designated home-nursing home nursing as prescribed in Article 88, paragraph (1), or delivery care pertaining to the insurance benefits.