Long-Term Care Insurance Act

The national government, pursuant to the provisions of a Cabinet Order, is subject to defray the costs incurred by a Municipality for the amount equivalent to the percentage as prescribed in each of the following items for the amount of expenses necessary for Long-Term Care Benefits and Prevention Benefits, according to the categories of allowance listed in said items:

costs necessary for Long-Term Care Benefits (except for those prescribed in the following item) and Prevention Benefits (except for those prescribed in the same item):20 percent of the necessary costs;

costs necessary for Long-Term Care Benefits (limited to those pertaining to a Facility Covered by Long-Term Care Insurance, a Long-Term Care Insurance Facility in a Specified Area, and daily life long-term care for a person admitted to a Specified Facility) and Prevention Benefits (limited to those pertaining to Daily Preventive Long-Term Care Admitted to a Specified Facility):15 percent of the necessary costs.

With regard to the application of the provisions of the preceding paragraph to a Municipality that has established a Municipal Ordinance based on the provisions of Article 43, paragraph (3), Article 44, paragraph (7), Article 45, paragraph (6), Article 55, paragraph (3), Article 56, paragraph (7), or Article 57, paragraph (6), the amount of costs necessary for Long-Term Care Benefits and Prevention Benefits prescribed in the same paragraph is to be the amount equivalent to the amount of costs necessary for said Long-Term Care Benefits and Prevention Benefits, calculated pursuant to the provisions of a Cabinet Order on the assumption that the measures under said Municipal Ordinance are not taken.

The national government provides Adjusting Subsidies to a Municipality pursuant to the provisions of a Cabinet Order, in order to adjust the finances of Long-Term Care Insurance by taking into consideration the distribution by age group of Primary Insured Persons, distribution of income of Primary Insured Persons, etc.;

The total amount of Adjusting Subsidies pursuant to the provisions of the preceding paragraph is to be the amount equivalent to 5 percent of the total amount of costs necessary for Long-Term Care Benefits and Prevention Benefits as prescribed in paragraph (1) of the preceding Article for each Municipality (in a case when the provisions of paragraph (2) of the same Article apply, the amount calculated by applying the provisions of the same paragraph; the same applies in the following paragraph).

The total amount of Adjusting Subsidies to be granted as a portion of each fiscal year is to be the amount equivalent to 5 percent of the total prospective amount of costs necessary for Long-Term Care Benefits and Prevention Benefits as prescribed in paragraph (1) of the preceding Article in each Municipality in said fiscal year, plus the amount of Adjusting Subsidies for the fiscal year prior to the year previous to said fiscal year that have not yet been provided, or the amount equivalent to 5 percent of said total prospective amount, minus an amount that is the portion provided that exceeded the amount to be provided in prior fiscal years of the year previous to said fiscal year.

The national government, pursuant to the provisions of a Cabinet Order, provides an amount equivalent to 20 percent of costs necessary for the Comprehensive Project for Long-Term Care Prevention and Daily Life Support and the project for In-Home Services, etc. in a Specified Area to a Municipality.

The national government, in order to adjust the finances of Long-Term Care Insurance, provides to a Municipality an amount calculated pursuant to the provisions of a Cabinet Order with regard to the amount of costs necessary for the Comprehensive Project for Long-Term Care Prevention and Daily Life Support and the project for In-Home Services, etc. in a Specified Area, taking into consideration the distribution by age group of Primary Insured Persons, distribution of income of Primary Insured Persons, etc.

The total amount of the amounts provided pursuant to the provisions of the preceding paragraph (including the amounts provided pursuant to the provisions of Article 106-8 (limited to the portion pertaining to item (ii)) and Article 106-9-2 (limited to the portion pertaining to item (ii)) of the Social Welfare Act) is to be the amount equivalent to 5 percent of the total amount of costs necessary for the Comprehensive Project for Long-Term Care Prevention and Daily Life Support and the project for In-Home Services, etc. in a Specified Area of each Municipality.

The national government, pursuant to the provisions of a Cabinet Order, grants an amount equivalent to 50 percent of the amount (hereinafter referred to as "specified community support project support amount") that is obtained by multiplying the percentage that is the result of the sum of the cost payment percentage of the Secondary Insured Person group as set forth in Article 125, paragraph (1) and 50 percent, by the amount of expenses necessary for a Community Support Project (except for the Comprehensive Project for Long-Term Care Prevention and Daily Life Support and the project for In-Home Services, etc. in a Specified Area) to a Municipality.

The national government, in addition to what is provided for in the preceding two Articles, grants subsidies to Municipalities within the scope of the budget, pursuant to the provisions of a Cabinet Order, in order to support the initiatives of Municipalities for supporting independent daily life of their Insured Persons in the community, preventing them from falling into a Condition of Need for Long-Term Care, etc., or reducing or preventing deterioration of a Condition of Need for Long-Term Care, etc., and ensuring the appropriateness of the expenses required for Long-Term Care Benefit, etc.

The national government, in order to support the initiatives of prefectures pertaining to the support under the provisions of Article 120-2, paragraph (1) and the projects under the provisions of paragraph (2) of that Article, grants subsidies to prefectures within the scope of the budget, pursuant to the provisions of a Cabinet Order.

A prefecture, pursuant to the provisions of Order of the Ministry of Health, Labour, and Welfare, is subject to defray to a Municipality the amount equivalent to the portion as prescribed in each of the following items for the amount of expenses necessary for Long-Term Care Benefits and Prevention Benefits, according to the categories of costs listed in each said item:

costs necessary for Long-Term Care Benefits (except for those prescribed in the following item) and Prevention Benefits (except for those prescribed in the same item):12.5 percent of the necessary costs;

costs necessary for Long-Term Care Benefits (limited to those pertaining to a Facility Covered by Long-Term Care Insurance, a Long-Term Care Insurance Facility in a Specified Area, and daily life long-term care for a person admitted to a Specified Facility) and Prevention Benefits (limited to those pertaining to Daily Preventive Long-Term Care Admitted to a Specified Facility):17.5 percent of the necessary costs.

The provisions of Article 121, paragraph (2) apply mutatis mutandis to the amount of expenses necessary for Long-Term Care Benefits and Prevention Benefits as prescribed in the preceding paragraph.

A prefecture, pursuant to the provisions of a Cabinet Order, provides an amount equivalent to 12.5 percent of the costs necessary for the Comprehensive Project for Long-Term Care Prevention and Daily Life Support and the project for In-Home Services, etc. in a Specified Area to a Municipality.

A prefecture, pursuant to the provisions of a Cabinet Order, subsidizes an amount equivalent to 25 percent of the specified community support project support amount to a Municipality.

A Municipality, pursuant to the provisions of a Cabinet Order, bears an amount equivalent to 12.5 percent of the amount of expenses necessary for Long-Term Care Benefits and Prevention Benefits by said general fund.

The provisions of Article 121, paragraph (2) apply mutatis mutandis to the amount of expenses necessary for Long-Term Care Benefits and Prevention Benefits as prescribed in the preceding paragraph.

A Municipality, pursuant to the provisions of a Cabinet Order, bears the cost of the amount equivalent to 12.5 percent of the amount of expenses necessary for the Comprehensive Project for Long-Term Care Prevention and Daily Life Support and the project for In-Home Services, etc. in a Specified Area by said general fund.

A Municipality, pursuant to the provisions of a Cabinet Order, bears the cost of the amount equivalent to 25 percent of the specified community support project support amount by the general fund.

A Municipality must, pursuant to the provisions of a Cabinet Order, transfer from the general account to the special account pertaining to Long-Term Care Insurance an amount calculated pursuant to the provisions of a Cabinet Order on the basis of the total amount by which the insurance premiums for Primary Insured Persons have been reduced based on the reduced imposition of insurance premiums on persons with low income, carried out as provided for by a Prefectural or Municipal Ordinance.

The national government shall, pursuant to Cabinet Order provisions, bear an amount equal to one-half of the amount to be transferred pursuant to the provisions of the preceding paragraph.

Each prefecture shall, pursuant to Cabinet Order provisions, bear an amount equal to one-fourth of the amount to be transferred pursuant to the provisions of paragraph (1).

A Municipality is to bear, pursuant to the provisions of a Cabinet Order, as expenses necessary for Community Support Projects, the amount calculated pursuant to the provisions of a Cabinet Order with regard to the expenses necessary for Community Support Projects conducted by the Municipality Where the Facility Is Located, in which the Facility Subject to Domicile Exception where an Insured Person to Whom the Domicile Exception Applies is undergoing Admission, etc. is located, for Insured Persons to Whom the Domicile Exception Applies by Long-Term Care Insurance provided by said Municipality.

With regard to the amount (hereinafter referred to as "Amount Subject to Medical Insurance Premium Payment") that is obtained by multiplying the payment percentage of the Secondary Insured Person group by the amount of expense necessary for Long-Term Care Benefits and Prevention Benefits among the expenses that are imposed upon a special account pertaining to Municipal Long-Term Care Insurance, pursuant to the provisions of a Cabinet Order, a Grant for Long-Term Care Benefit Expenses that is provided to a Municipality by the Organization is to be allocated to said amount.

The payment proportion of a Secondary Insured Person group as prescribed in the preceding paragraph is to be established based on the percentage obtained by multiplying 50 percent to the percentage of the total prospective number of Secondary Insured Persons pertaining to all Municipalities to the total prospective number of Insured Persons pertaining to all Municipalities and is to be specified by a Cabinet Order by taking into consideration the changes of said proportion every three years.

The provisions of Article 121, paragraph (2) apply mutatis mutandis to the amount of expenses necessary for Long-Term Care Benefits and Prevention Benefits as prescribed in paragraph (1).

The payment that is collected by the Organization pursuant to the provisions of Article 150, paragraph (1) is to be allocated to the Grant for Long-Term Care Benefit Expenses as set forth in paragraph (1).

With regard to the amount that is obtained by multiplying the payment percentage of the Secondary Insured Person group as set forth in paragraph (1) of the preceding Article by the amount of expenses necessary for the Comprehensive Project for Long-Term Care Prevention and Daily Life Support and the project for In-Home Services, etc. in a Specified Area among the expenses that are imposed on a special account pertaining to Municipal Long-Term Care Insurance (hereinafter referred to as "Amount Subject to Medical Insurance Premium Payment for Comprehensive Project for Long-Term Care Prevention and Daily Life Support"), pursuant to the provisions of a Cabinet Order, the Grants for Supporting Community Support Projects that the Organization provides to a Municipality are allocated to said amount.

Payments that are collected by the Organization pursuant to the provisions of Article 150, paragraph (1) are to be allocated to Grants for Supporting Community Support Projects as set forth in the preceding paragraph.

The national government, in addition to those items as prescribed in Article 121 through Article 122-3 and Article 124-2, may assist with a portion of the expenses necessary for an Insured Long-Term Care Project within the budget.

The national government, in a case when a prefecture grants subsidies pursuant to the provisions of Article 115-50, paragraph (1), may subsidize, within the budget, all or a part of the amount that said prefecture has subsidized to the persons prescribed in the same paragraph.

A prefecture, in addition to those items as prescribed in Article 123 and Article 124-2, may assist with a portion of the expenses necessary for an Insured Long-Term Care Project.

A Municipality must collect insurance premiums in order to allocate these amounts to the disbursements necessary for an Insured Long-Term Care Project (including the disbursements necessary for payment of a Fiscal Stability Fund contribution).

Insurance premiums as prescribed in the preceding paragraph are imposed upon a Primary Insured Person with the amount of an insurance premium calculated by the rate of an insurance premium that is calculated pursuant to the provisions of Order in accordance with the standards provided by a Cabinet Order.

The rate of an insurance premium as set forth in the preceding paragraph is to be determined in order to be able to maintain fiscal balance of revenue and expenses approximated through three years in consideration of the estimated amount of disbursements necessary for Insurance Benefits calculated based on the prospective volume, etc., of the Service Covered by Long-Term Care Benefits, etc., as prescribed in a Municipal Insured Long-Term Care Service Plan, the estimated amount of disbursements necessary for payment of a Fiscal Stability Fund contribution, the approximate amount of disbursements necessary for repayment of borrowings from a prefecture pursuant to the provisions of Article 147, paragraph (1), item (ii), and estimated amount of disbursements necessary for Community Support Projects and Health Care and Welfare Projects, the distribution of income of the Primary Insured Person group and said prospective amount, and the amount of national treasury impositions, etc.

A Municipality, notwithstanding the provisions of paragraph (1), does not collect an insurance premium from a Secondary Insured Person.

The base date for assessment of an insurance premium is to be the first date of said fiscal year.