Medical Care Act

The Minister of Health, Labour and Welfare may, based on an application from a clinically trained physician prescribed in Article 7, paragraph (1), certify the relevant physician that has the experience necessary having knowledge concerning the provision of medical care in an acute physician shortage area (meaning an area prescribed in Article 30-4, paragraph (65) and other areas specified by an Order of the Ministry of Health, Labour and Welfare; the same applies hereinafter) and other experience specified by an Order of the Ministry of Health, Labour and Welfare.

in the case of a participating hospital, etc. (meaning a participating hospital, etc. prescribed in Article 70-2, paragraph (2), item (ii)) of a regional medical coordination promotion corporation (meaning a regional medical coordination promotion corporation prescribed in Article 70-5, paragraph (1); the same applies in Article 30-4, paragraph (1211)), a statement to that effect;

A prefectural governor, when granting permission on an application for permission to establish a hospital, to increase the number of beds or alter bed classifications of a hospital, to set up beds in a clinic, or to increase the number of beds or alter bed classifications of a clinic, may attach to that permission the condition of providing, in the beds pertaining to the relevant application, medical care pertaining to those of the functional classifications of beds prescribed in Article 30-13, paragraph (1) (hereinafter referred to as "functional classification of beds" in this paragraph) for which the number of existing beds according to the functional classification of beds in the vision area (meaning the "vision area" prescribed in Article 30-430-3-3, paragraph (2), item (viiii), which is specified in a regional medical care planvision prescribed in Article 30-430-3-3, paragraph (1) (hereinafter referred to as "the "regional medical care planvision" in this Article, paragraph, paragraph (3), item (ii) and paragraph (7) of the following Article , Article 7-3, paragraph (1) and Article 7-37-4, paragraph (1)); the same applies in paragraph (3) of the following Article , Article 7-3, paragraph (1)) and Article 7-4, paragraph (1)) including the location of the hospital or clinic pertaining to the relevant application has not reached the future requirements for the number of beds (meaning the future requirements for the number of beds prescribed in Article 30-430-3-3, paragraph (2), item (vii), (a) iv); the same applies in paragraph (3), item (ii) of the following Article, Article 7-3, paragraph (1) and Article 7-4, paragraph (1), item (i)) in the relevant vision area specified in the regional medical care planvision, or any other condition specified by an Order of the Ministry of Health, Labour and Welfare as necessary for the promotion of the achievement of the regional medical care vision prescribed in Article 30-4, paragraph (2), item (vii) specified in the medical care plan.

In the case where a prefecture conducts the affairs relating to the permission set forth in paragraphs (1) to (3) pursuant to the provisions of Article 30-4, paragraph (109), or conducts the affairs relating to those permissions pursuant to the provisions of paragraph (1110) of that Article, when it is found that the circumstances specified by the Cabinet Order set forth in paragraph (109) of that Article have ceased to exist, or when operations relating to beds are no longer carried out in the beds specified by the Order of the Ministry of Health, Labour and Welfare set forth in paragraph (1110) of that Article, conditions may be attached to those permissions, namely taking measures to change the permission, the content of which is to reduce the number of specially permitted beds within the range of the number of beds that exceeds the target number of beds, and other conditions specified by Order of the Ministry of Health, Labour and Welfare as necessary for ensuring the medical care delivery system prescribed in Article 30-3, paragraph (1); here, the number is the number of hospital or clinic beds corresponding to the bed classifications of the beds to which the relevant permission relates (where the specially permitted beds are long-term care beds, etc. only, the total number of long-term care beds and general beds in that area) in the area that includes the location of the hospital or clinic to which the relevant permission relates (where the beds to which the relevant permission relates (hereinafter referred to as "specially permitted beds" in this paragraph) are long-term care beds or general beds (hereinafter referred to as "long-term care beds, etc." in this paragraph, the following Article and Article 7-3, paragraph (1)Section) only, this is to be the area provided for in Article 30-4, paragraph (2), item (xivxii) as prescribed by the medical care plan; (meaning the medical care plan prescribed in paragraph (1) of that Article; hereinafter referred to as the "medical care plan" in this paragraph, the following Article and Article 7-4, paragraph (1), item (ii)); where the specially permitted beds are psychiatric hospital beds, infectious disease hospital beds or tuberculosis hospital beds (hereinafter referred to as "psychiatric hospital beds, etc." in this paragraph and paragraph (1) of the following Article) only, this is to be the area of the prefecture; and where the specially permitted beds are long-term care beds, etc. and psychiatric hospital beds, etc., this is to be the area provided for in that Article 30-4, paragraph (2), item (xii) and the area of the prefecture), and the target number of beds is the target number of beds for that area corresponding to the bed classifications of the beds to which the relevant permission relates (where the specially permitted beds are long-term care beds, etc. only, the target number of beds for long-term care beds and general beds in that area) as prescribed in the medical care plan in accordance with the standards specified by Order of the Ministry of Health, Labour and Welfare set forth in Article 30-4, paragraph (87).

Where the following persons have applied for permission to establish a hospital, to increase the number of beds, or to alter bed classifications in a hospital, notwithstanding the provisions of paragraph (4) of the preceding Article, the prefectural governor may refuse the permission set forth in paragraph (1) or paragraph (2) of the same Article when, in the area that includes the hospital to which the relevant application relates (where the beds to which the relevant application relates are long-term care beds, etc. only, this is to be the area provided for in Article 30-4, paragraph (2), item (xivxii) as prescribed by the medical care plan; where the beds to which the relevant application relates are psychiatric hospital beds, etc. only, this is to be the area of the prefecture; and where the beds to which the relevant application relates are long-term care beds, etc. and psychiatric hospital beds, etc., this is to be the area provided for in Article 30-4, paragraph (2), item (xivxii) and the area of the prefecture), the number of hospital or clinic beds that correspond to the classifications of the beds that the relevant application relates to (or the total number of long-term care beds and general beds in the relevant area, where the beds that the relevant application relates to are long-term care beds, etc. only) has already reached the target number of beds for the relevant area that correspond to the classifications of the beds that the relevant application relates to (or the target number of beds for long-term care beds and general beds in the relevant area, where the beds that the relevant application relates to are long-term care beds, etc. only), as prescribed in a medical care plan that is in accordance with the requirements prescribed by the Order of the Ministry of Health, Labour and Welfare set forth in paragraph (87) of the same Article, or if it is considered that establishing a hospital, increasing the number of beds, or altering the bed classifications as per the relevant application would exceed the relevant target:

Where a person listed in any of the items of the preceding paragraph has applied for permission to establish beds in a clinic or to increase the number of beds in a clinic, the prefectural governor may, notwithstanding the provisions of paragraph (4) of the preceding Article, refuse the permission set forth in paragraph (3) of the same Article, when, in the area that includes the clinic to which the relevant application relates (an area provided for in Article 30-4, paragraph (2), item (xivxii) as prescribed by the medical care plan) the total number of long-term care beds and general beds has already reached the target number of long-term care beds and general beds for the relevant area as prescribed in a medical care plan that is in accordance with the requirements prescribed by the Order of the Ministry of Health, Labour and Welfare as set forth in paragraph (87) of the same Article, or if it is considered that establishing beds or increasing the number of beds as per the relevant application would exceed the relevant target.

Where the number of long-term care beds and general beds inan application has been made to the area (an area providedprefectural governor for in Article 30-4, paragraph (2), item (xiv) as prescribed by a medical care plan)permission to establish a hospital or to increase the number of beds in which a hospital (limited to those with related to long-term care beds, etc.), or clinic (limitedfor permission to those withestablish beds permitted as set forth in paragraph (3) of the preceding Article) established by a person listed in any of the items of paragraph (1) has already reacheda clinic or to increase the target number for long-term care beds and generalof beds in the relevant area as specified in a medical care plan thata clinic, and all of the following items apply, the governor is in accordance withto request the requirements prescribed by the Order ofperson who has filed the Ministry of Health, Labour and Welfare,relevant application (hereinafter referred to as set forththe "applicant" in paragraph (8) of the same Article, whenthis Article) to submit a document stating the relevant hospital or clinicreason why it is not engaging in all or some of the services related to long-term care beds, etc. under necessary to establish a hospital, to establish beds in a clinic, or to increase the permission set forthnumber of beds in paragraph (1)a hospital or paragraph (2) ofclinic in the preceding Article or beds for whichvision area including the permission set forth in paragraph (3)location of the same Article has been received, without justifiable grounds, the prefectural governor may order the establisher or administratorhospital or clinic to which the relevant application relates and other particulars specified by an Order of the relevant hospital or clinic to adopt measuresMinistry of Health, Labour and Welfare (referred to amend such permission so as to reduce the number of beds, upas the "reasons, etc." in paragraphs (5) and (6)), and to and including the number of beds which are not used for the relevant servicesparticipate in consultation at the place of consultation prescribed in Article 30-14, paragraph (1).

when the total number of long-term care beds and general beds in the area including the location of the hospital or clinic to which the relevant application relates (an area provided for in Article 30-4, paragraph (2), item (xii) as prescribed by the medical care plan) is found, as a result of the establishment of the hospital, the establishment of beds in a clinic, or the increase in the number of beds in a hospital or clinic to which the relevant application relates, to be less than the target number of beds for long-term care beds and general beds in the relevant area, as prescribed in the medical care plan in accordance with the requirements prescribed by the Order of the Ministry of Health, Labour and Welfare set forth in Article 30-4, paragraph (7);

when it is found that the total number of long-term care beds and general beds in the vision area including the location of the hospital or clinic to which the relevant application relates has already reached the total of the future requirements for the number of beds in the relevant vision area specified in the regional medical care vision, or would exceed that total as a result of the establishment of the hospital, the establishment of beds in a clinic, or the increase in the number of beds in a hospital or clinic to which the relevant application relates.

In the cases set forth in the preceding three paragraphs, in calculating the number of existing beds in the relevant area and the number of beds to which the relevant application relates,The applicant, when requested by the prefectural governor must carry out any necessary adjustments in consideration of the function and nature of the hospital or clinic, pursuant to the provisions of the Prefectural Ordinance in accordance with the requirements prescribed by the Order of the Ministry of Health, Labour and Welfare set forth in Article 30-4, paragraph (8)preceding paragraph, must endeavor to respond to the request.

The prefectural governor must hear the opinions of the Prefectural Council on Medical Service Facilities in advance, when, when an agreement is not reached through the governor wishes to refuse permission asconsultation at the place of consultation set forth in paragraph (1) through paragraph (3) 3) or when otherwise specified by an Order of the preceding Article pursuant to the provisions of paragraph (1) or paragraph (2) or if Ministry of Health, Labour and Welfare, may request the applicant to attend a meeting of the governor wishes to issue an order pursuant toprefectural council on medical service facilities and explain the provisions of paragraph (3)reasons, etc.

When a prefectural governor has issued an order as prescribed in paragraph (3) andThe applicant, when requested by the prefectural governor pursuant to the establisher or administratorprovisions of the hospital or clinic that has received the relevant order failspreceding paragraph, must endeavor to comply with it, attend a meeting of the prefectural governor may make a public announcement to that effectcouncil on medical service facilities and explain the reasons, etc.

When an incorporated administrative agency (an incorporated administrative agency as provided for inNotwithstanding the provisions of Article 27, paragraph (1) of4), the Act on General Rules for Incorporated Administrative Agencies (Act No. 103prefectural governor, if the governor finds, based on the content of 1999)) that has been specified by a Cabinet Order, or the Japan Institute for Health Security, wishes to establish a hospital, increase bed numbers, or alter bed classifications at a hospital it has established, or where it wishesconsultation at the place of consultation set forth in paragraph (3) and the content of the explanation set forth in the preceding paragraph, that the beds to establish beds in a clinic or increase bed numbers or alter bed classifications at a clinic, it must consult (or give notice where specially prescribed by Cabinet Order) with the Minister of Health, Labour and Welfare in advance regarding such plans. The same applies when it wishes to amend such planswhich the relevant application relates are not necessary for the promotion of the achievement of the regional medical care vision, may decide not to grant the permission set forth in Article 7, paragraphs (1) through (3) to the applicant (limited to those listed in the items of paragraph (1)).

Where the total number of long-term care beds and general beds in the area (an area provided for in Article 30-4, paragraph (2), item (xii) as prescribed by a medical care plan) in which a hospital (limited to those with long-term care beds, etc.) or clinic (limited to those with beds permitted as set forth in paragraph (3) of the preceding Article) established by a person listed in any of the items of paragraph (1) has already exceeded the target number for long-term care beds and general beds in the relevant area as specified in a medical care plan that is in accordance with the requirements prescribed by the Order of the Ministry of Health, Labour and Welfare, as set forth in paragraph (7) of the same Article, when the relevant hospital or clinic is not engaging in all or some of the services related to long-term care beds, etc. under the permission set forth in paragraph (1) or paragraph (2) of the preceding Article or beds for which the permission set forth in paragraph (3) of the same Article has been received, without justifiable grounds, the prefectural governor may order the establisher or administrator of the relevant hospital or clinic to adopt measures to amend such permission so as to reduce the number of beds, up to and including the number of beds which are not used for the relevant services.

In the cases set forth in paragraphs (1) through (3) and the preceding paragraph, in calculating the number of existing beds and the number of beds to which the relevant application relates in the relevant area and the relevant vision area, the prefectural governor must carry out any necessary adjustments in consideration of the function and nature of the hospital or clinic, pursuant to the provisions of the Prefectural Ordinance in accordance with the requirements prescribed by the Order of the Ministry of Health, Labour and Welfare set forth in Article 30-4, paragraph (7).

The prefectural governor must hear the opinions of the Prefectural Council on Medical Service Facilities in advance, when the governor wishes to refuse permission as set forth in paragraph (1) through paragraph (3) of the preceding Article pursuant to the provisions of paragraph (1), paragraph (2) or paragraph (7) or if the governor wishes to issue an order pursuant to the provisions of paragraph (8).

When a prefectural governor has issued an order as prescribed in paragraph (8) and the establisher or administrator of the hospital or clinic that has received the relevant order fails to comply with it, the prefectural governor may make a public announcement to that effect.

When an incorporated administrative agency (an incorporated administrative agency as provided for in Article 2, paragraph (1) of the Act on General Rules for Incorporated Administrative Agencies (Act No. 103 of 1999)) that has been specified by a Cabinet Order, or the Japan Institute for Health Security, wishes to establish a hospital, increase bed numbers, or alter bed classifications at a hospital it has established, or where it wishes to establish beds in a clinic or increase bed numbers or alter bed classifications at a clinic, it must consult (or give notice where specially prescribed by Cabinet Order) with the Minister of Health, Labour and Welfare in advance regarding such plans. The same applies when it wishes to amend such plans.

Where a prefectural governor has received an application for permission to establish a hospital or permission to increase the number of beds in a hospital (limited to those related to long-term care beds, etc.), if the governor finds that the total number of long-term care beds and general beds in the vision area including the location of the hospital pertaining to the relevant application has already reached the total number of beds required in the future prescribed in Article 30-4, paragraph (2), item (vii),(a)requirements for the number of beds in the relevant vision area as specified in the regional medical care planvision, or will exceed thethat total number of beds required due to the establishment of the hospital or the increase in the number of beds in the hospital pertaining to the relevant application, the governor may request the person who has filed the relevant application (hereinafter referred to as the "applicant" in this Article) to submit a document stating the reason why it is necessary to establish a hospital or increase the number of beds in the hospital in the relevant vision area and other particulars specified by an Order of the Ministry of Health, Labour and Welfare (hereinafter referred to as the "reasons, etc." in this Article).

The prefectural governor, when an agreement is not reached through the consultation at the place of consultation set forth in paragraph (2) or when otherwise specified by an Order of the Ministry of Health, Labour and Welfare, may request the applicant to attend a meeting of the Prefectural Council on Medical Service Facilities and explain the reasons, etc.

Notwithstanding the provisions of Article 7, paragraph (4), the prefectural governor, if the reasons, etc. are not found to be unavoidable based on the content of the consultation at the place of consultation set forth in paragraph (2) and the content of the explanation set forth in paragraph (4)the preceding paragraph, may decide not to grant the permission set forth in paragraph (1) or (2) of the same Article to the applicant (limited to those listed in the items of paragraph (1) of the preceding Article).

When any of the following items applies, the prefectural governor may request the establisher or administrator of a hospital (limited to those having long-term care beds, etc.) or clinic (limited to those that have established beds with the permission set forth in Article 7, paragraph (3)) located in the vision area set forth in item (i) or the area set forth in item (ii), where the governor finds it necessary to promote the differentiation and coordination of bed functions (meaning the bed functions prescribed in Article 30-3, paragraph (2), item (vii); the same applies hereinafter in this paragraph) to achieve the regional medical care vision, to participate in consultation at the place of consultation prescribed in Article 30-14, paragraph (1), and may hold consultation on particulars necessary to promote the differentiation and coordination of bed functions.

when the total number of long-term care beds and general beds in the vision area has already reached the total of the future requirements for the number of beds in the relevant vision area as specified in the regional medical care vision;

when the total number of long-term care beds and general beds in the area prescribed in Article 30-4, paragraph (2), item (xii) as specified in the medical care plan (meaning the number of existing beds as adjusted pursuant to Article 7-2, paragraph (9)) has already reached the target number of beds for long-term care beds and general beds in the relevant area, as specified in the medical care plan in accordance with the requirements prescribed by the Order of the Ministry of Health, Labour and Welfare set forth in Article 30-4, paragraph (7).

The establisher or administrator of the hospital or clinic set forth in the preceding paragraph, when requested by the prefectural governor pursuant to the provisions of that paragraph to participate in consultation at the place of consultation prescribed in Article 30-14, paragraph (1), must endeavor to respond to the request, and must also endeavor to implement the particulars agreed upon at the place of consultation among the related parties prescribed in Article 30-14, paragraph (1) (limited to cases where the relevant establisher or administrator participated).

when the establisher or administrator of the regional medical care support hospital has violated an order under the provisions of Article 7-2, paragraph (38), Article 27-2, paragraph (2), or Article 30-15, paragraph (6);

when the establisher or administrator of the advanced treatment hospital has violated an order under the provisions of Article 7-2, paragraph (38), Article 27-2, paragraph (2), or Article 30-15, paragraph (6);

basic particulars related to the regional medical care vision prescribed in Article 30-430-3-3, paragraph (2) item (vii1);

basic particulars related to the promotion of the differentiation and coordination of bed medical institution functions (meaning the contentscontent of medical care provided in by each hospital or clinic beds in accordance with theas a medical conditions of patientsinstitution in the region; the same applies hereinafter) in the region and the provision of information about bedmedical institution functions to medical care recipients;

basic particulars related to ensuring the promotion of the differentiation and coordination of bed functions (meaning the contents of medical care delivery system for outpatient provided in hospital or clinic beds in accordance with the medical conditions of patients; the same applies hereinafter) in the region and the provision of information about bed functions to medical care recipients;

basic particulars related to ensuring the primarymedical care functiondelivery system for outpatient medical care;

basic particulars related to ensuring the availability of physiciansprimary care function;

basic particulars related to ensuring the availability of medical care professionals (excluding physicians);

basic particulars related to ensuring the preparationavailability of the medical care plans provided for in Article 30-4, paragraph (1), and to evaluating the status of implementation of activities under medical care plans; andprofessionals (excluding physicians);

other importantbasic particulars related to ensuring the preparation of the regional medical care delivery system.vision prescribed in Article 30-3-3, paragraph (1), and to evaluating the status of progress;

basic particulars related to the preparation of the medical care plans provided for in Article 30-4, paragraph (1), and to evaluating the status of implementation of activities under medical care plans; and

other important particulars related to ensuring the medical care delivery system.

When the Minister of Health, Labour and Welfare finds it necessary in order to set down or change the particulars listed in itemitems (v) or (vito (vii) of paragraph (2) of the preceding Article, the minister may request the prefectural governor or the establisher or administrator of a hospital, etc. subject to a report on medical institution functions, etc. prescribed in Article 30-13, paragraph (2) to provide the content of the report provided for in paragraph (1) of that Article and other necessary information, pursuant to an Order of the Ministry of Health, Labour and Welfare.

When the Minister of Health, Labour and Welfare finds it necessary in order to set down or change the particulars listed in item (viiviii) of paragraph (2) of the preceding Article, the minister may request the prefectural governor or the establisher or administrator of a hospital, etc. subject to a report on outpatient functions prescribed in Article 30-18-2, paragraph (1) or of a clinic without beds prescribed in Article 30-18-3, paragraph (1) to provide the details of a report under the provisions of Article 30-18-2, paragraph (1) or Article 30-18-3, paragraph (1) and other necessary information, pursuant to an Order of the Ministry of Health, Labour and Welfare.

When the Minister of Health, Labour and Welfare finds it necessary in order to set down or change the particulars listed in item (viiiix) of paragraph (2) of the preceding Article, the minister may request the prefectural governor or the establisher or administrator of a hospital, etc. subject to a report on primary care functions prescribed in Article 30-18-4, paragraph (1) to provide the content of the report provided for in the same paragraph and other necessary information, pursuant to an Order of the Ministry of Health, Labour and Welfare.

Section 2 Regional Medical Care Visions and Medical Care Plans

The prefecture is to establish a vision of the future medical care delivery system in the relevant prefecture (hereinafter referred to as the "regional medical care vision") in conformity with the basic policy and in accordance with the actual conditions in the area.

The regional medical care vision is to specify the following particulars:

particulars related to the basic direction of the future medical care delivery system;

an area specified in accordance with the standards set down by an Order of the Ministry of Health, Labour and Welfare as the standards for promoting the differentiation and coordination of medical institution functions and bed functions in the region (hereinafter referred to as "vision area");

the outlook for future medical institution functions for each classification specified by an Order of the Ministry of Health, Labour and Welfare according to the medical institution functions prescribed in Article 30-13, paragraph (1) (limited to the part pertaining to long-term care beds or general beds; the same applies hereinafter in this Article) in a vision area (referred to simply as the "outlook for future medical institution functions" in Article 30-14, paragraph (1));

the future requirements for the number of beds for each functional classification of beds prescribed in Article 30-13, paragraph (1) in a vision area, calculated as specified by an Order of the Ministry of Health, Labour and Welfare (hereinafter referred to simply as "future requirements for the number of beds");

particulars related to the promotion of the differentiation and coordination of medical institution functions to achieve the regional medical care vision;

particulars related to the promotion of the differentiation and coordination of bed functions to achieve the regional medical care vision;

beyond what is set forth in the preceding items, particulars specified by an Order of the Ministry of Health, Labour and Welfare as necessary for the promotion of the differentiation and coordination of medical institution functions or bed functions;

particulars related to the promotion of the provision of information on medical institution functions;

particulars related to the promotion of the provision of information on bed functions.

In preparing the regional medical care vision, the prefecture must take into consideration the contents of reports under Article 30-13, paragraph (1), Article 30-18-2, paragraph (1), Article 30-18-3, paragraph (1) and Article 30-18-4, paragraph (1), the prospects for changes in the demographic structure and other trends in demand for medical care, the prospects for the arrangement of medical care professionals and medical institutions, and other circumstances.

In preparing the regional medical care vision, the prefecture must seek to ensure consistency with the prefectural plan prescribed in Article 4, paragraph (1) of the Act on Promotion of Comprehensive Securing of Medical and Long-Term Care in Communities, the Prefectural Insured Long-Term Care Service Plan prescribed in Article 118, paragraph (1) of the Long-Term Care Insurance Act, the prevention plan prescribed in Article 10, paragraph (1) of the Act on the Prevention of Infectious Diseases and Medical Care for Patients with Infectious Diseases, and the prefectural action plan prescribed in Article 7, paragraph (1) of the Act on Special Measures Against Novel Influenza (Act No. 31 of 2012).

In preparing the regional medical care vision, the prefecture must endeavor to ensure that harmony is maintained with plans prepared pursuant to the provisions of other Acts that specify particulars concerning ensuring medical care, and to seek coordination with public health, pharmacy, social welfare, and other measures that are closely related to medical care.

In preparing the regional medical care vision, the prefecture is to undertake liaison and coordination with the related prefectures when it considers it necessary in the light of the actual state of supply and demand of medical care in areas near the boundaries of the relevant prefecture.

The prefecture must hear the opinions of groups of persons with the relevant knowledge and experience in diagnoses or prescriptions, in order to prepare a draft regional medical care vision based on expert scientific opinions on medical care.

When stipulating the regional medical care vision, or intending to revise the regional medical care vision pursuant to the provisions of paragraph (10), the prefecture must hear the opinions of the Prefectural Council on Medical Service Facilities, municipalities (including the partial-affairs associations and cross-regional federations set forth in Article 284, paragraph (1) of the Local Autonomy Act (Act No. 67 of 1947) that handle first aid services; the same applies in paragraph (16) of the following Article) and the insurers' council set forth in Article 157-2, paragraph (1) of the Act on Assurance of Medical Care for Elderly People (Act No. 80 of 1982) (referred to as the "insurers' council" in paragraph (16) of the following Article) in advance.

When the prefecture has stipulated the regional medical care vision or revised it pursuant to the provisions of the following paragraph, it must, without delay, submit it to the Minister of Health, Labour and Welfare and give public notice of its contents.

The prefecture is to inspect, analyze and evaluate the regional medical care vision, and is to revise the regional medical care vision of the relevant prefecture when it finds it necessary.

The Minister of Health, Labour and Welfare is to collect, organize and analyze information (hereinafter in this paragraph referred to as "collection, etc.") from a cross-regional viewpoint that extends beyond prefectural boundaries, and to provide the prefectures with the results of that collection, etc. and other necessary assistance concerning technical matters regarding the promotion of the achievement of the regional medical care vision in accordance with the actual conditions of the area.

The Minister of Health, Labour and Welfare may provide the necessary advice to the prefectures regarding the method of preparing the regional medical care vision and other key practical particulars regarding the preparation of the regional medical care vision.