Article 55Maximum Payment pertaining to an Allowance for Preventive Long-Term Care Service
第五十五条(介護予防サービス費等に係る支給限度額)
Total sum of the total amounts of the Allowance for Preventive Long-Term Care Service and Exceptional Allowance for Preventive Service of Long-Term Care that are paid for Preventive Service of Long-Term Care, and the Allowance for Community-Based Preventive Long-Term Care Service and Exceptional Allowance for Community-Based Preventive Service of Long-Term Care that are paid for Designated Provider of Community-Based Service for Preventive Long-Term Care, as pertaining to a single category of Preventive Service of Long-Term Care, etc., that an In-Home Person Requiring Support receives monthly by category of Preventive Service of Long-Term Care, etc. (which means categories of two or more types as determined by the Minister of Health, Labour, and Welfare, with regard to Preventive Service of Long-Term Care (including equivalent services; the same applies hereinafter in this Article) and Community-Based Preventive Service of Long-Term Care (including equivalent services; the same applies hereinafter in this Article), after considering the inter-substitution by type; the same applies hereinafter in this Article) during the period provided by Order of the Ministry of Health, Labour, and Welfare, may not exceed the amount equivalent to 90 percent of the amount calculated pursuant to the provisions of Order of the Ministry of Health, Labour, and Welfare based on the base amount of maximum benefit for the payment categories of Preventive Service of Long-Term Care, etc.
居宅要支援被保険者が介護予防サービス等区分(介護予防サービス(これに相当するサービスを含む。以下この条において同じ。)及び地域密着型介護予防サービス(これに相当するサービスを含む。以下この条において同じ。)について、その種類ごとの相互の代替性の有無等を勘案して厚生労働大臣が定める二以上の種類からなる区分をいう。以下この条において同じ。)ごとに月を単位として厚生労働省令で定める期間において受けた一の介護予防サービス等区分に係る介護予防サービスにつき支給する介護予防サービス費の額の総額及び特例介護予防サービス費の額の総額並びに地域密着型介護予防サービスにつき支給する地域密着型介護予防サービス費の額の総額及び特例地域密着型介護予防サービス費の額の総額の合計額は、介護予防サービス費等区分支給限度基準額を基礎として、厚生労働省令で定めるところにより算定した額の百分の九十に相当する額を超えることができない。
The base amount of maximum benefit for the payment categories of Allowance for Preventive Long-Term Care Service, etc., as set forth in the preceding paragraph is to be the amount determined by the Minister of Health, Labour, and Welfare by category of Preventive Service of Long-Term Care, etc., after considering the types of standard use that are according to the categories of Needed Support Condition, of Preventive Service of Long-Term Care, and of Community-Based Preventive Service of Long-Term Care pertaining to the categories of said Preventive Service of Long-Term Care, etc., during the period as determined by Order of the Ministry of Health, Labour, and Welfare as prescribed in the same paragraph, standards provided by the Minister of Health, Labour, and Welfare as set forth in each item of Article 53, paragraph (2) and each item of Article 54-2, paragraph (2) pertaining to said Preventive Service of Long-Term Care and Community-Based Preventive Service of Long-Term Care.
前項の介護予防サービス費等区分支給限度基準額は、介護予防サービス等区分ごとに、同項に規定する厚生労働省令で定める期間における当該介護予防サービス等区分に係る介護予防サービス及び地域密着型介護予防サービスの要支援状態区分に応じた標準的な利用の態様、当該介護予防サービス及び地域密着型介護予防サービスに係る第五十三条第二項各号及び第五十四条の二第二項各号の厚生労働大臣が定める基準等を勘案して厚生労働大臣が定める額とする。
A Municipality, notwithstanding the provisions of the preceding paragraph and pursuant to the provisions of a municipal ordinance, in lieu of the base amount of the maximum benefit by payment category of Preventive Service of Long-Term Care, etc., as set forth in paragraph (1), may determine that an amount exceeding said base amount as the base amount of maximum benefit by payment category of Preventive Service of Long-Term Care in said Municipality.
A Municipality may stipulate that the total sum of the total amounts of Allowance for Preventive Long-Term Care Service and Exceptional Allowance for Preventive Service of Long-Term Care that are paid for single type of Preventive Service of Long-Term Care and the total amount of Allowance for Community-Based Preventive Long-Term Care Service and Exceptional Allowance for Community-Based Preventive Service of Long-Term Care that are paid for single type of Community-Based Preventive Service of Long-Term Care as allowances that were paid monthly to an In-Home Person Requiring Support by type of Preventive Service of Long-Term Care and Community-Based Preventive Service of Long-Term Care (limited to those types included in categories of Preventive Service of Long-Term Care, etc., and provided by the Minister of Health, Labour, and Welfare; the same applies in the following paragraph) during the period as determined by Order of the Ministry of Health, Labour, and Welfare may not exceed the amount equivalent to 90 percent of the amount calculated pursuant to the provisions of Order of the Ministry of Health, Labour, and Welfare based on the base amount of maximum benefit by payment type of Preventive Service of Long-Term Care, etc.
市町村は、居宅要支援被保険者が介護予防サービス及び地域密着型介護予防サービスの種類(介護予防サービス等区分に含まれるものであって厚生労働大臣が定めるものに限る。次項において同じ。)ごとに月を単位として厚生労働省令で定める期間において受けた一の種類の介護予防サービスにつき支給する介護予防サービス費の額の総額及び特例介護予防サービス費の額の総額の合計額並びに一の種類の地域密着型介護予防サービスにつき支給する地域密着型介護予防サービス費の額の総額及び特例地域密着型介護予防サービス費の額の総額の合計額について、介護予防サービス費等種類支給限度基準額を基礎として、厚生労働省令で定めるところにより算定した額の百分の九十に相当する額を超えることができないこととすることができる。
The base amount of maximum benefit by payment type of Preventive Service of Long-Term Care, etc., as set forth in the preceding paragraph is to be the amount that a Municipality stipulates by ordinance, by type of Preventive Service of Long-Term Care and Community-Based Preventive Service of Long-Term Care, after considering the type of standard use that is according to each Category of Needed Support Condition, of said Preventive Service of Long-Term Care and Community-Based Preventive Service of Long-Term Care during the period as determined by Order of the Ministry of Health, Labour, and Welfare as prescribed in the same paragraph, standards determined by the Minister of Health, Labour, and Welfare as set forth in each item of Article 53, paragraph (2) and each item of Article 54-2, paragraph (2) pertaining to said Preventive Service of Long-Term Care and Community-Based Preventive Service of Long-Term Care, etc., within the base amount of maximum benefit by payment category of Preventive Service of Long-Term Care, etc., as set forth in paragraph (1) pertaining to the categories of Preventive Service of Long-Term Care, etc., that include said Preventive Service of Long-Term Care and Community-Based Preventive Service of Long-Term Care (said base amount, with regard to the Municipality that provides Order pursuant to the provisions of paragraph (3), is to be the amount by which measures pursuant to the provisions of said municipal ordinance are undertaken).
前項の介護予防サービス費等種類支給限度基準額は、介護予防サービス及び地域密着型介護予防サービスの種類ごとに、同項に規定する厚生労働省令で定める期間における当該介護予防サービス及び地域密着型介護予防サービスの要支援状態区分に応じた標準的な利用の態様、当該介護予防サービス及び地域密着型介護予防サービスに係る第五十三条第二項各号及び第五十四条の二第二項各号の厚生労働大臣が定める基準等を勘案し、当該介護予防サービス及び地域密着型介護予防サービスを含む介護予防サービス等区分に係る第一項の介護予防サービス費等区分支給限度基準額(第三項の規定に基づき条例を定めている市町村にあっては、当該条例による措置が講じられた額とする。)の範囲内において、市町村が条例で定める額とする。
In a case when the total amount as prescribed in paragraph (1) exceeds the amount equivalent to 90 percent of the amount as prescribed in the same paragraph or when the total amount as prescribed in paragraph (4) exceeds the amount equivalent to 90 percent of the amount as prescribed in the same paragraph by payment of an Allowance for Preventive Long-Term Care Service or Exceptional Allowance for Preventive Long-Term Care Service, or an Allowance for Community-Based Preventive Long-Term Care Service or an Exceptional Allowance for Community-Based Preventive Long-Term Care Service, the amount of said Allowance for Preventive Long-Term Care Service or Exceptional Allowance for Preventive Long-Term Care Service, or Allowance for Community-Based Preventive Long-Term Care Service or Exceptional Allowance for Community-Based Preventive Long-Term Care Service is to be the amount calculated pursuant to the provisions of a Cabinet Order, notwithstanding the provisions of each item of Article 53, paragraph (2), Article 54, paragraph (3), each item of Article 54-2, paragraph (2), paragraph (4) of that Article, or paragraph (2) of the preceding Article.
Read this with the articles around it
(Payment of an Allowance for Preventive Long-Term Care Service)
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…
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。
Open this provision(Payment of an Allowance for Community-Based Preventive Long-Term Care Service)
The amount of Allowance for Community-Based Preventive Long-Term Care Service is to be according to the categories of Community-Based Service for Preventive Long-Term Care listed in the following…
地域密着型介護予防サービス費の額は、次の各号に掲げる地域密着型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。
Open this provision(Payment of an Allowance for Community-Based Preventive Long-Term Care Service)
A Municipality may, notwithstanding the provisions of each item of paragraph (2), set the amount determined by said Municipality…
市町村は、第二項各号の規定にかかわらず、地域密着型介護予防サービスの種類その他の事情を勘案して厚生労働大臣が定める基準により算定した額を限度として、同項各号に定める地域密着型介護予防サービス費の額に代えて…
Open this provision(Payment of an Exceptional Allowance for Community-Based Preventive Service of Long-Term Care)
The amount of an Exceptional Allowance for Community-Based Preventive Long-Term Care Service is to be provided by a Municipality based on the amount equivalent to 90 percent of the amount of expenses…
特例地域密着型介護予防サービス費の額は、当該地域密着型介護予防サービス又はこれに相当するサービスについて前条第二項各号の厚生労働大臣が定める基準により算定した費用の額(その額が現に当該地域密着型介護予防サービス又はこれに相当するサービスに要した費用(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…
Open this provision(Payment of an Exceptional Allowance for Preventive Service of Long-Term Care)
The amount of Exceptional Allowance for Preventive Long-Term Care Service is to be determined by a Municipality based on the amount equivalent to 90 percent of the amount of expenses calculated based…
特例介護予防サービス費の額は、当該介護予防サービス又はこれに相当するサービスについて前条第二項各号の厚生労働大臣が定める基準により算定した費用の額(その額が現に当該介護予防サービス又はこれに相当する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…
Open this provision(Maximum Payment pertaining to an Allowance for Preventive Long-Term Care Service)
Total sum of the total amounts of the Allowance for Preventive Long-Term Care Service and Exceptional Allowance for Preventive Service of Long-Term Care that are paid for Preventive Service of…
居宅要支援被保険者が介護予防サービス等区分(介護予防サービス(これに相当するサービスを含む。以下この条において同じ。)及び地域密着型介護予防サービス(これに相当するサービスを含む。以下この条において同じ。)について、その種類ごとの相互の代替性の有無等を勘案して厚生労働大臣が定める二以上の種類からなる区分をいう。以下こ…
Open this provision(Maximum Payment pertaining to an Allowance for Preventive Long-Term Care Service)
Total sum of the total amounts of the Allowance for Preventive Long-Term Care Service and Exceptional Allowance for Preventive Service of Long-Term Care that are paid for Preventive Service of…
居宅要支援被保険者が介護予防サービス等区分(介護予防サービス(これに相当するサービスを含む。以下この条において同じ。)及び地域密着型介護予防サービス(これに相当するサービスを含む。以下この条において同じ。)について、その種類ごとの相互の代替性の有無等を勘案して厚生労働大臣が定める二以上の種類からなる区分をいう。以下こ…
Open this provision(Maximum Payment pertaining to an Allowance for Preventive Long-Term Care Service)
The base amount of maximum benefit for the payment categories of Allowance for Preventive Long-Term Care Service, etc., as set forth in the preceding paragraph is to be the amount determined by the…
前項の介護予防サービス費等区分支給限度基準額は、介護予防サービス等区分ごとに、同項に規定する厚生労働省令で定める期間における当該介護予防サービス等区分に係る介護予防サービス及び地域密着型介護予防サービスの要支援状態区分に応じた標準的な利用の態様…
Open this provision(Maximum Payment pertaining to an Allowance for Preventive Long-Term Care Service)
A Municipality, notwithstanding the provisions of the preceding paragraph and pursuant to the provisions of a municipal ordinance, in lieu of the base amount of the maximum benefit by payment…
市町村は、前項の規定にかかわらず、条例で定めるところにより、第一項の介護予防サービス費等区分支給限度基準額に代えて、その額を超える額を、当該市町村における介護予防サービス費等区分支給限度基準額とすることができる。
Open this provision(Maximum Payment pertaining to an Allowance for Preventive Long-Term Care Service)
A Municipality may stipulate that the total sum of the total amounts of Allowance for Preventive Long-Term Care Service and Exceptional Allowance for Preventive Service of Long-Term Care that are…
市町村は、居宅要支援被保険者が介護予防サービス及び地域密着型介護予防サービスの種類(介護予防サービス等区分に含まれるものであって厚生労働大臣が定めるものに限る。次項において同じ。)ごとに月を単位として厚生労働省令で定める期間において受けた一の種類の介護予防サービスにつき支給する介護予防サービス費の額の総額及び特例介護…
Open this provision(Maximum Payment pertaining to an Allowance for Preventive Long-Term Care Service)
The base amount of maximum benefit by payment type of Preventive Service of Long-Term Care, etc., as set forth in the preceding paragraph is to be the amount that a Municipality stipulates by…
前項の介護予防サービス費等種類支給限度基準額は、介護予防サービス及び地域密着型介護予防サービスの種類ごとに、同項に規定する厚生労働省令で定める期間における当該介護予防サービス及び地域密着型介護予防サービスの要支援状態区分に応じた標準的な利用の態様…
Open this provisionCategory of Needed Support Condition
「要支援状態区分」
Each of the categories, set by a Ministry of Health, Labour and Welfare Order (厚生労働省令) according to how much support a person needs, one of which a condition needing support (要支援状態) must fall in (Article 7, paragraph (2)).
Short name set inArticle 7, paragraph (2)
Preventive Long-Term Care Servicemachine translation
「介護予防サービス」
Any of the services this Act groups as preventive long-term care services: preventive home-visit bathing, home-visit nursing and home-visit rehabilitation, preventive management and guidance for in-home medical care, preventive outpatient rehabilitation, preventive short-term admission for daily-life care or for medical care, preventive daily-life care for residents of specified facilities, rental of welfare equipment for preventive care, and the sale of specified welfare equipment for preventive care.
Defined inArticle 8-2, paragraph (1)· applies throughout the law
Community-Based Service for Preventive Long-Term Caremachine translation
「地域密着型介護予防サービス」
Preventive outpatient care for people with dementia (介護予防認知症対応型通所介護), multifunctional preventive care in a small group home (介護予防小規模多機能型居宅介護) and preventive communal living care for people with dementia (介護予防認知症対応型共同生活介護).
Defined inArticle 8-2, paragraph (12)· applies throughout the law
Municipality
「市町村」
A city, town or village, together with a special ward (特別区): the bodies that run long-term care insurance (介護保険) under this Act, whose insured persons Article 9 names.
Short name set inArticle 9, paragraph (1)
Insured In-Home Person Requiring Supportmachine translation
「居宅要支援被保険者」
An insured person certified as needing support (要支援認定) who receives that support at home.
Short name set inArticle 53, paragraph (1)
Category of Preventive Long-Term Care Service, etc.machine translation
「介護予防サービス等区分」
In Article 55, a group of two or more kinds of preventive long-term care services (介護予防サービス) and community-based preventive services (地域密着型介護予防サービス), including equivalent services, that the Minister of Health, Labour and Welfare sets taking into account whether the kinds can stand in for one another, within which the allowances paid for each month are capped.
Defined inArticle 55, paragraph (1)· applies only in this article
Prefectural or Municipal Ordinance
条例
A rule a local government makes for itself: a prefecture (都道府県), a city, town or village (市町村), or one of Tokyo's special wards (特別区) (Local Autonomy Act, Articles 1-3, 281 and 283). Its assembly (議会), whose members the residents elect, passes it (Articles 89 and 96, paragraph (1), item (i)), and its head — the governor or the mayor (Article 139) — promulgates it, that is, makes it public so that it can take effect (Article 16). The Constitution lets local governments make them within the limits of Acts (Constitution, Article 94), and one may not go against the national laws and regulations (法令), such as Acts, Cabinet Orders (政令) and Ministerial Orders (省令) (Local Autonomy Act, Article 14, paragraph (1)). Unless national laws and regulations provide otherwise, a local government can impose a duty or restrict a right only by one of these (Article 14, paragraph (2)), and it may write into one penalties for breaking it, within limits the Local Autonomy Act sets (Article 14, paragraph (3)). It is made for that local government's own affairs (Article 2, paragraph (2) and Article 14, paragraph (1)), so the same matter can be handled differently from one place to the next. It is a local rule, not a national one: an "ordinance" in the name of a national rule, such as an Ordinance for Enforcement of an Act, is usually a Ministerial Order (省令) or another national instrument.
Written by AI using Constitution, Art. 94 and Local Autonomy Act, Arts. 1-3, 2, 14, 16, 89, 96, 139, 281, 283 as a reference.