Medical Care Act

When a person wishes to establish a hospital, when a person who is neither a person registered pursuant to the provisions of Article 16-6, paragraph (1) of the Medical Practitioners' Act (Act No. 201 of 1948) (for a person who has been issued an order by the Minister of Health, Labour and Welfare pursuant to the provisions of Article 7-2, paragraph (1) of that Act, limited to a person registered pursuant to the provisions of paragraph (2) of that Article; hereinafter referred to as a "clinically trained physician") nor a person registered pursuant to the provisions of Article 16-4, paragraph (1) of the Dental Practitioners Act (Act No. 202 of 1948) (for a person who has been issued an order by the Minister of Health, Labour and Welfare pursuant to the provisions of Article 7-2, paragraph (1) of that Act, limited to a person registered pursuant to the provisions of paragraph (2) of that Article; hereinafter referred to as a "clinically trained dentist") wishes to establish a clinic, or when a person who is not a midwife (for a person who has been issued an order by the Minister of Health, Labour and Welfare pursuant to the provisions of Article 15-2, paragraph (1) of the Act on Public Health Nurses, Midwives and Nurses (Act No. 203 of 1948), limited to a person registered pursuant to the provisions of paragraph (3) of that Article; hereinafter the same applies in this Article, Article 8, paragraph (1) and Article 11) wishes to establish a birthing center, the person must first acquire permission to do so from the prefectural governor for the location of the relevant facility (the mayor of the city with a public health center or the mayor of the special ward in the case that the location of the relevant clinic or birthing center is within such a city with a public health center or a special ward; the same applies in Article 8, paragraph (1), Article 12, Article 24, Article 27, Article 28 and Article 29, paragraph (2)).

When a person who has established a hospital wishes to alter the number of beds, the classification of beds described in each of the following items (hereinafter referred to as "bed classifications"), or other particulars prescribed by an Order of the Ministry of Health, Labour and Welfare, when a person who is neither a clinically trained physician nor a clinically trained dentist but has established a clinic or a person who is not a midwife but has established a birthing center, wishes to alter the number of beds or other particulars prescribed by an Order of the Ministry of Health, Labour and Welfare, the same applies as in the preceding paragraph, except where prescribed by an Order of the Ministry of Health, Labour and Welfare:

psychiatric hospital beds (meaning hospital beds for the hospitalization of persons with psychiatric disorders; the same applies hereinafter):

infectious disease hospital beds (meaning hospital beds for the hospitalization of patients (including persons regarded as patients with category 1 infectious diseases, category 2 infectious diseases, pandemic influenza or similar infectious diseases, or designated infectious diseases pursuant to the provisions of Article 8 of the Act on the Prevention of Infectious Diseases and Medical Care for Patients with Infectious Diseases (Act No. 114 of 1998) (including as applied mutatis mutandis pursuant to Article 44-9 of the same Act)) with category 1 infectious diseases provided for in Article 6, paragraph (2) of the same Act, category 2 infectious diseases provided for in paragraph (3) of the same Article (except tuberculosis), pandemic influenza or similar infectious diseases provided for in paragraph (7) of the same Article, and designated infectious diseases provided for in paragraph (8) of the same Article (limited to those infectious diseases to which the provisions of Article 19 or Article 20 of the same Act apply mutatis mutandis under the provisions of Article 44-9 of the same Act), and persons found to have new infectious diseases provided for in Article 6, paragraph (9) of the same Act; the same applies hereinafter):

tuberculosis hospital beds (meaning hospital beds for the hospitalization of tuberculosis patients; the same applies hereinafter):

long-term care beds (meaning hospital or clinic beds other than those described in the above three items that are primarily for the hospitalization of patients requiring long-term recuperation; the same applies hereinafter): or

general beds (meaning hospital or clinic beds other than those described in each of the above items; the same applies hereinafter).

When a person wishes to provide beds in a clinic, or when the person wishes to alter the number of beds in a clinic, the bed classifications, or other particulars prescribed by an Order of the Ministry of Health, Labour and Welfare, the person must first acquire permission to do so from the prefectural governor of the area in which the relevant clinic is situated, except where prescribed by an Order of the Ministry of Health, Labour and Welfare.

Where there has been an application for permission as set forth in the preceding three paragraphs, the prefectural governor, mayor of a city with a public health center or mayor of a special ward must grant permission as set forth in the preceding three paragraphs if the buildings, equipment, and personnel of the facility pertaining to the relevant application comply with the requirements prescribed by the Order of the Ministry of Health, Labour and Welfare set forth in Article 21 and Article 23 and the Prefectural Ordinance set forth in Article 21.

A prefectural governor, when granting permission on an application for permission to establish a hospital, to increase the number of beds or alter bed classifications of a hospital, to set up beds in a clinic, or to increase the number of beds or alter bed classifications of a clinic, may attach to that permission the condition of providing, in the beds pertaining to the relevant application, medical care pertaining to those of the functional classifications of beds prescribed in Article 30-13, paragraph (1) (hereinafter referred to as "functional classification of beds" in this paragraph) for which the number of existing beds according to the functional classification of beds in the vision area (meaning the "vision area" prescribed in Article 30-3-3, paragraph (2), item (ii), which is specified in a regional medical care vision prescribed in Article 30-3-3, paragraph (1) (hereinafter referred to as the "regional medical care vision" in this paragraph, paragraph (3), item (ii) and paragraph (7) of the following Article, Article 7-3, paragraph (1) and Article 7-4, paragraph (1)); the same applies in paragraph (3) of the following Article, Article 7-3, paragraph (1) and Article 7-4, paragraph (1)) including the location of the hospital or clinic pertaining to the relevant application has not reached the future requirements for the number of beds (meaning the future requirements for the number of beds prescribed in Article 30-3-3, paragraph (2), item (iv); the same applies in paragraph (3), item (ii) of the following Article, Article 7-3, paragraph (1) and Article 7-4, paragraph (1), item (i)) in the relevant vision area specified in the regional medical care vision, or any other condition specified by an Order of the Ministry of Health, Labour and Welfare as necessary for the promotion of the achievement of the regional medical care vision.

In the case where a prefecture conducts the affairs relating to the permission set forth in paragraphs (1) to (3) pursuant to the provisions of Article 30-4, paragraph (9), or conducts the affairs relating to those permissions pursuant to the provisions of paragraph (10) of that Article, when it is found that the circumstances specified by the Cabinet Order set forth in paragraph (9) of that Article have ceased to exist, or when operations relating to beds are no longer carried out in the beds specified by the Order of the Ministry of Health, Labour and Welfare set forth in paragraph (10) of that Article, conditions may be attached to those permissions, namely taking measures to change the permission, the content of which is to reduce the number of specially permitted beds within the range of the number of beds that exceeds the target number of beds, and other conditions specified by Order of the Ministry of Health, Labour and Welfare as necessary for ensuring the medical care delivery system prescribed in Article 30-3, paragraph (1); here, the number is the number of hospital or clinic beds corresponding to the bed classifications of the beds to which the relevant permission relates (where the specially permitted beds are long-term care beds, etc. only, the total number of long-term care beds and general beds in that area) in the area that includes the location of the hospital or clinic to which the relevant permission relates (where the beds to which the relevant permission relates (hereinafter referred to as "specially permitted beds" in this paragraph) are long-term care beds or general beds (hereinafter referred to as "long-term care beds, etc." in this Section) only, this is to be the area provided for in Article 30-4, paragraph (2), item (xii) as prescribed by the medical care plan (meaning the medical care plan prescribed in paragraph (1) of that Article; hereinafter referred to as the "medical care plan" in this paragraph, the following Article and Article 7-4, paragraph (1), item (ii)); where the specially permitted beds are psychiatric hospital beds, infectious disease hospital beds or tuberculosis hospital beds (hereinafter referred to as "psychiatric hospital beds, etc." in this paragraph and paragraph (1) of the following Article) only, this is to be the area of the prefecture; and where the specially permitted beds 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), and the target number of beds is the target number of beds for that area corresponding to the bed classifications of the beds to which the relevant permission relates (where the specially permitted beds are long-term care beds, etc. only, the target number of beds for long-term care beds and general beds in that area) as prescribed in the medical care plan in accordance with the standards specified by Order of the Ministry of Health, Labour and Welfare set forth in Article 30-4, paragraph (7).

Notwithstanding the provisions of paragraph (4), the permission set forth in paragraph (1) may be refused to a person who wishes to establish a hospital, clinic or birthing center for profit.