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Long-Term Care Insurance Act

介護保険法(かいごほけんほう)

Chapter IX Business Related to Insured Long-Term Care of the Medical Information Infrastructure and Medical Fee Examination and Payment Organization

The law as Act Partially Amending the Medical Care Act, etc. (Act No. 87 of 2025) 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.

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:

機構は、医療情報基盤・診療報酬審査支払機構法第十八条に規定する業務のほか、第一条に規定する目的を達成するため、次に掲げる業務を行う。

Article 160, paragraph (1), item (i)

to collect a Levy from a medical insurer;

医療保険者から納付金を徴収すること。

Article 160, paragraph (1), item (ii)

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:

機構は、医療情報基盤・診療報酬審査支払機構法第十八条に規定する業務及び前項各号に掲げる業務のほか、第一条に規定する目的を達成するため、次に掲げる業務を行う。

Article 160, paragraph (2), item (i)

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);

第百十五条の四十七第十項の規定により市町村から委託を受けて行う第百十五条の四十五第二項第七号に掲げる事業に関する業務を行うこと。

Article 160, paragraph (2), item (ii)

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.

機構は、厚生労働大臣の認可を受けて、介護保険関係業務の一部を医療保険者が加入している団体で厚生労働大臣が定めるものに委託することができる。

Article 162第百六十二条

Statement of Operating Procedures(業務方法書)
Article 162, paragraph (1)

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.

機構は、介護保険関係業務に関し、当該業務の開始前に、業務方法書を作成し、厚生労働大臣の認可を受けなければならない。これを変更するときも、同様とする。

Article 162, paragraph (2)

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.

機構は、医療保険者に対し、毎年度、医療保険加入者(四十歳以上六十五歳未満のものに限る。)の数その他の厚生労働省令で定める事項に関する報告を求めるほか、第百六十条第一項第一号に掲げる業務に関し必要があると認めるときは、文書その他の物件の提出を求めることができる。

Article 164第百六十四条

Separate Accounting(区分経理)
Article 164, paragraph (1)

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.

機構は、介護保険関係業務(第百六十条第二項に規定する業務を除く。次条第一項、第百六十六条第一項、第百六十七条第一項及び第二項、第百六十八条第一項並びに第百七十条において同じ。)に係る経理については、その他の業務に係る経理と区分して、特別の会計を設けて行わなければならない。

Article 165第百六十五条

Approval of Budgets(予算等の認可)
Article 165, paragraph (1)

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.

機構は、介護保険関係業務に関し、毎事業年度、予算、事業計画及び資金計画を作成し、当該事業年度の開始前に、厚生労働大臣の認可を受けなければならない。これを変更するときも、同様とする。

Article 165, paragraph (2)

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))".

機構が第百六十条第二項に規定する業務を行う場合における医療情報基盤・診療報酬審査支払機構法第三十三条第一項の規定の適用については、同項中「収支予算」とあるのは、「収支予算(介護保険法(平成九年法律第百二十三号)第百六十条第二項に規定する業務に関するものを含む。)」とする。

Article 166第百六十六条

Financial Statements(財務諸表等)
Article 166, paragraph (1)

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.

機構は、介護保険関係業務に関し、毎事業年度、財産目録、貸借対照表及び損益計算書(以下この条において「財務諸表」という。)を作成し、当該事業年度の終了後三月以内に厚生労働大臣に提出し、その承認を受けなければならない。

Article 166, paragraph (2)

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.

機構は、前項の規定により財務諸表を厚生労働大臣に提出するときは、厚生労働省令で定めるところにより、これに当該事業年度の事業報告書及び予算の区分に従い作成した決算報告書並びに財務諸表及び決算報告書に関する監事の意見書を添付しなければならない。

Article 166, paragraph (3)

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.

機構は、第一項の規定による厚生労働大臣の承認を受けたときは、遅滞なく、財務諸表又はその要旨を官報に公告し、かつ、財務諸表及び附属明細書並びに前項の事業報告書、決算報告書及び監事の意見書を、主たる事務所に備えて置き、厚生労働省令で定める期間、一般の閲覧に供しなければならない。

Article 166, paragraph (4)

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)".

機構が第百六十条第二項に規定する業務を行う場合における医療情報基盤・診療報酬審査支払機構法第三十四条第一項の規定の適用については、同項中「業務」とあるのは、「業務及び介護保険法(平成九年法律第百二十三号)第百六十条第二項に規定する業務」とする。

Article 167第百六十七条

Disposition of Surplus and Deficit(利益及び損失の処理)
Article 167, paragraph (1)

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.

機構は、介護保険関係業務に関し、毎事業年度、損益計算において利益を生じたときは、前事業年度から繰り越した損失をうめ、なお残余があるときは、その残余の額は、積立金として整理しなければならない。

Article 167, paragraph (2)

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.

機構は、介護保険関係業務に関し、毎事業年度、損益計算において損失を生じたときは、前項の規定による積立金を減額して整理し、なお不足があるときは、その不足額は繰越欠損金として整理しなければならない。

Article 167, paragraph (3)

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.

機構は、予算をもって定める金額に限り、第一項の規定による積立金を第百六十条第一項第二号及び第三号に掲げる業務に要する費用に充てることができる。

Article 168第百六十八条

Debt and Bonds(借入金及び債券)
Article 168, paragraph (1)

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.

機構は、介護保険関係業務に関し、厚生労働大臣の認可を受けて、長期借入金若しくは短期借入金をし、又は債券を発行することができる。

Article 168, paragraph (2)

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.

第一項の規定による短期借入金は、当該事業年度内に償還しなければならない。ただし、資金の不足のため償還することができないときは、その償還することができない金額に限り、厚生労働大臣の認可を受けて、これを借り換えることができる。

Article 168, paragraph (4)

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.

第一項の規定による債券の債権者は、機構の財産について他の債権者に先立って自己の債権の弁済を受ける権利を有する。

Article 168, paragraph (7)

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).

前項の先取特権の順位は、民法(明治二十九年法律第八十九号)の規定による一般の先取特権に次ぐものとする。

Article 168, paragraph (8)

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.

機構は、厚生労働大臣の認可を受けて、第一項の規定による債券の発行に関する事務の全部又は一部を銀行又は信託会社に委託することができる。

Article 168, paragraph (9)

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.

会社法(平成十七年法律第八十六号)第七百五条第一項及び第二項並びに第七百九条の規定は、前項の規定により委託を受けた銀行又は信託会社について準用する。

Article 168, paragraph (10)

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.

第一項及び第二項並びに第五項から前項までに定めるもののほか、第一項の規定による債券に関し必要な事項は、政令で定める。

Article 169第百六十九条

Government Guarantee(政府保証)
Article 169, paragraph (1)

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.

政府は、法人に対する政府の財政援助の制限に関する法律(昭和二十一年法律第二十四号)第三条の規定にかかわらず、国会の議決を経た金額の範囲内で、機構による第百二十五条第一項の介護給付費交付金及び第百二十六条第一項の地域支援事業支援交付金の円滑な交付のために必要があると認めるときは、前条の規定による機構の長期借入金、短期借入金又は債券に係る債務について、必要と認められる期間の範囲において、保証することができる。

Article 170第百七十条

Investment of Surplus Funds(余裕金の運用)
Article 170, paragraph (1)

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.

信託業務を営む金融機関(金融機関の信託業務の兼営等に関する法律(昭和十八年法律第四十三号)第一条第一項の認可を受けた金融機関をいう。)への金銭信託

Article 170-2第百七十条の二

Consultation(協議)
Article 170-2, paragraph (1)

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.

この章に定めるもののほか、介護保険関係業務に係る機構の財務及び会計に関し必要な事項は、厚生労働省令で定める。

Article 172第百七十二条

Collection of Reports(報告の徴収等)
Article 172, paragraph (1)

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.

厚生労働大臣又は都道府県知事は、機構又は第百六十一条の規定による委託を受けた者(以下この項及び第二百七条第二項において「受託者」という。)について、介護保険関係業務に関し必要があると認めるときは、その業務又は財産の状況に関する報告を徴し、又は当該職員に実地にその状況を検査させることができる。ただし、受託者に対しては、当該受託業務の範囲内に限る。

Article 172, paragraph (2)

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.

第二十四条第三項の規定は、前項の規定による検査について、同条第四項の規定は、前項の規定による権限について準用する。

Article 172, paragraph (3)

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.

都道府県知事は、機構につき介護保険関係業務に関し医療情報基盤・診療報酬審査支払機構法第三十九条の規定による処分が行われる必要があると認めるとき、又は機構の役員につき介護保険関係業務に関し同法第十四条第三項若しくは第四項の規定による処分が行われる必要があると認めるときは、理由を付して、その旨を厚生労働大臣に通知しなければならない。

Article 173第百七十三条

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.

介護保険関係業務は、医療情報基盤・診療報酬審査支払機構法第四十三条第二項の規定の適用については、同法第十八条に規定する業務とみなす。

Article 174第百七十四条

Application for Examination(審査請求)
Article 174, paragraph (1)

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).

この法律に基づく機構の処分又はその不作為に不服のある者は、厚生労働大臣に対し、審査請求をすることができる。この場合において、厚生労働大臣は、行政不服審査法(平成二十六年法律第六十八号)第二十五条第二項及び第三項、第四十六条第一項及び第二項、第四十七条並びに第四十九条第三項の規定の適用については、機構の上級行政庁とみなす。

Article 175第百七十五条

Article 175, paragraph (1)

[Article repealed, deleted]

削除

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