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Chapter VII Sharing of Costs第七章 費用の負担
Article 151第百五十一条
Share of National Treasury（国庫負担）
Article 151, paragraph (1)
The national treasury bears the expenses required for the execution of the affairs of health insurance services each fiscal year (including affairs concerning the payment of young-old payments, etc., aid for the old-old, etc., the contributions under the provisions of Article 173, the long-term care payment, the contribution for securing medical care in the early phase of an epidemic under the provisions of the Act on the Prevention of Infectious Diseases and Medical Care for Patients with Infectious Diseases (referred to as "contribution for securing medical care in the early phase of an epidemic" in Article 153 and Article 154, paragraph (1)), and the children and child-rearing support levy), within the scope of the budget.
The share of the national treasury delivered to a health insurance society is calculated by the Minister of Health, Labour and Welfare based on the number of insured persons in that health insurance society.
Part A part of the expenses required for the payment of delivery expenses (including an amount equivalent to the expenses required for delivery care paid pursuant to the provisions of Article 98-2, paragraph (10) (including when applied mutatis mutandis pursuant to Article 98-24, paragraph (2)) and Article 134-2, paragraph (6) or (7)), lump-sum allowance forat childbirth (including the difference paid pursuant to the provisions of Article 101, paragraph (3) (including when applied mutatis mutandis pursuant to Article 106, paragraph (2) and childcare Article 149); hereinafter the same applies in this Article and Article 152-5), dependent's delivery expenses (including an amount equivalent to the lump-sum allowanceexpenses required for dependent's childbirth and childcare (referred delivery care paid pursuant to the provisions of Article 98-2, paragraph (10) as applied mutatis mutandis pursuant to Article 112-2, paragraph (3) and Article 134-2, paragraph (6) or (7) as "applied mutatis mutandis pursuant to Article 142-2, paragraph (3)), lump-sum allowance for at dependent's childbirth (including the difference paid pursuant to the provisions of Article 101, paragraph (3) as applied mutatis mutandis pursuant to Article 114, paragraph (2) and childcare, Article 149; hereinafter the same applies in this Article and Article 152-5) and special delivery expenses (including an amount equivalent to the expenses required for delivery care paid pursuant to the provisions of Article 134-2, paragraph (6) or (7) as applied mutatis mutandis pursuant to Article 145-2, paragraph (4)) (referred to as "delivery expenses, etc." in Article 152-4 and Article 152-5) (with regard to the expenses required for the payment of lump-sum allowance at childbirth and lump-sum allowance at dependent's childbirth, limited to the portion pertaining to the amount specified by Cabinet Order inunder Article 101, paragraphs (1) and (6) (including when applied mutatis mutandis pursuant to Article 106, paragraph (2), Article 114, paragraph (2) and Article 149; the same applies in Article 152-5); the same applies in Article 152-4) is to be covered, as specified by Cabinet Order, by the childbirth and childcare grant that provided by the Infrastructure Organization grants to insurers pursuant to the provisions of Article 124-4, paragraph (1) of the Act on Assurance of Medical Care for Elderly People.
Article 152-3, paragraph (1)（出産交付金の額）Amount of Childbirth GrantsChanged
The amount of the childbirth and childcare grant prescribed in the preceding Article is the amount of the estimated childbirth and childcare grant for the relevant fiscal year; provided, however, that where the amount of the estimated childbirth and childcare grant for the fiscal year before last exceeds the amount of the finalized childbirth and childcare grant for that fiscal year, it is to be the amount obtained by deducting from the amount of the estimated childbirth and childcare grant for the relevant fiscal year the total amount of the excess amount and the childbirth and childcare grant adjustment amount pertaining to the excess amount, and where the amount of the estimated childbirth and childcare grant for the fiscal year before last falls short of the amount of the finalized childbirth and childcare grant for that fiscal year, it is to be the amount obtained by adding to the amount of the estimated childbirth and childcare grant for the relevant fiscal year the total amount of the shortfall and the childbirth and childcare grant adjustment amount pertaining to the shortfall.
Article 152-3, paragraph (2)（出産交付金の額）Amount of Childbirth GrantsChanged
The childbirth and childcare grant adjustment amount in the proviso to the preceding paragraph is the amount calculated for each insurer, as specified by Order of the Ministry of Health, Labour and Welfare, taking into consideration interest and other circumstances arising from the excess or shortfall between the amount of the estimated childbirth and childcare grant and the amount of the finalized childbirth and childcare grant for all insurers prescribed in Article 7, paragraph (2) of the Act on Assurance of Medical Care for Elderly People (in the case of national health insurance operated by a prefecture together with the municipalities (including special wards) within that prefecture as provided for in the National Health Insurance Act, the prefecture) in the fiscal year before last.
The amount of the estimated childbirth and childcare grant in 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 as the prospective amount of expenses required for payment of the lump-sum allowance for childbirth and childcaredelivery expenses, etc. pertaining to the insurer in the relevant fiscal year by the childbirth and childcare support payment rate under Article 124-3, paragraph (1) of the Act on Assurance of Medical Care for Elderly People for that fiscal year (referred to simply as the "childbirth and childcare support payment rate" in the following Article).
The amount of the finalized childbirth and childcare grant in the proviso to Article 152-3, paragraph (1) is the amount obtained by multiplying the amount of expenses required for payment of the lump-sum allowance for childbirth and childcaredelivery expenses, etc. pertaining to the insurer in the fiscal year before last (with respect to expenses required for payment of the lump-sum allowance at childbirth and the lump-sum allowance at dependent's childbirth, limited to the portion pertaining to the amount specified by Cabinet Order in Article 101) , paragraphs (1) and (6)) by the childbirth and childcare support payment rate for that fiscal year.
The provisions of Articles 41 and 42 of the Act on Assurance of Medical Care for Elderly People apply mutatis mutandis to childbirth and childcare grants. In this case, the necessary technical replacement of terms is specified by Cabinet Order.
In addition to the expenses prescribed in Article 151, the national treasury subsidizes the amount obtained by multiplying, by a rate specified by Cabinet Order within a range from 0.13 to 0.20, the sum (or, if there is a young-old subsidy under the provisions of the Act on Assurance of Medical Care for Elderly People (hereinafter referred to as "young-old subsidy"), the amount obtained by deducting from that sum the amount specified by Cabinet Order on the basis of the amount of that young-old subsidy) of the following, from among the expenses required for the execution of health insurance services administered by JHIA: the amount of expenses required for payment of benefits for medical treatment pertaining to insured persons and 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, transport expenses, injury and sickness allowance, childbirth allowance, dependent's medical expenses, dependent's medical expenses for home-nursing, dependent's transport expenses, high-cost medical expenses and expenses for high-cost medical treatment combined with long-term care (in the case of benefits for medical treatment, an amount equivalent to the amount of co-payment is to be deducted) (excluding an amount equivalent to one third of the estimated benefit expenses subject to adjustment in each item of Article 34, paragraph (1) of that Act (referred to as "estimated benefit expenses subject to adjustment" in item (i) and Article 154, paragraph (1))); the amount obtained by multiplying the amount of expenses required for payment of the young-old payment under the provisions of that Act (hereinafter referred to as "young-old payment") by the ratio of the amount listed in that item to the amount listed in item (ii); and the amount of expenses required for payment of the contribution for securing medical care in the early phase of an epidemic.
the amount obtained by deducting an amount equivalent to two thirds of the estimated benefit expenses subject to adjustment from the amount obtained by multiplying an amount equivalent to two thirds of the estimated benefit expenses subject to adjustment by the estimated participant adjustment rate prescribed in Article 34, paragraph (7) of the Act on Assurance of Medical Care for Elderly People (if that amount is less than zero, zero);
the total amount of the amounts listed in Article 38, paragraph (2), item (i), (a) and (b) of the Act on Assurance of Medical Care for Elderly People.
高齢者の医療の確保に関する法律第三十八条第二項第一号イ及びロに掲げる額の合計額
Article 154第百五十四条
Article 154, paragraph (1)
In addition to the expenses prescribed in Article 151 and the preceding Article, the national treasury subsidizes every fiscal year the amount obtained by multiplying, by the rate specified by Cabinet Order prescribed in the preceding Article, the amount obtained by multiplying by the following ratio the sum (or, if there is a young-old subsidy, the amount obtained by deducting from that sum the amount obtained by multiplying the amount of that young-old subsidy by the benefit expense ratio) of the amount of expenses required for payment of benefits for medical treatment pertaining to specially-insured day laborers and 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, transport expenses, injury and sickness allowance, childbirth allowance, dependent's medical expenses, dependent's medical expenses for home-nursing, dependent's transport expenses, special medical expenses, high-cost medical expenses and expenses for high-cost medical treatment combined with long-term care (in the case of benefits for medical treatment, an amount equivalent to the amount of co-payment is to be deducted), from among the expenses required for the execution of health insurance services, the amount obtained by multiplying the amount of expenses required for payment of the young-old payment by the benefit expense ratio (meaning the ratio of the estimated benefit expenses subject to adjustment to the total amount of the estimated benefit expenses subject to adjustment and the estimated amount of aid for the old-old pertaining to the young-old prescribed in Article 34, paragraph (1), item (i), (a)(2) of the Act on Assurance of Medical Care for Elderly People; the same applies hereinafter in this Article), and the amount of expenses required for payment of the contribution for securing medical care in the early phase of an epidemic: the ratio obtained by dividing the total number of payment days of insurance premiums relating to specially-insured day laborers paid in the relevant fiscal year by employers other than employers who establish a health insurance society (including insurers of national health insurance providing national health insurance to persons who have made the request referred to in Article 3, paragraph (1), item (viii); the same applies in Article 171, paragraphs (2) and (3)) by the total number of payment days of insurance premiums relating to specially-insured day laborers paid in that fiscal year.
In addition to the expenses prescribed in Article 151, the preceding Article and the preceding paragraph, the national treasury subsidizes the amount obtained by multiplying, by the rate specified by Cabinet Order prescribed in that Article, the amount obtained by multiplying by the ratio prescribed in that paragraph the sum of the amounts of expenses required for payment of those, among the young-old payment that JHIA is to contribute, the aid for the old-old under the provisions of the Act on Assurance of Medical Care for Elderly People, the long-term care payment and the children and child-rearing support levy, that pertain to specially-insured day laborers (excluding the amount obtained by multiplying the amount of that young-old payment by the benefit expense ratio, and, if there is a young-old subsidy, the amount obtained by deducting from that sum the amount obtained by deducting from the amount of that young-old subsidy the amount obtained by multiplying that amount by the benefit expense ratio).
Beyond he expenses prescribed in Article 151 and the preceding two Articles, the national treasury may assist by providing a portion of the expenses required for the provision of specific health checkups from among the expenses required for the execution of health insurance businesses, within the scope of the budget.
An insurer, etc. collects insurance premiums to be allocated for the expenses required for health insurance services (including the expenses required for the payment of young-old payments, etc., aid for the old-old, etc., the long-term care payment, the contribution for securing medical care in the early phase of an epidemic, etc. and the children and child-rearing support levy, and, in the case of a health insurance society, the contributions pursuant to the provisions of Article 173).
Notwithstanding the provisions of the preceding paragraph, insurance premiums related to insured persons with optional and continued coverage administered by JHIA are collected by JHIA.
前項の規定にかかわらず、協会が管掌する健康保険の任意継続被保険者に関する保険料は、協会が徴収する。
Article 155-2第百五十五条の二
Delivery of Insurance Premiums（保険料等の交付）
Article 155-2, paragraph (1)
The Government, as specified by Cabinet Order, delivers the amount obtained by deducting an amount equivalent to the expenses required for the execution of affairs concerning health insurance services administered by the Minister of Health, Labor and Welfare (excluding the amount of the national treasury benefits pertaining to expenses pursuant to the provisions of Article 151) from the sum of the amount of insurance premiums collected by the Minister of Health, Labor and Welfare, other amounts collected pursuant to this Act, and an amount equivalent to the payments pursuant to the provisions of the Act on Payment of Government Charges with Revenue Stamps (Act No. 142 of 1948) to JHIA in order to allocate that amount for expenses required for health insurance services provided by JHIA.