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Chapter IX Business Related to Insured Long-Term Care of the Medical Information Infrastructure and Medical Fee Examination and Payment Organization第九章 医療情報基盤・診療報酬審査支払機構の介護保険関係業務
Article 160第百六十条
Operations of the Organization(機構の業務)
Article 160, paragraph (1)
The Organization is to conduct operations listed in the following items in order to accomplish the purposes as prescribed in Article 1 in addition to operations as prescribed in Article 18 of the Medical Information Infrastructure and Medical Fee Examination and Payment Organization Act:
to grant the Long-Term Care Benefit Expense as set forth in Article 125, paragraph (1) to a Municipality;
市町村に対し第百二十五条第一項の介護給付費交付金を交付すること。
Article 160, paragraph (1), item (iii)
to provide supporting grants for Community Support Projects as set forth in Article 126, paragraph (1) to a Municipality;
市町村に対し第百二十六条第一項の地域支援事業支援交付金を交付すること。
Article 160, paragraph (1), item (iv)
to conduct operations incidental to the operations listed in the preceding three items.
前三号に掲げる業務に附帯する業務を行うこと。
Article 160, paragraph (2)
The Organization is to conduct operations listed in the following items in order to accomplish the purposes as prescribed in Article 1 in addition to operations as prescribed in Article 18 of the Medical Information Infrastructure and Medical Fee Examination and Payment Organization Act and operations listed in the items of the preceding paragraph:
to conduct operations pertaining to the project listed in Article 115-45, paragraph (2), item (vii) that are performed upon entrustment from a Municipality pursuant to the provisions of Article 115-47, paragraph (10);
to conduct operations incidental to the operations listed in the preceding item.
前号に掲げる業務に附帯する業務を行うこと。
Article 160, paragraph (3)
Operations as prescribed in the preceding two paragraphs are referred to as business related to insured long-term care.
前二項に規定する業務は、介護保険関係業務という。
Article 161第百六十一条
Entrustment of Operations(業務の委託)
Article 161, paragraph (1)
The Organization, after obtaining the approval of the Minister of Health, Labour and Welfare, may entrust a portion of the business related to insured long-term care to an organization to which medical insurers belong that is specified by the Minister of Health, Labour and Welfare.
The Organization, with respect to business related to insured long-term care, must prepare a statement of operating procedures and obtain the approval of the Minister of Health, Labour and Welfare prior to commencement of said operations; the same applies when changing said statement.
Matters to be included in the statement of operating procedures as set forth in the preceding paragraph are determined by Order of the Ministry of Health, Labour, and Welfare.
前項の業務方法書に記載すべき事項は、厚生労働省令で定める。
Article 163第百六十三条
Reports(報告等)
Article 163, paragraph (1)
The Organization may request a medical insurer to submit a report every fiscal year of the number of Medical Insurance Subscribers (limited to those persons of the age of 40 years or more and less than the age of 65 years) and other matters as determined by Order of the Ministry of Health, Labour and Welfare, and when it is determined to be necessary for operations listed in Article 160, paragraph (1), item (i), may request the submission of documents and other items.
The Organization must conduct accounting for business related to insured long-term care (excluding operations prescribed in Article 160, paragraph (2); the same applies in paragraph (1) of the following Article, Article 166, paragraph (1), Article 167, paragraphs (1) and (2), Article 168, paragraph (1), and Article 170) by establishing a special account separately from the accounting for other operations.
The Organization must prepare a budget, business plan, and fund plan for every fiscal year concerning business related to insured long-term care and obtain the approval of the Minister of Health, Labour and Welfare prior to beginning of said fiscal year; the same applies when amending these items.
With regard to the application of Article 33, paragraph (1) of the Medical Information Infrastructure and Medical Fee Examination and Payment Organization Act in the case where the Organization conducts the operations prescribed in Article 160, paragraph (2), the phrase "income and expenditure budget" in that paragraph is deemed to be replaced with "income and expenditure budget (including that pertaining to the operations prescribed in Article 160, paragraph (2) of the Long-Term Care Insurance Act (Act No. 123 of 1997))".
The Organization, with respect to business related to insured long-term care, must prepare an inventory of property, Statement of Financial Position, and Statement of Operating Results (hereinafter referred to as "Financial Statements" in this Article) for every fiscal year, and submit said Financial Statements to the Minister of Health, Labour and Welfare within three months after the end of said fiscal year, and obtain the approval of said Minister.
The Organization, when submitting Financial Statements to the Minister of Health, Labour and Welfare pursuant to the provisions of the preceding paragraph, must attach to them a business report of said fiscal year, a statement of accounts that is prepared in accordance with categories of the budget, and a statement of opinion of an auditor concerning the Financial Statements and the statement of accounts, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare.
The Organization, when it obtains the approval of the Minister of Health, Labour and Welfare pursuant to the provisions of paragraph (1), must give public notice of the Financial Statements or a summary of the Financial Statements in the Official Gazette without delay, and maintain said Financial Statements and supporting detailed statements, and the business report, statement of accounts, and statement of opinion of the auditor as set forth in the preceding paragraph at its principal office, and offer them for public perusal for the period as determined by Order of the Ministry of Health, Labour and Welfare.
With regard to the application of Article 34, paragraph (1) of the Medical Information Infrastructure and Medical Fee Examination and Payment Organization Act in the case where the Organization conducts the operations prescribed in Article 160, paragraph (2), the term "operations" in that paragraph is deemed to be replaced with "operations and the operations prescribed in Article 160, paragraph (2) of the Long-Term Care Insurance Act (Act No. 123 of 1997)".
The Organization, with respect to business related to insured long-term care, in the event that a surplus is recorded according to the calculation of surplus and deficit for every fiscal year, must apply said surplus to offset any remaining deficit carried forward from the previous fiscal year, and, if there still remains a surplus, settle said surplus as a reserve fund.
The Organization, with respect to the business related to insured long-term care, in the event that a deficit is incurred according to the calculation of surplus and deficit for every fiscal year, must settle said deficit by reducing the reserve fund pursuant to the provisions of the preceding paragraph, and, if there still remains a deficit, settle said deficit as an item to be carried forward to the following fiscal year.
The Organization may allocate said reserve fund pursuant to the provisions of paragraph (1) to the expenses necessary for operations listed in Article 160, paragraph (1), item (ii) and item (iii), within the amount as prescribed by a budget.
The Organization, with respect to business related to insured long-term care, may borrow long-term debt, short-term debt, or issue bonds, after obtaining the approval of the Minister of Health, Labour and Welfare.
Long-term debt and bonds pursuant to the provisions of the preceding paragraph must be repaid within two years.
前項の規定による長期借入金及び債券は、二年以内に償還しなければならない。
Article 168, paragraph (3)
Short-term debt pursuant to the provisions of paragraph (1) must be repaid within said fiscal year, however, provided that when said short-term debt fails to be repaid due to a lack of funds, only said lack of funds portion may be refinanced, after obtaining the approval of the Minister of Health, Labour, and Welfare.
Short-term debt that is refinanced pursuant to the proviso of the preceding paragraph must be repaid within one year.
前項ただし書の規定により借り換えられた短期借入金は、一年以内に償還しなければならない。
Article 168, paragraph (5)
The Organization, in a case when issuing bonds pursuant to the provisions of paragraph (1), may issue said bonds subject to a bond discount.
機構は、第一項の規定による債券を発行する場合においては、割引の方法によることができる。
Article 168, paragraph (6)
A creditor holding bonds pursuant to the provisions of paragraph (1) has the right to receive payment of the creditor's own claim in preference to that of other creditors with regard to the property of the Organization.
The order of statutory lien as set forth in the preceding paragraph is to be in the first subordinate position of priority to a general statutory lien pursuant to the provisions of the Civil Code (Act No. 89 of 1896).
The Organization may entrust the whole or a portion of affairs concerning issuance of bonds pursuant to the provisions of paragraph (1) to banks and trust companies after obtaining the approval of the Minister of Health, Labour and Welfare.
The provisions of Article 705, paragraph (1) and paragraph (2), and Article 709 of the Companies Act (Act No. 86 of 2005) apply mutatis mutandis to banks and trust companies that are entrusted pursuant to the provisions of the preceding paragraph.
In addition to those items as prescribed in paragraph (1), paragraph (2), and paragraph (5) through paragraph (9), other necessary matters concerning bonds pursuant to the provisions of paragraph (1) are provided by a Cabinet Order.
The national government, notwithstanding the provisions of Article 3 of the Act on Restrictions on Financial Assistance by the Government to Corporations (Act No. 24 of 1946), within the amount approved by resolution of the Diet, when it determines necessary for efficient payments by the Organization of the grants for Long-Term Care Benefits pursuant to the provisions of Article 125, paragraph (1) and supporting grants for Community Support Projects pursuant to the provisions of Article 126, paragraph (1), may provide guarantees within the scope of the period that is determined to be necessary with regard to liabilities pertaining to long-term debt, short-term debt, or bonds of the Organization pursuant to the provisions of the preceding Article.
The Organization must not invest surplus funds in the course of business pertaining to business related to insured long-term care, except by the following methods:
機構は、次の方法によるほか、介護保険関係業務に係る業務上の余裕金を運用してはならない。
Article 170, paragraph (1), item (i)
retention of national government bonds, local government bonds and other securities specified by the Minister of Health, Labour, and Welfare;
国債、地方債その他厚生労働大臣が指定する有価証券の保有
Article 170, paragraph (1), item (ii)
as deposits in banks or other financial institutions specified by the Minister of Health, Labour and Welfare;
銀行その他厚生労働大臣が指定する金融機関への預金
Article 170, paragraph (1), item (iii)
as a money trust in financial institutions (which means financial institutions that obtain approval as set forth in Article 1, paragraph (1) of the Act Concerning Additional Operations of Trust Business by Financial Institutions, etc., (Act No. 43 of 1943)) that operate trust business.
The Minister of Health, Labour, and Welfare must consult with the Minister of Finance in advance, in the following cases:
厚生労働大臣は、次の場合には、あらかじめ、財務大臣に協議しなければならない。
Article 170-2, paragraph (1), item (i)
when intending to provide an approval as set forth in Article 168, paragraph (1), paragraph (3), or paragraph (8);
第百六十八条第一項、第三項又は第八項の認可をしようとするとき。
Article 170-2, paragraph (1), item (ii)
when intending to provide an appointment as set forth in item (i) or item (ii) of the preceding Article.
前条第一号又は第二号の指定をしようとするとき。
Article 171第百七十一条
Delegation to Order of the Ministry of Health, Labour, and Welfare(厚生労働省令への委任)
Article 171, paragraph (1)
In addition to those matters provided in this Chapter, the necessary matters concerning finance and accounting of the Organization pertaining to business related to insured long-term care are determined by Order of the Ministry of Health, Labour and Welfare.
The Minister of Health, Labour and Welfare or a prefectural governor, with regard to the Organization or a person that is entrusted pursuant to the provisions of Article 161 (hereinafter referred to as "trustee" in this paragraph and Article 207, paragraph (2)), when he or she determines it necessary with respect to business related to insured long-term care, may collect a report concerning the status of said operations or property, or direct personnel to inspect said condition in practice, provided, however, that with regard to a trustee, this applies only within the scope of the entrusted business.
The provisions of Article 24, paragraph (3) apply mutatis mutandis to an inspection pursuant to the provisions of the preceding paragraph, and the provisions of paragraph (4) of the same Article apply mutatis mutandis to the authority granted pursuant to the provisions of the preceding paragraph.
A prefectural governor, with regard to the Organization, when it is determined necessary with respect to business related to insured long-term care to conduct the disposition of a matter pursuant to the provisions of Article 39 of the Medical Information Infrastructure and Medical Fee Examination and Payment Organization Act, or when it is determined necessary to execute an action for an officer of the Organization with respect to business related to insured long-term care, pursuant to the provisions of Article 14, paragraph (3) or paragraph (4) of the same Act, must provide notification of said fact to the Minister of Health, Labour and Welfare and provide the reasons thereof.
Special Provisions on Application of the Medical Information Infrastructure and Medical Fee Examination and Payment Organization Act(医療情報基盤・診療報酬審査支払機構法の適用の特例)
Article 173, paragraph (1)
Business related to insured long-term care, with regard to application of the provisions of Article 43, paragraph (2) of the Medical Information Infrastructure and Medical Fee Examination and Payment Organization Act, is deemed to be operations as prescribed in Article 18 of the same Act.
A person who is dissatisfied with a disposition by the Organization based on this Act or its inaction may file an application for examination with the Minister of Health, Labour and Welfare. In this case, the Minister of Health, Labour and Welfare is deemed to be the superior administrative agency of the Organization for the purpose of the application of the provisions of Article 25, paragraphs (2) and (3), Article 46, paragraphs (1) and (2), Article 47 and Article 49, paragraph (3) of the Administrative Complaint Review Act (Act No. 68 of 2014).