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 (xii) 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 (xii) 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 (7) 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:

a person as provided for in Article 31;

mutual aid associations and federations thereof formed under the provisions of the National Public Officers Mutual Aid Association Act (Act No. 128 of 1958);

mutual aid associations formed under the provisions of the Local Public Officers Mutual Aid Association Act (Act No. 152 of 1962);

beyond what is listed in the preceding two items, mutual aid associations and federations thereof formed under laws and regulations prescribed by Cabinet Order;

the Promotion and Mutual Aid Corporation for Private Schools of Japan which administers the private school mutual aid system pursuant to the provisions of the Private School Personnel Mutual Aid Association Act (Act No. 245 of 1953);

the National Federation of Health Insurance Societies and its federations formed under the provisions of the Health Insurance Act (Act No. 70 of 1922);

the National Health Insurance Association and national health insurance organizations formed under the provisions of the National Health Insurance Act (Act No. 192 of 1958); or

Japan Community Health Care Organization.

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 (xii) 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 (7) 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 an application has been made to the prefectural governor for permission to establish a hospital or to increase the number of beds in a hospital (limited to those related to long-term care beds, etc.), or for permission to establish beds in a clinic or to increase the number of beds in a clinic, and all of the following items apply, the governor is to 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, to establish beds in a clinic, or to increase the number of beds in a hospital or clinic in the vision area including the location of the hospital or clinic to which the relevant application relates and other particulars specified by an Order of the Ministry of Health, Labour and Welfare (referred to as the "reasons, etc." in paragraphs (5) and (6)), and to participate 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.

The applicant, when requested by the prefectural governor pursuant to the provisions of the preceding paragraph, must endeavor to respond to the request.

The prefectural governor, when an agreement is not reached through the consultation at the place of consultation set forth in paragraph (3) 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.

The applicant, when requested by the prefectural governor pursuant to the provisions of the preceding paragraph, must endeavor 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 governor finds, based on the content of the consultation 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 which 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 of the future requirements for the number of beds in the relevant vision area as specified in the regional medical care vision, or will exceed that total 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).

When the prefectural governor finds that the reasons, etc. are not sufficient, the governor may request the applicant to participate in the consultation at the place of consultation prescribed in Article 30-14, paragraph (1).

The applicant, when requested by the prefectural governor pursuant to the provisions of the preceding paragraph, must endeavor to respond to the request.

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.

The applicant, when requested by the prefectural governor pursuant to the provisions of the preceding paragraph, must endeavor to attend the 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 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 the prefectural governor decides not to grant the permission set forth in paragraph (1) or (2) of Article 7 under the provisions of the preceding paragraph, the governor must hear the opinions of the Prefectural Council on Medical Service Facilities in advance.

The provisions of the preceding paragraphs apply mutatis mutandis to an application for permission to set up new beds in a clinic or permission to increase the number of beds in a clinic. In this case, the term "paragraph (1) or (2) of the same Article" in paragraph (6) is to be replaced with "paragraph (3) of the same Article", and the term "paragraph (1) or (2) of Article 7" in the preceding paragraph is to be replaced with "paragraph (3) of Article 7".