Search

Search provisions, jump to a law or an article

1 article

Article 22Collection of Fraudulent Gains

第二十二条(不正利得の徴収等)

When there is a person who has received insurance benefits through deception or other wrongful act, a Municipality may collect the whole or a part of the amount of the benefit from that person and, in addition, when the insurance benefits received through the deception or other wrongful act are payment of an Allowance for Long-Term Care Service to a Person Admitted to a Specified Facility pursuant to the provisions of Article 51-3, paragraph (1), payment of an Exceptional Allowance for Long-Term Care Service to a Person Admitted to a Specified Facility pursuant to the provisions of Article 51-4, paragraph (1), payment of an Allowance for Preventive Long-Term Care Service to a Person Admitted to a Specified Facility pursuant to the provisions of Article 61-3, paragraph (1), or payment of an Exceptional Allowance for Preventive Long-Term Care Service to a Person Admitted to a Specified Facility pursuant to the provisions of Article 61-4, paragraph (1), the Municipality may, in accordance with standards determined by the Minister of Health, Labour and Welfare, collect from that person an amount equivalent to 200 percent or less of the amount paid to that person through the deception or other wrongful act.

偽りその他不正の行為によって保険給付を受けた者があるときは、市町村は、その者からその給付の価額の全部又は一部を徴収することができるほか、当該偽りその他不正の行為によって受けた保険給付が第五十一条の三第一項の規定による特定入所者介護サービス費の支給、第五十一条の四第一項の規定による特例特定入所者介護サービス費の支給、第六十一条の三第一項の規定による特定入所者介護予防サービス費の支給又は第六十一条の四第一項の規定による特例特定入所者介護予防サービス費の支給であるときは、市町村は、厚生労働大臣の定める基準により、その者から当該偽りその他不正の行為によって支給を受けた額の百分の二百に相当する額以下の金額を徴収することができる。

In the case prescribed in the preceding paragraph, when the insurance benefit was provided because a physician who diagnoses the degree of need for medical treatment with regard to Home-Visit Nursing, Home-Visit Rehabilitation, Outpatient Rehabilitation, Short-Term Admission for Recuperation, Periodic Patrol and On-Demand Home-Visit Long-Term Care and Nursing, Home-Visit Nursing Service for Preventive Long-Term Care, Home-Visit Rehabilitation Service for Preventive Long-Term Care, Outpatient Rehabilitation for Preventive Long-Term Care or Short-Term Admission for Recuperation for Preventive Long-Term Care, or another physician or dentist who engages in In-Home Service or equivalent services, Community-Based Service or equivalent services, Facility Service, or Preventive Long-Term Care Service or equivalent services, made a false entry in a medical certificate that is to be submitted to a Municipality, the Municipality may order said physician or dentist to pay the Levy prescribed in that paragraph jointly and severally with the person that received the insurance benefit.

前項に規定する場合において、訪問看護、訪問リハビリテーション、通所リハビリテーション若しくは短期入所療養介護、定期巡回・随時対応型訪問介護看護又は介護予防訪問看護、介護予防訪問リハビリテーション、介護予防通所リハビリテーション若しくは介護予防短期入所療養介護についてその治療の必要の程度につき診断する医師その他居宅サービス若しくはこれに相当するサービス、地域密着型サービス若しくはこれに相当するサービス、施設サービス又は介護予防サービス若しくはこれに相当するサービスに従事する医師又は歯科医師が、市町村に提出されるべき診断書に虚偽の記載をしたため、その保険給付が行われたものであるときは、市町村は、当該医師又は歯科医師に対し、保険給付を受けた者に連帯して同項の徴収金を納付すべきことを命ずることができる。

When a Designated In-Home Service Provider prescribed in Article 41, paragraph (1); a Designated Community-Based Service Provider prescribed in Article 42-2, paragraph (1); a Designated In-Home Long-Term Care Support Provider prescribed in Article 46, paragraph (1); a Facility Covered by Long-Term Care Insurance; a Designated Provider of Preventive Long-Term Care Service prescribed in Article 53, paragraph (1); a Designated Provider of Community-Based Service for Preventive Long-Term Care prescribed in Article 54-2, paragraph (1); or a Designated Preventive Long-Term Care Support Provider prescribed in Article 58, paragraph (1) (hereinafter referred to as a "Designated In-Home Service Provider, etc." in this paragraph) receives a payment pursuant to the provisions of Article 41, paragraph (6), Article 42-2, paragraph (6), Article 46, paragraph (4), Article 48, paragraph (4), Article 51-3, paragraph (4), Article 53, paragraph (4), Article 54-2, paragraph (6), Article 58, paragraph (4), or Article 61-3, paragraph (4) by deception or other wrongful act, a Municipality may collect from said Designated In-Home Service Provider, etc. the amount to be returned with regard to the amount paid, and may also collect the amount obtained by multiplying the amount to be returned by 40 percent.

市町村は、第四十一条第一項に規定する指定居宅サービス事業者、第四十二条の二第一項に規定する指定地域密着型サービス事業者、第四十六条第一項に規定する指定居宅介護支援事業者、介護保険施設、第五十三条第一項に規定する指定介護予防サービス事業者、第五十四条の二第一項に規定する指定地域密着型介護予防サービス事業者又は第五十八条第一項に規定する指定介護予防支援事業者(以下この項において「指定居宅サービス事業者等」という。)が、偽りその他不正の行為により第四十一条第六項、第四十二条の二第六項、第四十六条第四項、第四十八条第四項、第五十一条の三第四項、第五十三条第四項、第五十四条の二第六項、第五十八条第四項又は第六十一条の三第四項の規定による支払を受けたときは、当該指定居宅サービス事業者等から、その支払った額につき返還させるべき額を徴収するほか、その返還させるべき額に百分の四十を乗じて得た額を徴収することができる。

Read this with the articles around it

© 2026 japanlaw.orgA copy for reading and reference — not an official source, and not legal advice. Only the Japanese text published by the government has legal effect.Run by Genjido LLC (Genjido 合同会社) · [email protected]ContactSourcesTermsPrivacy