Medical Care Act

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 a clinically trained physician, a clinically trained dentist, or a midwife establishes a clinic or birthing center, the physician must notify the prefectural governor of the area in which the clinic or birthing center is situated within ten days of its establishment.

The founder of a facility for receiving online medical care must notify the prefectural governor of the area in which the facility is situated (or, where its location is within the area of a city with a public health center or a special ward of Tokyo, the mayor of the city with a public health center or the mayor of the special ward) within ten days of its establishment.

The establisher of a hospital, clinic or birthing center, or the founder of a facility for receiving online medical care, must not suspend the operation of the relevant hospital, clinic, birthing center or facility for receiving online medical care for more than one year without justifiable grounds; provided, however, that this does not apply to the establisher of a clinic or birthing center of which the prefectural governor was notified and that was established pursuant to the provisions of paragraph (1) of the preceding Article.

When the establisher of a hospital, clinic or birthing center, or the founder of a facility for receiving online medical care, suspends the operation of the relevant hospital, clinic, birthing center or facility for receiving online medical care, they must notify the prefectural governor (in the case of a clinic, birthing center or facility for receiving online medical care, where its location is within the area of a city with a public health center or a special ward of Tokyo, the mayor of the city with a public health center or the mayor of the special ward; the same applies in the following Article, Article 24-2, Article 29, paragraph (1), Article 29-2 and Article 30) within ten days. The same applies when they resume the operation of a suspended hospital, clinic, birthing center or facility for receiving online medical care.

When the establisher of a hospital, clinic or birthing center, or the founder of a facility for receiving online medical care, discontinues the operation of the relevant hospital, clinic, birthing center or facility for receiving online medical care, they must notify the prefectural governor within ten days.

When the establisher of a hospital, clinic or birthing center, or the founder of a facility for receiving online medical care, has died or has become the subject of an adjudication of disappearance, the person who is obligated to submit a notification of such person's death or disappearance pursuant to the provisions of the Family Register Act (Act No. 224 of 1947) must notify the prefectural governor of the area in which the relevant hospital, clinic, birthing center or facility for receiving online medical care is situated of the same within ten days.

The establisher of a hospital (excluding hospitals specified by an Order of the Ministry of Health, Labour and Welfare set forth in paragraph (3); the same applies in the following paragraph) or clinic is to have it managed by a clinically trained physician where a medical practice is operated at the relevant hospital or clinic, or must have it managed by a clinically trained dentist where a dental practice is operated at the relevant hospital or clinic.

Where both a medical practice and dental practice are operated at a hospital or clinic, the establisher of the relevant hospital or clinic is to have it managed by a clinically trained physician where it is primarily for the operation of a medical practice, or must have it managed by a clinically trained dentist where it is primarily for the operation of a dental practice.

The establisher of a hospital that provides necessary support for securing medical care in an acute physician shortage area or other hospitals specified by an Order of the Ministry of Health, Labour and Welfare, in the case that the hospital is engaged in medical practice or in the case that the hospital is engaged in both medical practice and dental practice and mainly engages in medical practice, may have it managed by a clinically trained physician certified under Article 5-2, paragraph (1); provided, however, that in the case that affects the provision of medical care in the region or in other cases specified by an Order of the Ministry of Health, Labour and Welfare, the hospital may be managed by a clinically trained physician who has not been certified under Article 5-2, paragraph (1).

The establisher of an advanced treatment hospital who intends to have it managed in accordance with the provisions of the preceding Article, pursuant to the provisions of an Order of the Ministry of Health, Labour and Welfare, must appoint as its administrator a person who has the necessary ability and experience to perform the particulars listed in each item of Article 16-3, paragraph (1) and other tasks related to the management and operation of the advanced treatment hospital.

The appointment of an administrator of an advanced treatment hospital under the provisions of the preceding paragraph, pursuant to the provisions of an Order of the Ministry of Health, Labour and Welfare, must be made based on the results of the examination by a council for selecting a candidate for administrator, which consists of the establisher of the advanced treatment hospital and persons other than those who have a special relationship as specified by an Order of the Ministry of Health, Labour and Welfare.

An establisher of a birthing center must have the relevant birthing center managed by a midwife.

The establisher of a hospital, clinic, or birthing center must manage the relevant hospital, clinic, or birthing center themselves if they are a person capable of being the administrator of a hospital, clinic, or birthing center; provided, however, that it is permissible for the establisher to have another party manage where permitted by the prefectural governor of the area in which the hospital, clinic, or birthing center is situated.

The physician, dentist, or midwife who manages a hospital, clinic, or birthing center must be a person who does not manage any other hospital, clinic, or birthing center, except where permitted by the prefectural governor of the area in which the relevant hospital, clinic, or birthing center is situated as falling under any of the following items:

when intending to manage a clinic established in an acute physician shortage area;

when intending to manage a clinic established in a long-term care health facility or other facilities specified by an Order of the Ministry of Health, Labour and Welfare;

when intending to manage a clinic established in an office or other places of business for employees, etc;

when intending to manage a clinic established to secure the medical care delivery system prescribed in Article 30-3, paragraph (1) on holidays or at night in the region; or

other cases specified by an Order of the Ministry of Health, Labour and Welfare.

The establisher of a regional medical care support hospital must submit reports concerning its operation to the prefectural governor pursuant to the provisions of an Order of the Ministry of Health, Labour and Welfare.

The prefectural governor must make public the details of the reports set forth in the preceding paragraph pursuant to the provisions of an Order of the Ministry of Health, Labour and Welfare.

The establisher of an advanced treatment hospital must submit reports concerning its operation to the Minister of Health, Labour and Welfare pursuant to the provisions of an Order of the Ministry of Health, Labour and Welfare.

The Minister of Health, Labour and Welfare must make public the details of the reports set forth in the preceding paragraph pursuant to the provisions of an Order of the Ministry of Health, Labour and Welfare.

The establisher of a core hospital for clinical research must submit a report on its operations to the Minister of Health, Labour and Welfare pursuant to the provisions of an Order of the Ministry of Health, Labour and Welfare.

The Minister of Health, Labour and Welfare is to make public the content of the report prescribed in the preceding paragraph pursuant to the provisions of an Order of the Ministry of Health, Labour and Welfare.

The administrator of a clinic with facilities for the hospitalization of patients is to endeavor to ensure a system for the relevant clinic's physicians to make prompt diagnoses that enable appropriate medical treatment to be provided, even where the symptoms of a hospitalized patient change suddenly, and must ensure close cooperation with other hospitals or clinics.

The administrator of a birthing center is not to allow ten or more pregnant women, women in labor, or women resting after childbirth to be admitted at the same time; provided, however, that this does not apply to temporary and emergency admissions in the case that there are no other appropriate facilities for hospitalization or admission.

The administrator of a hospital or clinic must post the following information concerning the relevant hospital or clinic in a visible location within the relevant hospital or clinic, pursuant to the provisions of an Order of the Ministry of Health, Labour and Welfare:

the name of the administrator;

the names of practicing physicians or dentists;

the days and hours of the physicians' or dentists' practices; and

beyond those listed in the preceding three items, the particulars prescribed by an Order of the Ministry of Health, Labour and Welfare.

The administrator of a birthing center must post the following information concerning the relevant birthing center in a visible location within the relevant birthing center, pursuant to the provisions of an Order of the Ministry of Health, Labour and Welfare:

the name of the administrator;

the names of midwives engaging in services;

the midwives' working days and hours; and

beyond what is listed in the preceding three items, the particulars prescribed by an Order of the Ministry of Health, Labour and Welfare.