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Read the text in force →健康保険法
Chapter IV Insurance Benefits (Articles 80 to 84)
The law as Act Partially Amending the Health Insurance Act, etc. (Act No. 31 of 2026) leaves it, with the words it changes marked.
The main text is read a page at a time: a chapter to a page, and a long chapter in runs of articles. The whole main text, and the supplementary provisions and appended tables this amendment changes. Those it leaves untouched are on the page for the text in force.
The Minister of Health, Labour and Welfare may rescind the designation referred to in Article 63, paragraph (3), item (i) pertaining to a medical institution providing services covered by health insurance or pharmacy providing services covered by health insurance if the medical institution or pharmacy falls under any of the following items:
厚生労働大臣は、次の各号のいずれかに該当する場合においては、当該保険医療機関又は保険薬局に係る第六十三条第三項第一号の指定を取り消すことができる。
a physician providing health insurance treatment at a medical institution providing services covered by health insurance (including a physician providing health insurance treatment who engages in delivery care) or a pharmacist filling health insurance prescriptions at a pharmacy providing services covered by health insurance has violated the provisions of Article 72, paragraph (1) (including when applied mutatis mutandis pursuant to Article 85, paragraph (9), Article 85-2, paragraph (5), Article 86, paragraph (5), Article 98-5, Article 98-24, paragraph (2), Article 110, paragraph (7), Article 112-2, paragraph (3), and Article 149; excluding when the medical institution providing services covered by health insurance or pharmacy providing services covered by health insurance had made efforts to provide reasonable care and supervision so as to prevent that violation);
保険医療機関において診療に従事する保険医（分娩の手当に従事する保険医を含む。）又は保険薬局において調剤に従事する保険薬剤師が、第七十二条第一項（第八十五条第九項、第八十五条の二第五項、第八十六条第五項、第九十八条の五、第九十八条の二十四第二項、第百十条第七項、第百十二条の二第三項及び第百四十九条において準用する場合を含む。）の規定に違反したとき（当該違反を防止するため、当該保険医療機関又は保険薬局が相当の注意及び監督を尽くしたときを除く。）。
the administrator of a medical institution providing services covered by health insurance has violated the provisions of Article 70-2, paragraph (2) (including when applied mutatis mutandis pursuant to Article 98-5) (excluding when the administrator has exercised reasonable care and supervision as the administrator of that medical institution providing services covered by health insurance in order to prevent that violation);
保険医療機関の管理者が、第七十条の二第二項（第九十八条の五において準用する場合を含む。）の規定に違反したとき（当該違反を防止するため、当該保険医療機関の管理者として、相当の注意及び監督を尽くしたときを除く。）。
beyond the preceding two items, a medical institution providing services covered by health insurance or pharmacy providing services covered by health insurance has violated the provisions of Article 70, paragraph (1) (including when applied mutatis mutandis pursuant to Article 85, paragraph (9), Article 85-2, paragraph (5), Article 86, paragraph (5), Article 98-5, Article 98-24, paragraph (2), Article 110, paragraph (7), Article 112-2, paragraph (3), and Article 149);
前二号のほか、保険医療機関又は保険薬局が、第七十条第一項（第八十五条第九項、第八十五条の二第五項、第八十六条第五項、第九十八条の五、第九十八条の二十四第二項、第百十条第七項、第百十二条の二第三項及び第百四十九条において準用する場合を含む。）の規定に違反したとき。
wrongdoing is found with regard to a claim for expenses incurred in providing medical services, or a claim for payment pursuant to the provisions of Article 85, paragraph (5) (including when these provisions are applied mutatis mutandis to Article 85-2, paragraph (5), and Article 86, paragraph (5)) or Article 110, paragraph (4) (including when applied mutatis mutandis to Article 149);
療養の給付に関する費用の請求又は第八十五条第五項（第八十五条の二第五項及び第八十六条第五項において準用する場合を含む。）若しくは第百十条第四項（これらの規定を第百四十九条において準用する場合を含む。）の規定による支払に関する請求について不正があったとき。
the medical institution providing services covered by health insurance or pharmacy providing services covered by health insurance is requested to make a report, or to submit or present medical records, record books and other documents pursuant to the provisions of Article 78, paragraph (1) (including the cases where the same provision is applied mutatis mutandis pursuant to Article 85, paragraph (9), Article 85-2, paragraph (5), Article 86, paragraph (5), Article 110, paragraph (7), and Article 149; the same applies in the following item) but fails to comply with the order or submits a false report;
保険医療機関又は保険薬局が、第七十八条第一項（第八十五条第九項、第八十五条の二第五項、第八十六条第五項、第百十条第七項及び第百四十九条において準用する場合を含む。次号において同じ。）の規定により報告若しくは診療録その他の帳簿書類の提出若しくは提示を命ぜられてこれに従わず、又は虚偽の報告をしたとき。
the establisher or an employee of the medical institution providing services covered by health insurance or pharmacy providing services covered by health insurance has been requested to appear pursuant to the provision of Article 78, paragraph (1) but failed to comply with the order or answer questions pursuant to the provisions of the same paragraph, answered untruthfully, or refused, obstructed, or evaded an inspection pursuant to the same paragraph (except if the medical institution or pharmacy had made efforts to provide reasonable care and supervision so as to prevent that conduct);
保険医療機関又は保険薬局の開設者又は従業者が、第七十八条第一項の規定により出頭を求められてこれに応ぜず、同項の規定による質問に対して答弁せず、若しくは虚偽の答弁をし、又は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（当該保険医療機関又は保険薬局の従業者がその行為をした場合において、その行為を防止するため、当該保険医療機関又は保険薬局が相当の注意及び監督を尽くしたときを除く。）。
there are grounds that correspond to any of the preceding items with respect to benefits for medical treatment pursuant to medical insurance laws other than this act, benefits for medical treatment pursuant to the Act on Assurance of Medical Treatment for Insured Persons or Dependents or Medical Care for Elderly People, or medical treatment pertaining to dietary treatment expenses for inpatients, to living support expenses for inpatients or to medical expenses combined with treatment outside insurance coverage;
この法律以外の医療保険各法による療養の給付若しくは被保険者若しくは被扶養者の療養又は高齢者の医療の確保に関する法律による療養の給付、入院時食事療養費に係る療養、入院時生活療養費に係る療養若しくは保険外併用療養費に係る療養に関し、前各号のいずれかに相当する事由があったとき。
the establisher or administrator of the a registered midwife prescribed in Article 98-4 who is engaged in delivery care at a delivery-handling medical institution providing services covered by health insurance or pharmacy providing services covered by health insurance has been sentenced to a finehas violated the provisions of Article 98-13, paragraph (1) (including when applied mutatis mutandis pursuant to the provisions of this Act or other laws concerning citizens' health and medical care which are specified by Cabinet Order, and the execution of the sentence has not yet been completed or the execution of the sentence still appliesArticle 98-24, paragraph (2), Article 112-2, paragraph (3), and Article 149) (except if the delivery-handling medical institution providing services covered by health insurance had made efforts to provide reasonable care and supervision so as to prevent that violation);
分娩取扱保険医療機関又は保険薬局の開設者又は管理者が、この法律その他国民の保健医療に関する法律で政令で定めるものにおいて分娩の手当に従事する第九十八条の四に規定する登録助産師が、第九十八条の十三第一項（第九十八条の二十四第二項、第百十二条の二第三項及び第百四十九条において準用する場合を含む。）の規定により罰金の刑に処せられ、その執行を終わり、又は執行を受けることがなくなるまでの者に該当するに至ったとき違反したとき（当該違反を防止するため、当該分娩取扱保険医療機関が相当の注意及び監督を尽くしたときを除く。）。
the establisher or administrator ofwith respect to a delivery-handling medical institution providing services covered by health insurance or pharmacy providing services covered by health insurance has come to fall under, wrongdoing is found with regard to a claim for payment pursuant to the categoryprovisions of a person who has been sentenced Article 98-2, paragraph (3) (including when applied mutatis mutandis pursuant to imprisonment or a severer punishment, Article 98-24, paragraph (2), Article 112-2, paragraph (3), and the execution of the sentence has not yet been completed or the execution of the sentence still applies; orArticle 149) or Article 101, paragraph (2) (including when applied mutatis mutandis pursuant to Article 106, paragraph (2), Article 114, paragraph (2), and Article 149);
分娩取扱保険医療機関又は保険薬局の開設者又は管理者が、拘禁刑以上の刑に処せられ、その執行を終わり、又は執行を受けることがなくなるまでの者に該当するに至について、第九十八条の二第三項（第九十八条の二十四第二項、第百十二条の二第三項及び第百四十九条において準用する場合を含む。）又は第百一条第二項（第百六条第二項、第百十四条第二項及び第百四十九条において準用する場合を含む。）の規定による支払に関する請求について不正があったとき。
beyond what is provided for in the preceding items, the establisher of the medical institution providing services covered by health insurance or pharmacy providing services covered by health insurance has violated the delivery-handling medical institution providing services covered by health insurance is requested to make a report, or to submit or present medical records, birth records and other record books and documents pursuant to the provisions of this Act or other medical insurance laws which are specified by Cabinet Order, or an Article 98-20, paragraph (1) (including the cases where the same provision is applied mutatis mutandis pursuant to Article 98-24, paragraph (2), Article 112-2, paragraph (3), and Article 149; the same applies in the following item) but fails to comply with the order or disposition based thereonsubmits a false report;
前各号に掲げる場合のほか、分娩取扱保険医療機関又は保険薬局の開設者が、この法律その他国民の保健医療に関する法律で政令で定めるもの又はこれらの法律に基づく命令が第九十八条の二十第一項（第九十八条の二十四第二項、第百十二条の二第三項及び第百四十九条において準用する場合を含む。次号において同じ。）の規定により報告若しくは診療録、助産録その他の帳簿書類の提出若しくは処分に違反提示を命ぜられてこれに従わず、又は虚偽の報告をしたとき。
the establisher or an employee of the delivery-handling medical institution providing services covered by health insurance has been requested to appear pursuant to the provision of Article 98-20, paragraph (1) but failed to comply with the order or answer questions pursuant to the provisions of the same paragraph, answered untruthfully, or refused, obstructed, or evaded an inspection pursuant to the same paragraph (except if, where an employee of the delivery-handling medical institution providing services covered by health insurance committed that act, the delivery-handling medical institution providing services covered by health insurance had made efforts to provide reasonable care and supervision so as to prevent that act);
分娩取扱保険医療機関の開設者又は従業者が、第九十八条の二十第一項の規定により出頭を求められてこれに応ぜず、同項の規定による質問に対して答弁せず、若しくは虚偽の答弁をし、又は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（当該分娩取扱保険医療機関の従業者がその行為をした場合において、その行為を防止するため、当該分娩取扱保険医療機関が相当の注意及び監督を尽くしたときを除く。）。
the establisher of the delivery-handling medical institution providing services covered by health insurance has violated an order pursuant to the provisions of Article 98-23, paragraph (3) (including when applied mutatis mutandis pursuant to Article 98-24, paragraph (2), Article 106, paragraph (2), Article 112-2, paragraph (3), Article 114, paragraph (2), and Article 149);
分娩取扱保険医療機関の開設者が第九十八条の二十三第三項（第九十八条の二十四第二項、第百六条第二項、第百十二条の二第三項、第百十四条第二項及び第百四十九条において準用する場合を含む。）の規定による命令に違反したとき。
there are grounds that correspond to any of items (i) through (iii) or item (viii) through the preceding item with respect to delivery care of an insured person or dependent under medical insurance laws other than this act;
この法律以外の医療保険各法による被保険者又は被扶養者の分娩の手当に関し、第一号から第三号まで又は第八号から前号までのいずれかに相当する事由があったとき。
the establisher or administrator of the medical institution providing services covered by health insurance or pharmacy providing services covered by health insurance has been sentenced to a fine pursuant to the provisions of this Act or other laws pertaining to citizen's health and medical care which are specified by Cabinet Order, and the execution of the sentence has not yet been completed or the execution of the sentence still applies;
保険医療機関又は保険薬局の開設者又は管理者が、この法律その他国民の保健医療に関する法律で政令で定めるものの規定により罰金の刑に処せられ、その執行を終わり、又は執行を受けることがなくなるまでの者に該当するに至ったとき。
the establisher or administrator of a medical institution providing services covered by health insurance or pharmacy providing services covered by health insurance has come to fall under the category of a person who has been sentenced to imprisonment or a severer punishment, and the execution of the sentence has not yet been completed or the execution of the sentence still applies; or
保険医療機関又は保険薬局の開設者又は管理者が、拘禁刑以上の刑に処せられ、その執行を終わり、又は執行を受けることがなくなるまでの者に該当するに至ったとき。
beyond what is provided for in the preceding items, the establisher of the medical institution providing services covered by health insurance or pharmacy providing services covered by health insurance has violated the provisions of this Act or other laws pertaining to citizen's health and medical care which are specified by Cabinet Order, or an order or disposition based thereon;
前各号に掲げる場合のほか、保険医療機関又は保険薬局の開設者が、この法律その他国民の保健医療に関する法律で政令で定めるもの又はこれらの法律に基づく命令若しくは処分に違反したとき。
The Minister of Health, Labour and Welfare may cancel the registration under Article 64 pertaining to the physician providing health insurance treatment or pharmacist filling health insurance prescriptions concerned (in the case listed in item (ii), the registration under that Article pertaining to the physician providing health insurance treatment who is the administrator of the medical institution providing services covered by health insurance concerned) in the case where any of the following items applies:
厚生労働大臣は、次の各号のいずれかに該当する場合においては、当該保険医又は保険薬剤師に係る第六十四条の登録（第二号に掲げる場合にあっては、当該保険医療機関の管理者の保険医に係る同条の登録）を取り消すことができる。
the physician providing health insurance treatment or pharmacist filling health insurance prescriptions has violated the provisions of Article 72, paragraph (1) (including when applied mutatis mutandis to Article 85, paragraph (9), Article 85-2, paragraph (5), Article 86, paragraph (5), Article 98-5, Article 98-24, paragraph (2), Article 110, paragraph (7), Article 112-2, paragraph (3), and Article 149);
保険医又は保険薬剤師が、第七十二条第一項（第八十五条第九項、第八十五条の二第五項、第八十六条第五項、第九十八条の五、第九十八条の二十四第二項、第百十条第七項、第百十二条の二第三項及び第百四十九条において準用する場合を含む。）の規定に違反したとき。
the administrator of a medical institution providing services covered by health insurance has violated the provisions of Article 70-2, paragraph (2) (including when applied mutatis mutandis pursuant to Article 98-5) (excluding when the administrator has exercised reasonable care and supervision as the administrator of that medical institution providing services covered by health insurance in order to prevent that violation);
保険医療機関の管理者が、第七十条の二第二項（第九十八条の五において準用する場合を含む。）の規定に違反したとき（当該違反を防止するため、当該保険医療機関の管理者として、相当の注意及び監督を尽くしたときを除く。）。
the physician providing health insurance treatment or pharmacist filling health insurance prescriptions had been requested to appear pursuant to the provisions of Article 78, paragraph (1) (including when applied mutatis mutandis pursuant to Article 85, paragraph (9), Article 85-2, paragraph (5), Article 86, paragraph (5), Article 110, paragraph (7), and Article 149; the same applies hereinafter in this item) but failed to respond or to reply to questions pursuant to the provisions of Article 78, paragraph (1), or answered untruthfully, or refused, obstructed, or evaded an inspection pursuant to the provisions of the same paragraph;
保険医又は保険薬剤師が、第七十八条第一項（第八十五条第九項、第八十五条の二第五項、第八十六条第五項、第百十条第七項及び第百四十九条において準用する場合を含む。以下この号において同じ。）の規定により出頭を求められてこれに応ぜず、第七十八条第一項の規定による質問に対して答弁せず、若しくは虚偽の答弁をし、又は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。
there are grounds that correspond to any of the preceding three items with respect to medical care or prescription based on medical insurance laws other than this act or the Act on Assurance of Medical Care for Elderly People;
この法律以外の医療保険各法又は高齢者の医療の確保に関する法律による診療又は調剤に関し、前三号のいずれかに相当する事由があったとき。
the physician providing health insurance treatment or pharmacist filling health insurance prescriptions has (limited to a physician engaged in delivery care; the same applies in the following item) had been sentencedrequested to a fineappear pursuant to the provisions of this Act and other laws concerning citizens' health and medical care which are specified by Cabinet Order, Article 98-20, paragraph (1) (including when applied mutatis mutandis pursuant to Article 98-24, paragraph (2), Article 112-2, paragraph (3), and Article 149; the execution of the sentence has not yet been completed same applies hereinafter in this item) but failed to respond or to reply to questions pursuant to the executionprovisions of Article 98-20, paragraph (1), or answered untruthfully, or refused, obstructed, or evaded an inspection pursuant to the sentence still appliesprovisions of the same paragraph;
保険医又は保険薬剤師が、この法律その他国民の保健医療に関する法律で政令で定めるもの（分娩の手当に従事する医師に限る。次号において同じ。）が、第九十八条の二十第一項（第九十八条の二十四第二項、第百十二条の二第三項及び第百四十九条において準用する場合を含む。以下この号において同じ。）の規定により罰金の刑に処せられ、その執行を終わり出頭を求められてこれに応ぜず、第九十八条の二十第一項の規定による質問に対して答弁せず、若しくは虚偽の答弁をし、又は執行を受けることがなくなるまでの者に該当するに至っ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。
with respect to the physician providing health insurance treatment or pharmacist filling health insurance prescriptions has come, there are grounds that correspond to fall under the categoryany of a person who has been sentenced to imprisonmentitem (i), item (ii) or a severer punishment, and the execution of the sentence has not yet been completed or the execution of the sentence still applies; orpreceding item with respect to delivery care based on medical insurance laws other than this act;
保険医又は保険薬剤師が、拘禁刑以上の刑に処せられ、その執行を終わり、又は執行を受けることがなくなるまでの者に該について、この法律以外の医療保険各法による分娩の手当に関し、第一号、第二号又は前号のいずれかに相当するに至事由があったとき。
beyond the cases listed in the preceding items, the physician providing health insurance treatment or pharmacist filling health insurance prescriptions violates has been sentenced to a fine pursuant to the provisions of this Act, medical insurance and other laws other than this act concerning citizens' health and medical care which are specified by Cabinet Order, or an order and the execution of the sentence has not yet been completed or disposition based on these Acts.the execution of the sentence still applies;
前各号に掲げる場合のほか、保険医又は保険薬剤師が、この法律その他国民の保健医療に関する法律で政令で定めるもの又はこれらの法律に基づく命令若しくは処分に違反しの規定により罰金の刑に処せられ、その執行を終わり、又は執行を受けることがなくなるまでの者に該当するに至ったとき。
the physician providing health insurance treatment or pharmacist filling health insurance prescriptions has come to fall under the category of a person who has been sentenced to imprisonment or a severer punishment, and the execution of the sentence has not yet been completed or the execution of the sentence still applies; or
保険医又は保険薬剤師が、拘禁刑以上の刑に処せられ、その執行を終わり、又は執行を受けることがなくなるまでの者に該当するに至ったとき。
beyond the cases listed in the preceding items, the physician providing health insurance treatment or pharmacist filling health insurance prescriptions violates this Act or other laws concerning citizens' health and medical care which are specified by Cabinet Order, or an order or disposition based on these Acts.
前各号に掲げる場合のほか、保険医又は保険薬剤師が、この法律その他国民の保健医療に関する法律で政令で定めるもの又はこれらの法律に基づく命令若しくは処分に違反したとき。
When intending to issue the Order of the Ministry of Health, Labour and Welfare referred to in Article 70, paragraph (1) (including when applied mutatis mutandis pursuant to Article 85, paragraph (9), Article 85-2, paragraph (5), Article 86, paragraph (5), Article 98-5, Article 98-24, paragraph (2), Article 110, paragraph (7), Article 112-2, paragraph (3), and Article 149) or Article 70, paragraph (3), Article 70-2 (including when applied mutatis mutandis pursuant to Article 98-5), or Article 72, paragraph (1) (including when applied mutatis mutandis pursuant to Article 85, paragraph (9), Article 85-2, paragraph (5), Article 86, paragraph (5), Article 98-5, Article 98-24, paragraph (2), Article 110, paragraph (7), Article 112-2, paragraph (3), and Article 149), or intending to make a determination under Article 63, paragraph (2), item (iii), (v) or (vi), or Article 76, paragraph (2) (including when these provisions are applied mutatis mutandis pursuant to Article 149), the Minister of Health, Labour and Welfare is to consult with the Central Social Insurance Medical Council; provided, however, that this does not apply to a determination under Article 63, paragraph (2), item (iii) pertaining to advanced medical care techniques.
厚生労働大臣は、第七十条第一項（第八十五条第九項、第八十五条の二第五項、第八十六条第五項、第九十八条の五、第九十八条の二十四第二項、第百十条第七項、第百十二条の二第三項及び第百四十九条において準用する場合を含む。）若しくは第三項、第七十条の二（第九十八条の五において準用する場合を含む。）若しくは第七十二条第一項（第八十五条第九項、第八十五条の二第五項、第八十六条第五項、第九十八条の五、第九十八条の二十四第二項、第百十条第七項、第百十二条の二第三項及び第百四十九条において準用する場合を含む。）の厚生労働省令を定めようとするとき、又は第六十三条第二項第三号、第五号若しくは第六号若しくは第七十六条第二項（これらの規定を第百四十九条において準用する場合を含む。）の定めをしようとするときは、中央社会保険医療協議会に諮問するものとする。ただし、第六十三条第二項第三号の定めのうち高度の医療技術に係るものについては、この限りでない。
When intending to make or rescind a designation referred to in Article 63, paragraph (3), item (i) pertaining to a medical institution providing services covered by health insurance or pharmacy providing services covered by health insurance, or to rescind a registration referred to in Article 64 pertaining to a physician providing health insurance covered treatment or pharmacist filling health insurance prescriptions, the Minister of Health, Labour and Welfare is to consult with the relevant Local Social Medical Insurance Council as specified by Cabinet Order.
厚生労働大臣は、保険医療機関若しくは保険薬局に係る第六十三条第三項第一号の指定を行おうとするとき、若しくはその指定を取り消そうとするとき、又は保険医若しくは保険薬剤師に係る第六十四条の登録を取り消そうとするときは、政令で定めるところにより、地方社会保険医療協議会に諮問するものとする。
When the Minister of Health, Labour and Welfare determines not to make a designation referred to in Article 63, paragraph (3), item (i) pertaining to a medical institution providing services covered by health insurance, determines to make a designation excluding all or some of the beds pertaining to that medical institution's application (including an alternation of such a designation), or determines not to make a designation referred to in the same item pertaining to a pharmacy providing services covered by health insurance, or a registration referred to in Article 64 pertaining to a physician providing health insurance treatment or pharmacist filling health insurance prescriptions, the Minister must grant the establisher of the medical institution or pharmacy, or the physician or pharmacist, an opportunity to hear an explanation. In this case, the Minister must give notification of the date, time, and place for the explanation and the circumstances thereof in writing, in advance.
厚生労働大臣は、保険医療機関に係る第六十三条第三項第一号の指定をしないこととするとき、若しくはその申請に係る病床の全部若しくは一部を除いて指定（指定の変更を含む。）を行おうとするとき、若しくは保険薬局に係る同号の指定をしないこととするとき、又は保険医若しくは保険薬剤師に係る第六十四条の登録をしないこととするときは、当該医療機関若しくは薬局の開設者又は当該保険医若しくは保険薬剤師に対し、弁明の機会を与えなければならない。この場合においては、あらかじめ、書面で、弁明をすべき日時、場所及びその事由を通知しなければならない。
Rules on benefits for medical treatment, and on medical care and prescription services covered by health insurance and provided by hospitals, clinics, and pharmacies listed in Article 63, paragraph (3), items (ii) and (iii) are governed by Order of the Ministry of Health, Labour and Welfare referred to in Article 70, paragraph (1) and Article 72, paragraph (1).
第六十三条第三項第二号及び第三号に掲げる病院若しくは診療所又は薬局において行われる療養の給付及び健康保険の診療又は調剤に関する準則については、第七十条第一項及び第七十二条第一項の厚生労働省令の例による。
A person who receives benefits for medical care from a hospital, clinic, or pharmacy listed in Article 63, paragraph (3), item (ii) must pay the amount calculated pursuant to the provisions of Article 74 as co-payment to the hospital, clinic, or pharmacy upon receiving the benefits; provided, however, that if the insurer is a health insurance society, the amount of the co-payment may be decreased or payment thereof may not be required, pursuant to the insurer's constitution.
第六十三条第三項第二号に掲げる病院若しくは診療所又は薬局から療養の給付を受ける者は、その給付を受ける際、第七十四条の規定の例により算定した額を、一部負担金として当該病院若しくは診療所又は薬局に支払わなければならない。ただし、保険者が健康保険組合である場合においては、規約で定めるところにより、当該一部負担金を減額し、又はその支払を要しないものとすることができる。
A health insurance society may, pursuant to its constitution, have a person who receives benefits for medical treatment from a hospital, clinic, or pharmacy listed in Article 63, paragraph (3), item (iii) pay the amount of co-payment within the extent of the amount calculated pursuant to the provisions of Article 74.
健康保険組合は、規約で定めるところにより、第六十三条第三項第三号に掲げる病院若しくは診療所又は薬局から療養の給付を受ける者に、第七十四条の規定の例により算定した額の範囲内において一部負担金を支払わせることができる。