Medical Care Act

In the case where the reference date bed functions and the bed functions after the reference date pertaining to a report under the provisions of Article 30-13, paragraph (1) are different, or in other cases specified by an Order of the Ministry of Health, Labour and Welfare, the prefectural governor, if the number of beds of hospitals, etc. subject to a report on medical institution functions, etc. in the vision area including the location of the hospital, etc. subject to a report on medical institution functions, etc. having filed the relevant report (hereinafter referred to as a "reporting hospital, etc." in this Article), according to the functional classification of beds pertaining to the bed functions after the reference date pertaining to the relevant report, has already reached the future requirements for the number of beds in the relevant vision area as specified in the regional medical care vision according to the functional classification of beds pertaining to the bed functions after the reference date pertaining to the relevant report, may request the establisher or administrator of a reporting hospital, etc. to submit a document stating the reasons why the reference date bed functions and the bed functions after the reference date pertaining to the relevant report are different, and other particulars specified by an Order of the Ministry of Health, Labour and Welfare (hereinafter referred to as "reasons, etc." in this Article).

When the prefectural governor finds that the reasons, etc. stated in the document set forth in the preceding paragraph are not sufficient, the governor may request the establisher or administrator of the relevant reporting hospital, etc. to participate in the consultation at the place of consultation.

The establisher or administrator of a reporting hospital, etc., when requested by the prefectural governor under the preceding paragraph, must endeavor to respond to the request.

When no agreement is 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, the prefectural governor may request the establisher or administrator of the relevant reporting hospital, etc. to attend a meeting of the Prefectural Council on Medical Service Facilities and explain the relevant reasons, etc.

The establisher or administrator of a reporting hospital, etc., when requested by the prefectural governor under the preceding paragraph, must endeavor to attend a meeting of the Prefectural Council on Medical Service Facilities and explain the relevant reasons, etc.

If the relevant 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, the prefectural governor may order the establisher or administrator of the reporting hospital, etc. (limited to those established by the persons listed in the items of Article 7-2, paragraph (1)) not to change the reference date bed functions pertaining to a report under the provisions of Article 30-13, paragraph (1) to the bed functions after the reference date pertaining to the relevant report and to take other necessary measures, after hearing the opinions of the Prefectural Council on Medical Service Facilities.

The provisions of the preceding paragraph apply mutatis mutandis to a reporting hospital, etc. established by a person other than those listed in the items of Article 7-2, paragraph (1), when it is especially necessary for promoting the achievement of the regional medical care vision. In this case, the term "order" in the preceding paragraph is replaced with "request".

The prefectural governor, when no agreement is reached through consultation at the place of consultation on particulars necessary to promote the achievement of the regional medical care vision, or when otherwise specified by an Order of the Ministry of Health, Labour and Welfare, may instruct the establisher or administrator of a hospital, etc. subject to a report on medical institution functions, etc. (limited to those established by the persons listed in the items of Article 7-2, paragraph (1)) in the vision area, etc. to provide medical care pertaining to those of the functional classifications of beds for which the number of existing beds according to the functional classification of beds in the vision area pertaining to the relevant vision area, etc. has not reached the future requirements for the number of beds in the relevant vision area specified in the regional medical care vision, and to take other necessary measures, after hearing the opinions of the Prefectural Council on Medical Service Facilities.

The provisions of the preceding paragraph apply mutatis mutandis to a hospital, etc. subject to a report on medical institution functions, etc. established by a person other than those listed in the items of Article 7-2, paragraph (1), when it is especially necessary for promoting the achievement of the regional medical care vision. In this case, the term "instruct" in the preceding paragraph is replaced with "request".

When the prefectural governor finds that the establisher or administrator of a hospital, etc. subject to a report on medical institution functions, etc. who has received a request under Article 30-15, paragraph (6) as applied mutatis mutandis by replacing the terms in accordance with paragraph (7) of the same Article, or under paragraph (1) of the preceding Article as applied mutatis mutandis by replacing the terms in accordance with paragraph (2) of the same Article has not taken measures pertaining to the relevant request without justifiable grounds, the governor may recommend that the relevant establisher or administrator of a hospital, etc. subject to a report on medical institution functions, etc. should take the relevant measures, after hearing the opinions of the Prefectural Council on Medical Service Facilities.

In the event that a prefectural governor has issued an order under the provisions of Article 30-15, paragraph (6), an instruction under the provisions of Article 30-16, paragraph (1), or a recommendation under the provisions of the preceding Article, and the establisher or administrator of a hospital, etc. subject to a report on medical institution functions, etc. who has received the relevant order, instruction or recommendation fails to comply with it, the prefectural governor may make a public announcement to that effect.

The administrator of a hospital, etc. subject to a report on medical institution functions, etc. that provides outpatient medical care (hereinafter referred to as a "hospital, etc. subject to a report on outpatient functions" in this Article) must, in order to promote the differentiation and coordination of the functions of hospitals and clinics relating to outpatient medical care in the region, report the following particulars to the prefectural governor of the location of the hospital, etc. subject to a report on outpatient functions, pursuant to an Order of the Ministry of Health, Labour and Welfare:

the details of the outpatient medical care provided at the hospital, etc. subject to a report on outpatient functions that falls under the outpatient medical care specified by an Order of the Ministry of Health, Labour and Welfare as medical care in providing which medical care professionals or pharmaceuticals, medical devices and other supplies related to medical care are intensively utilized;

in the case where the hospital, etc. subject to a report on outpatient functions intends to play, in the region, the role of a core hospital or clinic that provides the outpatient medical care specified by an Order of the Ministry of Health, Labour and Welfare under the preceding item, that fact; and

other particulars prescribed by Order of the Ministry of Health, Labour and Welfare.

If the administrator of a hospital, etc. subject to a report on outpatient functions fails to make a report pursuant to the provisions of paragraph (1) (excluding the part pertaining to item (ii)) or has made a false report, the prefectural governor may order the establisher of the relevant hospital, etc. subject to a report on outpatient functions to have the relevant administrator give the relevant report or correct the details of the relevant report within a period that the governor prescribes.

The provisions of Article 30-13, paragraphs (3), (4) and (6) apply mutatis mutandis to a report under the provisions of paragraph (1). In this case, the term "hospital, etc. subject to a report on medical institution functions, etc." in paragraph (3) of that Article is replaced with "hospital, etc. subject to a report on outpatient functions", and the term "preceding paragraph" in paragraph (6) of that Article is replaced with "Article 30-18-2, paragraph (2)", and "hospital, etc. subject to a report on medical institution functions, etc." with "hospital, etc. subject to a report on outpatient functions".

The administrator of a clinic that does not have facilities for admitting patients (hereinafter referred to as a "clinic without beds" in this Article) may, in order to promote the differentiation and coordination of the functions of hospitals and clinics relating to outpatient medical care in the region, report the following particulars to the prefectural governor of the location of the clinic without beds, pursuant to an Order of the Ministry of Health, Labour and Welfare:

the details of the outpatient medical care provided at the clinic without beds that falls under the outpatient medical care specified by an Order of the Ministry of Health, Labour and Welfare under paragraph (1), item (i) of the preceding Article;

in the case where the clinic without beds intends to play, in the region, the role of a core clinic that provides the outpatient medical care specified by an Order of the Ministry of Health, Labour and Welfare under paragraph (1), item (i) of the preceding Article, that fact; and

other particulars prescribed by Order of the Ministry of Health, Labour and Welfare.

The provisions of Article 30-13, paragraphs (3) and (4) apply mutatis mutandis to a report under the provisions of the preceding paragraph. In this case, the term "hospital, etc. subject to a report on medical institution functions, etc." in paragraph (3) of that Article is replaced with "clinic without beds".

The administrator of a hospital or clinic specified by an Order of the Ministry of Health, Labour and Welfare as necessary for ensuring the primary care function in the region (hereinafter referred to as a "hospital, etc. subject to a report on primary care functions" in this Article) must, in order to ensure the primary care function for elderly persons with chronic diseases and other persons requiring continuous medical care as specified by an Order of the Ministry of Health, Labour and Welfare (referred to as "persons requiring continuous medical care" in items (i) and (ii)), report the following particulars to the prefectural governor of the location of the hospital, etc. subject to a report on primary care functions, pursuant to an Order of the Ministry of Health, Labour and Welfare:

whether or not there is, and the details of, the function (limited to that specified by an Order of the Ministry of Health, Labour and Welfare), among the primary care function, of comprehensively and continuously providing persons requiring continuous medical care with medical care for frequently occurring diseases and other day-to-day medical care;

in the case of a hospital, etc. subject to a report on primary care functions that has the function prescribed in the preceding item, whether or not there is, and the details of, each of the following functions among the primary care function for persons requiring continuous medical care (limited, for the functions listed in (a) through (d), to those specified by an Order of the Ministry of Health, Labour and Welfare);

the function of providing medical care outside the regular consultation hours of the hospital, etc. subject to a report on primary care functions;

the function of providing the support necessary for admitting patients as inpatients when their condition suddenly worsens or in other cases where hospitalization is necessary, or for enabling a person leaving a hospital or clinic who continues to require medical treatment to make a smooth transition to medical treatment at another hospital, clinic, long-term care health facility, integrated facility for medical and long-term care, or home, etc.;

the function of providing necessary medical care at home, etc.;

the function of providing necessary medical care in coordination with persons providing long-term care and other services closely related to medical care; and

other functions specified by an Order of the Ministry of Health, Labour and Welfare;

when the hospital, etc. subject to a report on primary care functions and another hospital or clinic ensure the function prescribed in the preceding item by coordinating with each other pursuant to an Order of the Ministry of Health, Labour and Welfare, the name of the other hospital or clinic and the details of that coordination; and

other particulars prescribed by Order of the Ministry of Health, Labour and Welfare.

The prefectural governor, pursuant to an Order of the Ministry of Health, Labour and Welfare, is to confirm that a hospital, etc. subject to a report on primary care functions that has made a report under the provisions of the preceding paragraph (limited to one that has reported that it has any of the functions prescribed in item (ii), (a) through (e) of that paragraph) has, for the function pertaining to that report, a system for ensuring that function that meets the requirements specified by an Order of the Ministry of Health, Labour and Welfare (including where it ensures that function by coordinating with another hospital or clinic).

When the prefectural governor has made the confirmation under the preceding paragraph, the governor is to report the result to the place of consultation prescribed in paragraph (1) of the following Article and to make it public, pursuant to an Order of the Ministry of Health, Labour and Welfare.

The administrator of a hospital, etc. subject to a report on primary care functions that has received the confirmation under the provisions of paragraph (2) must, when a change has occurred in the system for which the confirmation was received, report that fact to the prefectural governor, pursuant to an Order of the Ministry of Health, Labour and Welfare. In this case, the prefectural governor who has received the report is to confirm that the system in which the change has occurred meets the requirements specified by an Order of the Ministry of Health, Labour and Welfare under that paragraph (including where it ensures the relevant function prescribed in that paragraph by coordinating with another hospital or clinic).

The provisions of paragraph (3) apply mutatis mutandis to the confirmation under the provisions of the preceding paragraph.

When the administrator of a hospital, etc. subject to a report on primary care functions has failed to make a report pursuant to the provisions of paragraph (1) or (4) or has made a false report, the prefectural governor may order the establisher of the relevant hospital, etc. subject to a report on primary care functions to have the relevant administrator make a report or correct the contents of the report, by setting a period of time.

The provisions of Article 30-13, paragraphs (3), (4) and (6) apply mutatis mutandis to reports by hospitals, etc. subject to a report on primary care functions under the provisions of paragraphs (1) and (4). In this case, the term "the preceding paragraph" in paragraph (6) of that Article is replaced with "Article 30-18-4, paragraph (6)".