1 article

Article 53Payment of an Allowance for Preventive Long-Term Care Service

第五十三条（介護予防サービス費の支給）

A Municipality, when an Insured Person who has received a Certification of Needed Support and receives support at home (hereinafter referred to as an "Insured In-Home Person Requiring Support") has received, from a person designated by the prefectural governor (hereinafter referred to as a "Designated Provider of Preventive Long-Term Care Service"), Preventive Long-Term Care Service provided by a Business Office conducting the Preventive Long-Term Care Service Business pertaining to said designation (hereinafter referred to as "Designated Preventive Long-Term Care Service") (limited to a case when said Insured In-Home Person Requiring Support has notified a Municipality in advance, pursuant to the provisions of Article 58, paragraph (4), of receiving Designated Preventive Long-Term Care Support prescribed in paragraph (1) of the same Article and said Designated Preventive Long-Term Care Service is subject to said Designated Preventive Long-Term Care Support, or other cases specified by Order of the Ministry of Health, Labour and Welfare), pays to said Insured In-Home Person Requiring Support an Allowance for Preventive Long-Term Care Service for the expenses required for said Designated Preventive Long-Term Care Service (excluding the expenses required to purchase Specified Equipment for Preventive Long-Term Care Covered by Public Aid and, with regard to the expenses required for Outpatient Rehabilitation for Preventive Long-Term Care, Short-Term Admission for Daily Preventive Long-Term Care, Short-Term Admission for Recuperation for Preventive Long-Term Care, and Daily Preventive Long-Term Care Admitted to a Specified Facility, the expenses necessary to provide meals, stay and other expenses necessary for daily life as determined by Order of the Ministry of Health, Labour and Welfare; the same applies hereinafter in this Article); provided, however, that this does not apply when said Insured In-Home Person Requiring Support, in a case where he or she has been issued a designation pursuant to the provisions of Article 37, paragraph (1), receives Preventive Long-Term Care Service other than the type pertaining to said designation.

市町村は、要支援認定を受けた被保険者のうち居宅において支援を受けるもの（以下「居宅要支援被保険者」という。）が、都道府県知事が指定する者（以下「指定介護予防サービス事業者」という。）から当該指定に係る介護予防サービス事業を行う事業所により行われる介護予防サービス（以下「指定介護予防サービス」という。）を受けたとき（当該居宅要支援被保険者が、第五十八条第四項の規定により同条第一項に規定する指定介護予防支援を受けることにつきあらかじめ市町村に届け出ている場合であって、当該指定介護予防サービスが当該指定介護予防支援の対象となっているときその他の厚生労働省令で定めるときに限る。）は、当該居宅要支援被保険者に対し、当該指定介護予防サービスに要した費用（特定介護予防福祉用具の購入に要した費用を除き、介護予防通所リハビリテーション、介護予防短期入所生活介護、介護予防短期入所療養介護及び介護予防特定施設入居者生活介護に要した費用については、食事の提供に要する費用、滞在に要する費用その他の日常生活に要する費用として厚生労働省令で定める費用を除く。以下この条において同じ。）について、介護予防サービス費を支給する。ただし、当該居宅要支援被保険者が、第三十七条第一項の規定による指定を受けている場合において、当該指定に係る種類以外の介護予防サービスを受けたときは、この限りでない。

The amount of Allowance for Preventive Long-Term Care Service is to according to the categories of Preventive Service of Long-Term Care listed in each item of the following and the amount as prescribed in said items:

介護予防サービス費の額は、次の各号に掲げる介護予防サービスの区分に応じ、当該各号に定める額とする。

Home-Visit Bathing Service for Preventive Long-Term Care, Home-Visit Nursing Service for Preventive Long-Term Care, Home-Visit Rehabilitation Service for Preventive Long-Term Care, Management and Guidance for In-Home Medical Service for Preventive Long-Term Care, Outpatient Rehabilitation for Preventive Long-Term Care, and Equipment Rental for Preventive Long-Term Care Covered by Public Aid: for each type of these Preventive Long-Term Care Services, an amount equivalent to 90 percent of the amount of expenses calculated in accordance with the standards determined by the Minister of Health, Labour and Welfare (when said calculated amount exceeds the amount of expenses actually required for said Designated Preventive Long-Term Care Service, the amount of expenses actually required for said Designated Preventive Long-Term Care Service) in consideration of the average expenses required for said Designated Preventive Long-Term Care Service, calculated in consideration of the content of the Designated Preventive Long-Term Care Service pertaining to the type of said Preventive Long-Term Care Service, the area where the Business Office conducting said Designated Preventive Long-Term Care Service business is located, etc. (in the case of the expenses required for Outpatient Rehabilitation for Preventive Long-Term Care, excluding the expenses necessary to provide meals and other expenses necessary for daily life as determined by Order of the Ministry of Health, Labour and Welfare);

介護予防訪問入浴介護、介護予防訪問看護、介護予防訪問リハビリテーション、介護予防居宅療養管理指導、介護予防通所リハビリテーション及び介護予防福祉用具貸与　これらの介護予防サービスの種類ごとに、当該介護予防サービスの種類に係る指定介護予防サービスの内容、当該指定介護予防サービスの事業を行う事業所の所在する地域等を勘案して算定される当該指定介護予防サービスに要する平均的な費用（介護予防通所リハビリテーションに要する費用については、食事の提供に要する費用その他の日常生活に要する費用として厚生労働省令で定める費用を除く。）の額を勘案して厚生労働大臣が定める基準により算定した費用の額（その額が現に当該指定介護予防サービスに要した費用の額を超えるときは、当該現に指定介護予防サービスに要した費用の額とする。）の百分の九十に相当する額

Short-Term Admission for Daily Preventive Long-Term Care, Short-Term Admission for Recuperation for Preventive Long-Term Care, and Daily Preventive Long-Term Care Admitted to a Specified Facility:the amount equivalent to 90 percent of the amount calculated by the type of Preventive Service of Long-Term Care and after considering the average expenses necessary for said Designated Preventive Service of Long-Term Care that is calculated after considering the categories of Needed Support Condition, the area where the provider that performs said Designated Preventive Service of Long-Term Care Business is located, etc., pertaining the type of said Preventive Service of Long-Term Care (excluding the expenses necessary to provide meals, residence, and other expenses as determined by Order of the Ministry of Health, Labour, and Welfare as necessary for daily life), based on the standards provided by the Minister of Health, Labour, and Welfare (when said calculated amount exceeds the actual expenses required for said Designated Preventive Service of Long-Term Care, said amount is to the actual expenses required for said Designated Preventive Service of Long-Term Care).

介護予防短期入所生活介護、介護予防短期入所療養介護及び介護予防特定施設入居者生活介護　これらの介護予防サービスの種類ごとに、要支援状態区分、当該介護予防サービスの種類に係る指定介護予防サービスの事業を行う事業所の所在する地域等を勘案して算定される当該指定介護予防サービスに要する平均的な費用（食事の提供に要する費用、滞在に要する費用その他の日常生活に要する費用として厚生労働省令で定める費用を除く。）の額を勘案して厚生労働大臣が定める基準により算定した費用の額（その額が現に当該指定介護予防サービスに要した費用の額を超えるときは、当該現に指定介護予防サービスに要した費用の額とする。）の百分の九十に相当する額

The Minister of Health, Labour, and Welfare, when it intends to determine the standards as prescribed in the items of the preceding paragraph, shmust hear the opinion of the Social Security Council in advance.

厚生労働大臣は、前項各号の基準を定めようとするときは、あらかじめ社会保障審議会の意見を聴かなければならない。

When an Insured In-Home Person Requiring Support receives Designated Preventive Service of Long-Term Care from a Designated Provider of a Preventive Service to Long-Term Care, a Municipality may pay the expenses required for said Designated Preventive Service of Long-Term Care that said Insured In-Home Person Requiring Support should pay to said Designated Provider of a Preventive Service to Long-Term Care to said Designated Provider of a Preventive Service to Long-Term Care on behalf of said Insured In-Home Person Requiring Support within the limit of the amount to be paid to said Insured In-Home Person Requiring Support as an Allowance for Preventive Long-Term Care Service.

居宅要支援被保険者が指定介護予防サービス事業者から指定介護予防サービスを受けたときは、市町村は、当該居宅要支援被保険者が当該指定介護予防サービス事業者に支払うべき当該指定介護予防サービスに要した費用について、介護予防サービス費として当該居宅要支援被保険者に対し支給すべき額の限度において、当該居宅要支援被保険者に代わり、当該指定介護予防サービス事業者に支払うことができる。

When the payment pursuant to the provisions of the preceding paragraph is paid, it is to be deemed that an Allowance for Preventive Long-Term Care Service is paid to said Insured In-Home Person Requiring Support.

前項の規定による支払があったときは、居宅要支援被保険者に対し介護予防サービス費の支給があったものとみなす。

A Municipality, when a Designated Provider of a Preventive Service to Long-Term Care requests an Allowance for Preventive Long-Term Care Service, pays after conducting an examination according to standards provided by the Minister of Health, Labour, and Welfare as set forth in each item of paragraph (2), standards concerning effective support methods for prevention of long-term care pertaining to the Designated Preventive Service of Long-Term Care as prescribed in Article 115-4, paragraph (2), and standards concerning facilities and management of a Designated Preventive Service to Long-Term Care Business (limited to the part concerning the handling of Designated Preventive Service of Long-Term Care).

市町村は、指定介護予防サービス事業者から介護予防サービス費の請求があったときは、第二項各号の厚生労働大臣が定める基準並びに第百十五条の四第二項に規定する指定介護予防サービスに係る介護予防のための効果的な支援の方法に関する基準及び指定介護予防サービスの事業の設備及び運営に関する基準（指定介護予防サービスの取扱いに関する部分に限る。）に照らして審査した上、支払うものとする。

The provisions of Article 41, paragraph (2), paragraph (3), paragraph (10), and paragraph (11) apply mutatis mutandis to payment of an Allowance for Preventive Long-Term Care Service and the provisions of paragraph (8) of the same Article apply mutatis mutandis to a Designated Provider of a Preventive Service to Long-Term Care. In this case, the necessary technical replacement of terms in these provisions is specified by a Cabinet Order.

第四十一条第二項、第三項、第十項及び第十一項の規定は、介護予防サービス費の支給について、同条第八項の規定は、指定介護予防サービス事業者について準用する。この場合において、これらの規定に関し必要な技術的読替えは、政令で定める。

In addition to those matters as prescribed in each of the preceding paragraphs, other necessary matters for payment of an Allowance for Preventive Long-Term Care Service and for the request of an Allowance for Preventive Long-Term Care Service by a Designated Provider of a Preventive Service to Long-Term Care are prescribed by Order of the Ministry of Health, Labour, and Welfare.

前各項に規定するもののほか、介護予防サービス費の支給及び指定介護予防サービス事業者の介護予防サービス費の請求に関して必要な事項は、厚生労働省令で定める。

Read this with the articles around it

Search

Article 53Payment of an Allowance for Preventive Long-Term Care Service