Medical Care Act

An association or foundation that wishes to establish a hospital, a clinic where a physician or dentist will work full-time, a long-term care health facility, or an integrated facility for medical and long-term care may incorporate the relevant facility pursuant to the provisions of this Act.

A corporation pursuant to the provisions of the previous paragraph is to include in its name the term "medical corporation".

An entity that is not a medical corporation must not use the term "medical corporation" in its name.

A medical corporation, as well as seeking to independently strengthen its operational foundations, is to seek to improve the quality of the medical care it provides and ensure transparency in its operation, and must endeavor to actively fulfill its role as a major medical care actor in the community.

A medical corporation must possess the assets necessary for it to operate.

Necessary particulars concerning the assets set forth in the preceding paragraph are to be as prescribed by an Order of the Ministry of Health, Labour and Welfare, in accordance with the scale, etc. of medical care functions established by the medical corporation.

A medical corporation may carry out all or some of the following operations, provided there is no hindrance to the operation of the hospital, clinic, long-term care health facility, or integrated facility for medical and long-term care it has established (including a hospital, clinic, long-term care health facility, or integrated facility for medical and long-term care publically established by the relevant medical corporation and managed by a designated administrator provided for in Article 244-2, paragraph (3) of the Local Autonomy Act (hereinafter referred to as "hospital, etc. managed by a designated administrator")), pursuant to the provisions of its articles of incorporation or its act of endowment:

the training or re-training of medical personnel;

the establishment of a research center for medicine or dentistry;

the establishment of clinics other than clinics provided for in Article 39, paragraph (1);

the establishment of facilities that allow people to engage in aerobic exercise for the prevention of illness (meaning physical exercise undertaken in order to maintain or rehabilitate physiological functions related to whole-body stamina, through the continuous intake of oxygen; the same applies in the following item) that are affiliated with a clinic and whose personnel, equipment, and operation comply with standards prescribed by the Minister of Health, Labour and Welfare;

the establishment of facilities that allow the use of a hot spring for the prevention of illness that has a space for aerobic exercise and whose personnel, equipment, and operation comply with standards prescribed by the Minister of Health, Labour and Welfare;

beyond what is listed in each of the preceding items, operations related to health and hygiene;

the establishment of the activities prescribed by the Minister of Health, Labour and Welfare, among those listed in Article 2, paragraphs (2) and (3) of the Social Welfare Act (Act No. 45 of 1951); and

the establishment of the fee-based home care for the elderly provided for in Article 29, paragraph (1) of the Act on Social Welfare Services for the Elderly (Act No. 133 of 1963).

A medical corporation that has received authorization from the prefectural governor as falling under the following requirements, pursuant to the provisions of a Cabinet Order (hereinafter referred to as "social medical corporations") may undertake operations as prescribed by the Minister of Health, Labour and Welfare (hereinafter referred to as "profit-making activities"), for the purpose of allocating its proceeds to the administration of a hospital, clinic, long-term care health facility, or integrated facility for medical and long-term care established by the relevant social medical corporation, pursuant to the provisions of its articles of incorporation or act of endowment, provided that this does not hinder the operation of the hospital, clinic, long-term care health facility, or integrated facility for medical and long-term care the relevant medical corporation has established (including hospitals, etc. managed by a designated administrator):

no more than one-third of the total number of officers is composed of the officer, their spouse, their relatives within the third degree of kinship, or other persons who have a special relationship with the officer as specified by an Order of the Ministry of Health, Labour and Welfare.;

no more than one-third of the total number of members of an associated medical corporation is composed of the member, their spouse, their relatives within the third degree of kinship, or other persons who have a special relationship with the member as specified by an Order of the Ministry of Health, Labour and Welfare;

no more than one-third of the total number of councillors of an associated medical corporation is composed of the councillor, their spouse, their relatives within the third degree of kinship, or other persons who have a special relationship with the councillor as specified by an Order of the Ministry of Health, Labour and Welfare;

it carries out operations related to activities to ensure emergency medical care (limited to those listed in the medical care plan prepared by the prefecture of the hospital or clinic established by the relevant medical corporation; the same applies in the following Article) in the prefecture (in the case of a medical corporation listed in (a) or (b) below, the prefecture specified in (a) or (b) respectively) in which the relevant hospital or clinic is situated;

a medical corporation that establishes hospitals or clinics in two or more prefectures (excluding those listed in (b)):All prefectures where the relevant hospitals or clinics are located; or

a medical corporation that establishes hospitals in one prefecture and clinics in the area prescribed in Article 30-4, paragraph (2), item (xii) specified in the medical care plan of the prefecture other than the prefecture where the relevant hospitals are located, which is adjacent to the area prescribed in the same item specified in the medical care plan of the prefecture where the relevant hospitals are located, and medical care in the relevant hospitals and the relevant clinics is provided in an integrated manner in conformity with the standards specified by an Order of the Ministry of Health, Labour and Welfare:The prefecture where the relevant hospitals are located;

the operations set forth in the preceding item comply with the standards prescribed by the Minister of Health, Labour and Welfare with regard to the following particulars:

the buildings and equipment of the hospitals or clinics engaged in the relevant operations;

the system by which the relevant operations are undertaken; and

the outcome of the relevant operations;

beyond what is listed in each of the preceding items, particulars that comply with the requirements set out by an Order of the Ministry of Health, Labour and Welfare with regard to public operations; and

it is stipulated in the articles of incorporation or the act of endowment that any residual assets at the time of dissolution will belong to the national government, local government, or another social medical corporation.

In granting the authorization set forth in the preceding paragraph, the prefectural governor must hear the opinions of the Prefectural Council on Medical Service Facilities in advance.

Accounting for profit-making activities are to be kept separate from accounting for the operation of a hospital, clinic, long-term care health facility, or integrated facility for medical and long-term care established by the relevant social medical corporation (including a hospital, etc. managed by a designated administrator), and from operations listed in each item of the preceding Article, and must be accounted for in a special account.

Out of medical corporations that have received authorization set forth in paragraph (1) of the preceding Article (hereinafter referred to as "authorization as a social medical corporation" in this paragraph and Article 64-2, paragraph (1)), those that have fallen under Article 64-2, paragraph (1), item (i) due to the fact that they no longer meet the requirements listed in paragraph (1), item (v), (c) of the preceding Article (limited to the case where the relevant failure to meet the requirements is due to reasons specified by an Order of the Ministry of Health, Labour and Welfare as reasons not attributable to the relevant medical corporations) and have their authorization as a social medical corporation rescinded pursuant to the provisions of Article 64-2, paragraph (1) (limited to those that fall under the requirements listed in each item (excluding item (v), (c)) of paragraph (1) of the preceding Article) may prepare a plan for the continuous implementation of activities to ensure emergency medical care (hereinafter referred to as the "implementation plan" in this Article) and submit it to the prefectural governor to receive approval to the effect that the implementation plan is appropriate.

A medical corporation that has received the approval set forth in the preceding paragraph may conduct profit-making operations in accordance with the provisions of paragraphs (1) and (3) of the preceding Article.

The provisions of paragraph (2) of the preceding Article apply mutatis mutandis to the case of granting the approval set forth in paragraph (1).

Beyond what is provided for in the preceding three paragraphs, particulars necessary for the approval of an implementation plan and its revocation is specified by Cabinet Order.

A medical corporation must complete its registration pursuant to the provisions of a Cabinet Order, in the case of its establishment, the establishment of secondary offices, a relocation of its offices, a change in other registered particulars, dissolution, merger, split, the appointment or change of a liquidator, and the completion of liquidation.

Particulars which are to be registered pursuant to the provisions of the preceding paragraph may not be duly asserted against a third party after registration.

A medical corporation may not be established without the authorization of the prefectural governor of the location of its principal office (hereinafter referred to simply as "prefectural governor" in this Chapter (excluding paragraph (3) and Article 66-3)).

A person who wishes to establish a medical corporation must stipulate at least the following particulars in its articles of incorporation or act of endowment:

its purpose;

its name;

the name and established location of the hospital, clinic, long-term care health facility, or integrated facility for medical and long-term care (including a publically established hospital, clinic, long-term care health facility, or integrated facility for medical and long-term care that is to be managed by a designated administrator as provided in Article 244-2, paragraph (3) of the Local Autonomy Act) to be established;

the location of its offices;

provisions on assets and accounting;

provisions on officers;

provisions on the board of directors;

for an association of medical corporations, provisions on general meetings and the acquisition or loss of member status;

for medical corporation foundations, provisions on the board of councillors and councillors;

provisions on dissolution;

provisions on changes to the articles of incorporation or act of endowment; and

the method of public notice.

If a person who wishes to establish a medical corporation foundation dies without stipulating the name, location of its offices, or method of appointment and dismissal of directors, the prefectural governor must determine such particulars by the authority of the governor or at the request of an interested party.

The initial officers at the time of the establishment of a medical corporation must be stipulated in the articles of incorporation or act of endowment.

Where, among the particulars listed in paragraph (2), item (x), provisions on persons with vested rights to residual assets have been established, such persons must be selected from among the national government or local governments, or medical corporations or other persons who deliver medical care, as prescribed by an Order of the Ministry of Health, Labour and Welfare.

Beyond the provisions of this Section, any necessary particulars related to applications for authorization to establish a medical corporation is to be as prescribed by an Order of the Ministry of Health, Labour and Welfare.

Where there has been an application for authorization pursuant to the provisions of paragraph (1) of the preceding Article, the prefectural governor must reach a decision on such authorization based on an examination of whether the assets of the medical corporation to which the relevant application relates comply with the requirements set forth in Article 41, and whether the articles of incorporation or act of endowment are not in violation of laws and regulations.

In granting or refusing authorization pursuant to the provisions of paragraph (1) of the preceding Article, the prefectural governor must hear the opinions of the Prefectural Council on Medical Service Facilities in advance.

A medical corporation is to be incorporated through the registration of its establishment at the location of the principal office thereof, pursuant to the provisions of a Cabinet Order.

A medical corporation must prepare an inventory of assets at the time of incorporation, and keep it in its principal office at all times.