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

①The 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:

②The 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:

③Operations as prescribed in the preceding two paragraphs are referred to as business related to insured long-term care.

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.

①The 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.

②Matters 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.

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.

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.

①The 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.

②With 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))".

①The 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.

②The 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.

③The 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.

④With 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)".

①The 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.

②The 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.

③The 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.

①The 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.

②Long-term debt and bonds pursuant to the provisions of the preceding paragraph must be repaid within two years.

③Short-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.

④Short-term debt that is refinanced pursuant to the proviso of the preceding paragraph must be repaid within one year.

⑤The Organization, in a case when issuing bonds pursuant to the provisions of paragraph (1), may issue said bonds subject to a bond discount.

⑥A 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.

⑦The 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).

⑧The 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.

⑨The 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.

⑩In 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.

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.

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:

The Minister of Health, Labour, and Welfare must consult with the Minister of Finance in advance, in the following cases:

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.

①The 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.

②The 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.

③A 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.

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.

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).