Medical Care Act

A prefecture, if it finds it necessary for the preparation of the regional medical care vision or the medical care plan, or for the execution of activities based on the medical care plan, may request the delivery of any necessary information from the municipalities and other public offices, medical insurers provided for in Article 7, paragraph (7) of the Long-Term Care Insurance Act (referred to as "medical insurers" in Article 30-14, paragraph (1) and Article 30-18-5, paragraph (1)), or establishers, administrators or founders of medical institutions, including information concerning the functions of medical institutions within the boundaries of the relevant prefecture.

The prefecture, every three years, must inspect, analyze and evaluate the particulars listed in Article 30-4, paragraph (2), items (vi), (viii) and (ix), and, out of the particulars listed in the following items, those relating to the particulars listed in items (vi), (viii) and (ix) of that paragraph and other particulars specified by an Order of the Ministry of Health, Labour and Welfare (referred to as "specified particulars" in the following paragraph), and is to revise the medical care plan of the relevant prefecture when it finds it necessary:

particulars listed in each item of Article 30-4, paragraph (2) (excluding items (vi), (viii) and (ix)); and

if the medical care plan stipulates the particulars listed in each item of Article 30-4, paragraph (3), particulars listed in the relevant items.

The prefecture, every six years, inspect, is to analyze and evaluate the particulars listed in each item of the preceding paragraph (excluding specified particulars), and is to revise the medical care plan of the relevant prefecture when it finds it necessary.

Establishers, administrators and founders of medical institutions are to endeavor to cooperate as necessary in the construction of the medical care coordination system, in order to contribute to the implementation of the regional medical care vision and the medical care plan.

Establishers and administrators of medical institutions listed in the following items, when providing the necessary cooperation set forth in the preceding paragraph, are to endeavor to fulfill the roles prescribed in the respective items, while coordinating their operations with those of other medical institutions, in order to efficiently provide high-quality and appropriate medical care:

hospitals:To secure necessary medical care in the community by cooperating in the promotion of differentiation and coordination of the medical institution functions and bed functions in the community, according to the medical institution functions and bed functions; and

clinics with beds:To provide the following medical care and ensure other necessary medical care in the community so that patients can lead their daily lives in their familiar communities, according to the content of the medical care they provide:

to provide medical care necessary for patients discharged from hospitals to make a smooth transition to in-home medical treatment;

to provide necessary in-home medical care; and

to hospitalize patients and provide them with necessary medical care when their condition suddenly changes or otherwise when hospitalization is necessary.

Administrators of hospitals or clinics are to provide in-home medical care, and are to seek cooperation with welfare services and endeavor to give the necessary support for the provision of in-home medical care, in order to contribute to the implementation of the regional medical care vision and the medical care plan.

Establishers and administrators of hospitals are to endeavor to allow the use of all or parts of the hospital's buildings, equipment, instruments, and tools by physicians, dentists, or pharmacists who do not work at the relevant hospital in their practice, research, or training, provided there is no hindrance to the medical care services of the relevant hospital, in order to contribute to the implementation of the regional medical care vision and the medical care plan.

The Minister of Health, Labour and Welfare may provide the necessary advice to the prefectures regarding the method of preparing medical care plans and other key practical particulars regarding the preparation of medical care plans.

In addition to what is provided for in the preceding paragraph, the Minister of Health, Labour and Welfare is to provide the necessary advice to prefectures regarding the implementation of the particulars listed in Article 30-4, paragraph (2), items (iv) to (vi) as prescribed in the medical care plan, so that the setting of the targets set forth in item (i) of that paragraph, effective initiatives for achieving those targets, and the implementation of evaluations of the effects of those initiatives are comprehensively promoted.

The national government may provide subsidies to prefectures for part of the costs required for activities based on medical care plans, within the extent of the budget, in order to promote the fulfillment of medical care plans.

National government and local governments are to endeavor to undertake any necessary measures, including improving hospitals or clinics in areas with insufficient hospitals or clinics, promoting the differentiation and coordination of the medical institution functions and bed functions in the community and ensuring the availability of physicians, in order to promote the fulfillment of the regional medical care vision and medical care plans.

Beyond what is set forth in the preceding paragraph, the national government is to endeavor to improve the system for providing medical care as necessary on a cross-regional level which extends beyond prefectural boundaries.

The prefectural governor, where it is specifically necessary in order to promote the fulfillment of the regional medical care vision and the medical care plan, may hear the opinions of the Prefectural Council on Medical Service Facilities, and recommend that a person who wishes to establish a hospital or clinic, or an establisher or administrator of a hospital or clinic, establish a hospital, increase a hospital's number of beds, or change its bed classifications, or recommend that such a person establish beds in a clinic or increase the number of beds in a clinic.

When a person who wishes to establish a hospital or clinic, or the establisher or administrator of a hospital or clinic, who has received a recommendation under the provisions of the preceding paragraph does not comply with it, the prefectural governor is to notify the Minister of Health, Labour and Welfare to that effect.

The provisions of Article 7-2, paragraphs (8) through (10) apply mutatis mutandis to hospitals established by persons other than those listed in each item of paragraph (1) of the same Article (limited to those having long-term care beds or general beds) or clinics (limited to those setting up beds with permission under Article 7, paragraph (3)), when it is especially necessary for promoting the achievement of the medical care plan. In this case, the term "order" in Article 7-2, paragraph (8) is replaced with "request", the term "paragraphs (1) through (3) and the preceding paragraph" in paragraph (9) of the same Article is replaced with "the preceding paragraph", the term "area and the relevant vision area" is replaced with "area", the term "the number of existing beds and the number of beds to which the relevant application relates" is replaced with "the number of beds", the term "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)" in paragraph (10) of the same Article is replaced with "issue an order pursuant to the provisions of paragraph (8)", and the term "issue an order" is replaced with "issue a request".

When a prefectural governor finds that the establisher or administrator of a hospital or clinic that has received a request under Article 7-2, paragraph (8) as applied mutatis mutandis by replacing the terms in accordance with the preceding paragraph has not taken measures pertaining to the relevant request without justifiable grounds, the prefectural governor may recommend that the relevant establisher or administrator of the hospital or clinic should take the relevant measures, after hearing the opinions of the Prefectural Council on Medical Service Facilities.

In the case where a prefectural governor has made a recommendation under the preceding paragraph, the governor, if the establisher or administrator of a hospital or clinic that has received the relevant recommendation fails to comply with it, may make a public announcement to that effect.

Upon request from a prefectural governor, the Minister of Health, Labour and Welfare is to register as a disaster and infectious disease medical care worker a person who has consented to be dispatched to an area where a disaster has occurred, or an area where an infectious disease that may seriously affect the lives and health of the people through its spread has spread or is at risk of spreading, and to engage in operations relating to ensuring the medical care listed in Article 30-4, paragraph (2), item (v), (b) or (c) (limited to a physician, nurse or other person who has the knowledge and skills necessary for those operations and who satisfies the standards specified by Order of the Ministry of Health, Labour and Welfare, such as having completed a training course conducted by the Minister of Health, Labour and Welfare).

The registration under the preceding paragraph is to be made, as provided by Order of the Ministry of Health, Labour and Welfare, upon application by a person who has consented to engage in the operations prescribed in that paragraph.

In the case where any of the following applies to a disaster and infectious disease medical care worker under paragraph (1) of the preceding Article (hereinafter referred to as a "disaster and infectious disease medical care worker" in this Section), the Minister of Health, Labour and Welfare must delete the registration:

when the person has applied for deletion of the registration;

when the Minister has come to know that the person has died.

In the case where any of the following applies to a disaster and infectious disease medical care worker, the Minister of Health, Labour and Welfare may delete the registration:

when it is found that the person no longer satisfies the standards specified by Order of the Ministry of Health, Labour and Welfare set forth in paragraph (1) of the preceding Article;

when the person has received registration on the basis of false or wrongful facts; or

when there has been a crime or wrongful act in relation to the operations prescribed in paragraph (1) of the preceding Article.

Upon request from a prefectural governor, the Minister of Health, Labour and Welfare may, to the extent necessary for the implementation of the provisions of this Section, provide to the prefectural governor information that the Minister holds concerning disaster and infectious disease medical care workers and that is specified by Order of the Ministry of Health, Labour and Welfare.

The Minister of Health, Labour and Welfare may entrust the affairs relating to the training and registration under Article 30-12-2, paragraph (1) and the affairs relating to the provision of information under the preceding Article to a person designated by the Minister of Health, Labour and Welfare.

A person entrusted pursuant to the provisions of the preceding paragraph may, with the approval of the Minister of Health, Labour and Welfare, re-entrust all or part of the affairs entrusted to them pursuant to the provisions of that paragraph to another person.