Medical Care Act

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).