Medical Care Act

The Minister of Health, Labour and Welfare, in accordance with the comprehensive securing policy prescribed in Article 3, paragraph (1) of the Act on Promotion of Comprehensive Securing of Medical and Long-Term Care in Communities (Act No. 64 of 1989) and the medical information digitalization promotion policy prescribed in Article 11-2, paragraph (1) of that Act, is to set forth a basic policy (hereinafter referred to as the "basic policy") for ensuring the presence of a system that efficiently delivers good quality and appropriate medical care (hereinafter referred to as the "medical care delivery system").

The basic policy is to prescribe the following particulars:

particulars that should form the basis of any measures to be undertaken for ensuring the medical care delivery system;

basic particulars related to investigation and research into ensuring the medical care delivery system;

particulars related to targets for ensuring the medical care delivery system;

basic particulars related to the sharing of functions and cooperation between medical institutions, and to promoting the provision of information that concerns medical care functions to recipients of medical care;

basic particulars related to the regional medical care vision prescribed in Article 30-3-3, paragraph (1);

basic particulars related to the promotion of the differentiation and coordination of medical institution functions (meaning the content of medical care provided by each hospital or clinic as a medical institution in the region; the same applies hereinafter) in the region and the provision of information about medical institution functions to medical care recipients;

basic particulars related to the promotion of the differentiation and coordination of bed functions (meaning the contents of medical care 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 medical care delivery system for outpatient medical care;

basic particulars related to ensuring the primary care function;

basic particulars related to ensuring the availability of physicians;

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

basic particulars related to the preparation of the regional medical care 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 intends to set or change the basic policy, the Minister is to consult with the heads of the relevant administrative organs.

When the Minister of Health, Labour and Welfare has set forth or amended the basic policy, the minister is to provide a public notice thereof without delay.

When the Minister of Health, Labour and Welfare finds it necessary in order to set down or change the particulars listed in items (v) to (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 (viii) 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 (ix) 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.

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.