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Read the text in force →国民健康保険法
Chapter IV Insurance Benefits (Articles 54-2-2 to 54-3)
The law as Act Partially Amending the Health Insurance Act, etc. (Act No. 31 of 2026) leaves it, with the words it changes marked.
The main text is read a page at a time: a chapter to a page, and a long chapter in runs of articles. The whole main text, and the supplementary provisions and appended tables this amendment changes. Those it leaves untouched are on the page for the text in force.
Guidance by the Minister of Health, Labour and Welfare or prefectural governors must be received by each designated home-nursing provider and nurses and other employees at the office relevant to its designation with respect to designated home-nursing.
指定訪問看護事業者及び当該指定に係る事業所の看護師その他の従業者は、指定訪問看護に関し、厚生労働大臣又は都道府県知事の指導を受けなければならない。
When the Minister of Health, Labour and Welfare or a prefectural governor finds it necessary in relation to the payment of medical expenses for home-nursing, said minister or governor may order a designated home-nursing provider or an entity which was a designated home-nursing provider or any of the persons who were nurses or other employees at the office relevant to such designation (hereinafter referred to as a "Former Designated Home-nursing Business, etc." in this paragraph) to make a report or submit or present the books and other documents, may request a designated home-nursing provider or nurses or other employees at the office relevant to its designation (including Former Designated Home-nursing Businesses, etc.) to appear, or may have personnel question persons involved or inspect the books and other documents or other articles of such designated home-nursing provider at the office relevant to its designation.
厚生労働大臣又は都道府県知事は、訪問看護療養費の支給に関して必要があると認めるときは、指定訪問看護事業者又は指定訪問看護事業者であつた者若しくは当該指定に係る事業所の看護師その他の従業者であつた者（以下この項において「指定訪問看護事業者であつた者等」という。）に対し報告若しくは帳簿書類の提出若しくは提示を命じ、指定訪問看護事業者若しくは当該指定に係る事業所の看護師その他の従業者（指定訪問看護事業者であつた者等を含む。）に対し出頭を求め、又は当該職員に関係者に対して質問させ、若しくは当該指定訪問看護事業者の当該指定に係る事業所について帳簿書類その他の物件を検査させることができる。
The provisions of Article 45-2, paragraph (2) shall apply mutatis mutandis to questions asked or inspections conducted pursuant to the provisions of the preceding paragraph, and the provisions of paragraph (3) of the same Article shall apply mutatis mutandis to the authority under the provisions of the preceding paragraph.
第四十五条の二第二項の規定は、前項の規定による質問又は検査について、同条第三項の規定は、前項の規定による権限について準用する。
When a prefectural governor finds it necessary that a disposition be made pursuant to the provisions of Article 95 of the Health Insurance Act with respect to a designated home-nursing provider in relation to designated home-nursing provided under this Act, said governor must notify the Minister of Health, Labour and Welfare thereof, together with the reason therefor.
都道府県知事は、指定訪問看護事業者につきこの法律による指定訪問看護に関し健康保険法第九十五条の規定による処分が行われる必要があると認めるときは、理由を付して、その旨を厚生労働大臣に通知しなければならない。
In the case where a Householder who is in arrears with insurance premiums (limited to a Householder who has a domicile within the area of the Municipality) or a Society member who is in arrears with insurance premiums (excluding a Householder or Society member all of whose insured persons belonging to the household are able to receive payment of general medical expenses under the Atomic Bomb Survivors' Assistance Act (Act No. 117 of 1994) or other benefits relating to medical care specified by Order of the Ministry of Health, Labour and Welfare (referred to as "payment of general medical expenses for atomic bomb survivors, etc." in this paragraph and paragraph (45)); hereinafter referred to as a "householder, etc. in arrears with insurance premiums" in this Article) still does not pay those insurance premiums during the period until the period specified by Order of the Ministry of Health, Labour and Welfare has elapsed from the due date for payment of those insurance premiums even though the Municipality or Society concerned has taken measures contributing to payment of insurance premiums specified by Order of the Ministry of Health, Labour and Welfare, such as encouraging payment of those insurance premiums and ensuring opportunities for consultation on payment of those insurance premiums (referred to as "encouragement of insurance premium payment, etc." in the following paragraph and Article 63-2, paragraphs (1) and (2)), then, except where it is found that there are special circumstances specified by Cabinet Order, such as a disaster, in the arrears of those insurance premiums, when an insured person belonging to that household (excluding persons able to receive payment of general medical expenses for atomic bomb survivors, etc. and persons in the period until the first March 31 on or after the day on which they reach the age of 18; the same applies hereinafter in this Article (excluding paragraphs (45) and (56))) receives medical treatment from a health insurance-covered medical institution, etc. or receives designated home nursing from a designated home-nursing provider, Municipalities and Societies are to pay special medical expenses to the householder, etc. in arrears with insurance premiums with respect to the expenses incurred in that medical treatment or designated home nursing, in lieu of benefits for medical treatment or payment of expenses for Dietary Treatment for inpatients, etc. (meaning expenses for Dietary Treatment for inpatients, Living Support expenses for inpatients, medical expenses combined with treatment outside insurance coverage, medical expenses or medical expenses for home-nursing; the same applies in paragraphs (45) and (56)) (referred to as "Benefits for Medical Treatment, etc." in the following paragraph and paragraph (56)).
市町村及び組合は、保険料を滞納している世帯主（当該市町村の区域内に住所を有する世帯主に限る。）又は組合員（その世帯に属する全ての被保険者が原子爆弾被爆者に対する援護に関する法律（平成六年法律第百十七号）による一般疾病医療費の支給その他厚生労働省令で定める医療に関する給付（以下この項及び第四五項において「原爆一般疾病医療費の支給等」という。）を受けることができる世帯主又は組合員を除く。以下この条において「保険料滞納世帯主等」という。）が、当該保険料の納期限から厚生労働省令で定める期間が経過するまでの間に、当該市町村又は組合が当該保険料の納付の勧奨及び当該保険料の納付に係る相談の機会の確保その他厚生労働省令で定める保険料の納付に資する取組（次項並びに第六十三条の二第一項及び第二項において「保険料納付の勧奨等」という。）を行つてもなお当該保険料を納付しない場合においては、当該保険料の滞納につき災害その他の政令で定める特別の事情があると認められる場合を除き、当該世帯に属する被保険者（原爆一般疾病医療費の支給等を受けることができる者及び十八歳に達する日以後の最初の三月三十一日までの間にある者を除く。以下この条（第四五項及び第五六項を除く。）において同じ。）が保険医療機関等から療養を受けたとき、又は指定訪問看護事業者から指定訪問看護を受けたときは、その療養又は指定訪問看護に要した費用について、療養の給付又は入院時食事療養費等（入院時食事療養費、入院時生活療養費、保険外併用療養費、療養費又は訪問看護療養費をいう。第四五項及び第五六項において同じ。）の支給（次項及び第五六項において「療養の給付等」という。）に代えて、当該保険料滞納世帯主等に対し、特別療養費を支給する。
Even before the period specified by Order of the Ministry of Health, Labour and Welfare prescribed in the preceding paragraph has elapsed, in the case where a householder, etc. in arrears with insurance premiums still does not pay the insurance premiums even though the Municipality or Society concerned has carried out encouragement of insurance premium payment, etc., when an insured person belonging to the household receives medical treatment from a health insurance-covered medical institution, etc. or receives designated home nursing from a designated home-nursing provider, Municipalities and Societies may pay special medical expenses to that householder, etc. in arrears with insurance premiums with respect to the expenses incurred in that medical treatment or designated home nursing, in lieu of Benefits for Medical Treatment, etc.; provided, however, that this does not apply when it is found that there are special circumstances specified by Cabinet Order in that paragraph.
市町村及び組合は、前項に規定する厚生労働省令で定める期間が経過する前においても、当該市町村又は組合が保険料納付の勧奨等を行つてもなお保険料滞納世帯主等が当該保険料を納付しない場合においては、その世帯に属する被保険者が保険医療機関等から療養を受けたとき、又は指定訪問看護事業者から指定訪問看護を受けたときは、その療養又は指定訪問看護に要した費用について、療養の給付等に代えて、当該保険料滞納世帯主等に対し、特別療養費を支給することができる。ただし、同項の政令で定める特別の事情があると認められるときは、この限りでない。
When paying special medical expenses pursuant to the provisions of paragraph (1) or the main clause of the preceding paragraph, Municipalities and Societies are to notify in advance the householder, etc. in arrears with insurance premiums, as provided by Order of the Ministry of Health, Labour and Welfare, that special medical expenses will be paid when an insured person belonging to the household receives medical treatment from a health insurance-covered medical institution, etc. or receives designated home nursing from a designated home-nursing provider.
市町村及び組合は、第一項又は前項本文の規定により特別療養費を支給するときは、あらかじめ、厚生労働省令で定めるところにより、保険料滞納世帯主等に対し、その世帯に属する被保険者が保険医療機関等から療養を受けたとき、又は指定訪問看護事業者から指定訪問看護を受けたときは、特別療養費を支給する旨を通知するものとする。
In the case where a householder, etc. in arrears with insurance premiums who is subject to the application of paragraph (1) or the main clause of paragraph (2) has paid the arrears of insurance premiums in full, or where it is found that there are special circumstances specified by Cabinet Order, such as a significant decrease in theThe amount in arrears pertaining to that person or a disaster, or where an insured person belonging to that household has become a person able to receive payment of generalspecial medical expenses for atomic bomb survivors, etc., when an insured person belonging to the household ofshall be the Householder or Society member who falls under these cases (amount specified in the case where an insured person belonging toitem (i) (or the household of that householder, etc. in arrears with insurance premiums has become a person able to receive paymenttotal sum of general medical expenses for atomic bomb survivors, etc., limited to that insured person;such amount and the same applies hereinafteramount specified in this paragraph and the following paragraph) receives medical treatment from a health insurance-covered medical institution, etc. item (ii) or receives designated home nursing from a designated home-nursing provider, Municipalities and Societies are to provide benefits for(iii) when such medical treatment to the insured person belonging to the household of that Householder or Society member, or pay expenses forincludes Dietary Treatment for inpatients, etc. to that Householder or Society member.and Living Support, respectively):
市町村及び組合特別療養費の額は、第一項又は第二項本文の規定の適用を受けている保険料滞納世帯主等が滞納している保険料を完納した場合若しくはその者に係る滞納額の著しい減少、災害その他の政令で定める特別の事情があると認められる場合又はその世帯に属する被保険者が原爆一般疾病医療費の支給等を受けることができる者となつた場合において、これらの場合に該当する世帯主又は組合員の世帯に属する被保険者（当該保険料滞納世帯主等の世帯に属する被保険者が原爆一般疾病医療費の支給等を受けることができる者となつた場合にあつては号に規定する額（当該療養に食事療養が含まれるときは、当該額及び第二号に規定する額の合算額、当該被保険者に限る。以下この項及び次項において同じ。）が保険医療機関等から療養を受けたとき、又は指定訪問看護事業者から指定訪問看護を受けた療養に生活療養が含まれるときは、当該世帯主若しくは組合員の世帯に属する被保険者に対し療養の給付を行い、又は当該世帯主若しくは組合員に対し入院時食事療養費等を支給額及び第三号に規定する額の合算額）とする。
the amount obtained by deducting, with respect to such medical treatment (excluding Dietary Treatment and Living Support), from the amount specified in the one of (a) through (d) below that applies to the relevant case, the amount obtained by multiplying that amount by the ratio listed in the items of Article 42, paragraph (1), in accordance with the categories listed in the items of that paragraph (or, where the ratio of co-payment has been reduced pursuant to the provisions of Article 43, paragraph (1), the ratio after such reduction) (or, if any of the measures listed in the items of Article 44, paragraph (1) needs to be taken with respect to the co-payment set forth in Article 42, paragraph (1) for benefits for medical treatment, the amount calculated as if those measures were taken);
当該療養（食事療養及び生活療養を除く。）につき、次のイからニまでに掲げる場合の区分に応じ、当該イからニまでに定める額から、その額に第四十二条第一項各号の区分に応じ、同項各号に掲げる割合（第四十三条第一項の規定により一部負担金の割合が減ぜられたときは、当該減ぜられた割合とする。）を乗じて得た額（療養の給付に係る第四十二条第一項の一部負担金について第四十四条第一項各号の措置が採られるべきときは、当該措置が採られたものとした場合の額とする。）を控除した額
in cases where benefits for medical treatment can be received: the amount of expenses calculated in accordance with the rules prescribed by the Minister of Health, Labour and Welfare pursuant to the provisions of Article 76, paragraph (2) of the Health Insurance Act (or, when said amount exceeds the amount of expenses actually incurred in such medical treatment, such amount of expenses actually incurred in such medical treatment);
療養の給付を受けることができる場合 健康保険法第七十六条第二項の規定による厚生労働大臣の定めの例により算定した費用の額（その額が現に当該療養に要した費用の額を超えるときは、当該現に療養に要した費用の額とする。）
in cases prescribed in Article 53, paragraph (2) where payment of medical expenses combined with treatment outside insurance coverage can be received: the amount of expenses calculated in accordance with the rules prescribed by the Minister of Health, Labour and Welfare pursuant to the provisions of Article 86, paragraph (2), item (i) of the Health Insurance Act (or, when said amount exceeds the amount of expenses actually incurred in such medical treatment, such amount of expenses actually incurred in such medical treatment);
第五十三条第二項に規定する場合であつて、保険外併用療養費の支給を受けることができる場合 健康保険法第八十六条第二項第一号の規定による厚生労働大臣の定めの例により算定した費用の額（その額が現に当該療養に要した費用の額を超えるときは、当該現に療養に要した費用の額とする。）
in cases prescribed in Article 53, paragraph (3) where payment of medical expenses combined with treatment outside insurance coverage can be received: the amount calculated by deducting, from the amount of expenses calculated in accordance with the rules prescribed by the Minister of Health, Labour and Welfare pursuant to the provisions of Article 86, paragraph (3), item (i), (a) of the Health Insurance Act (or, when said amount exceeds the amount of expenses actually incurred in such medical treatment, such amount of expenses actually incurred in such medical treatment), the amount calculated in accordance with the rules prescribed by the Minister of Health, Labour and Welfare pursuant to the provisions of (b) of that item;
第五十三条第三項に規定する場合であつて、保険外併用療養費の支給を受けることができる場合 健康保険法第八十六条第三項第一号イの規定による厚生労働大臣の定めの例により算定した費用の額（その額が現に当該療養に要した費用の額を超えるときは、当該現に療養に要した費用の額とする。）から同号ロの規定による厚生労働大臣の定めの例により算定した額を控除した額
in cases where payment of medical expenses for home-nursing can be received: the amount of expenses calculated in accordance with the rules prescribed by the Minister of Health, Labour and Welfare pursuant to the provisions of Article 88, paragraph (4) of the Health Insurance Act (or, when said amount exceeds the amount of expenses actually incurred in such medical treatment, such amount of expenses actually incurred in such medical treatment).
訪問看護療養費の支給を受けることができる場合 健康保険法第八十八条第四項の規定による厚生労働大臣の定めの例により算定した費用の額（その額が現に当該療養に要した費用の額を超えるときは、当該現に療養に要した費用の額とする。）
the amount calculated by deducting the amount of Standard Co-payment for Dietary Treatment from the amount of expenses calculated for such Dietary Treatment in accordance with the standards set by the Minister of Health, Labour and Welfare pursuant to the provisions of Article 85, paragraph (2) of the Health Insurance Act (or, when said amount exceeds the amount of expenses actually incurred in such Dietary Treatment, such amount of expenses actually incurred in such Dietary Treatment);
当該食事療養につき健康保険法第八十五条第二項の規定による厚生労働大臣の定める基準の例により算定した費用の額（その額が現に当該食事療養に要した費用の額を超えるときは、当該現に食事療養に要した費用の額とする。）から、食事療養標準負担額を控除した額
the amount calculated by deducting the amount of Standard Living Expense Co-payment from the amount of expenses calculated for such Living Support in accordance with the standards set by the Minister of Health, Labour and Welfare pursuant to the provisions of Article 85-2, paragraph (2) of the Health Insurance Act (or, when said amount exceeds the amount of expenses actually incurred in such Living Support, such amount of expenses actually incurred in such Living Support).
当該生活療養につき健康保険法第八十五条の二第二項の規定による厚生労働大臣の定める基準の例により算定した費用の額（その額が現に当該生活療養に要した費用の額を超えるときは、当該現に生活療養に要した費用の額とする。）から、生活療養標準負担額を控除した額
When providing benefits for medical treatment or paying expenses for Dietary Treatment for inpatients, etc. pursuantIn the case where a householder, etc. in arrears with insurance premiums who is subject to the provisionsapplication of paragraph (1) or the preceding main clause of paragraph, Municipalities and Societies (2) has paid the arrears of insurance premiums in full, or where it is found that there are to notify special circumstances specified by Cabinet Order, such as a significant decrease in advance the amount in arrears pertaining to that person or a disaster, or where an insured person belonging to that household has become a person able to receive payment of general medical expenses for atomic bomb survivors, etc., when an insured person belonging to the household of the Householder or Society member who falls under these cases (in the case prescribed in where an insured person belonging to the household of that paragraph, as provided by Order of the Ministry of Health, Labour and Welfare, that Benefits householder, etc. in arrears with insurance premiums has become a person able to receive payment of general medical expenses for Medical Treatmentatomic bomb survivors, etc. will be provided when an, limited to that insured person belonging to ; the same applies hereinafter in this paragraph and the household following paragraph) receives medical treatment from a health insurance-covered medical institution, etc. or receives designated home nursing from a designated home-nursing provider, Municipalities and Societies are to provide benefits for medical treatment to the insured person belonging to the household of that Householder or Society member, or pay expenses for Dietary Treatment for inpatients, etc. to that Householder or Society member.
市町村及び組合は、前項第一項又は第二項本文の規定により療養の給付を行い、又は入院時食事療養費等を支給するときは、あらかじめ、厚生労働省令で定めるところにより、同項に規定するの適用を受けている保険料滞納世帯主等が滞納している保険料を完納した場合若しくはその者に係る滞納額の著しい減少、災害その他の政令で定める特別の事情があると認められる場合又はその世帯に属する被保険者が原爆一般疾病医療費の支給等を受けることができる者となつた場合において、これらの場合に該当する世帯主又は組合員に対し、その世帯に属する被保険者（当該保険料滞納世帯主等の世帯に属する被保険者が保険原爆一般疾病医療費の支給等を受けることができる者となつた場合にあつては、当該被保険者に限る。以下この項及び次項において同じ。）が保険医療機関等から療養を受けたとき、又は指定訪問看護事業者から指定訪問看護を受けたときは、当該世帯主若しくは組合員の世帯に属する被保険者に対し療養の給付等を行う旨を通知するものとを行い、又は当該世帯主若しくは組合員に対し入院時食事療養費等を支給する。
The provisions of Article 64 of the Health Insurance Act and paragraph (3) of Article 36, Articles 40 and 41, paragraph (3) of Article 45, Article 45-2, paragraph (5) of Article 52, paragraph (2) of Article 53, paragraphs (3), (8) and (10) of Article 54-2, Article 54-2-2 and the preceding Article of this Act shall apply mutatis mutandis toWhen providing benefits for medical treatment or designated home nursing covered by special medicalpaying expenses received at or from a health insurance-covered medical institutionfor Dietary Treatment for inpatients, etc. or a designated home-nursing provider andpursuant to the paymentprovisions of special medical expenses associated with such medical treatment or designated home nursing. In this case, the phrase "The amount of medical expenses combined with treatment outside insurance coverage" in Article 53,preceding paragraph (2) shall be deemed, Municipalities and Societies are to be replaced with "The amount of special medical expenses" andnotify in advance the phrase "Article 86, paragraph (2), item (i) ofHouseholder or Society member who falls under the Health Insurance Act"case prescribed in that paragraph shall be deemed to be replaced with "Article 76, paragraph (2) of the Health Insurance Act in the case where benefits for medical treatment can be received, those prescribed by, as provided by Order of the MinisterMinistry of Health, Labour and Welfare pursuant to the provisions of Article 86, paragraph (2), item (i) of the same Act in the case where payment of medical expenses combined with treatment outside insurance coverage can be received, or those prescribed by the Minister of Health, Labour and Welfare pursuant, that Benefits for Medical Treatment, etc. will be provided when an insured person belonging to the provisions of Article 88, paragraph (4) of the same Act in the case where payment ofhousehold receives medical treatment from a health insurance-covered medical expenses for home-nursing can be received", and any technical replacement of terms necessary for the other provisions shall be specified by Cabinet Orderinstitution, etc. or receives designated home nursing from a designated home-nursing provider.
健康保険法第六十四条並びに本法第三十六条第三項、第四十条、第四十一条、第四十五条第三項、第四十五条の二、第五十二条第五項、第五十三条第二項、第五十四条の二第三項、第八項及び第十項、第五十四条の二の二並びに前条市町村及び組合は、前項の規定は、保険医療機関等又は指定訪問看護事業者について受けた特別療養費に係る療養又は指定訪問看護及びこれらに伴う特別により療養の給付を行い、又は入院時食事療養費の支給について準用する。この場合において、第五十三条第二項中「保険外併用療養費の額」とあるのは「特別療養費の額」と、「健康保険法第八十六条第二項第一号」とあるのは「、療養の給付を受けることができる場合は健康保険法第七十六条第二項の規定による等を支給するときは、あらかじめ、厚生労働大臣の定めの例省令で定めるところにより、保険外併用療養費の支給同項に規定する場合に該当する世帯主又は組合員に対し、その世帯に属する被保険者が保険医療機関等から療養を受けることができる場合は同法第八十六条第二項第一号の規定による厚生労働大臣の定めの例により、たとき、又は指定訪問看護事業者から指定訪問看護療養費の支給を受けることができる場合は同法第八十八条第四項」と読み替えるほか、その他の規定に関し必要な技術的読替えは、政令で定めたときは、療養の給付等を行う旨を通知するものとする。
When theThe provisions of paragraph (3) of Article 54, 36, Articles 40 and 41, paragraph (1) would apply to an insured person belonging to 3) of Article 45, Article 45-2, paragraph (5) of Article 52, paragraphs (3), (8) and (10) of Article 54-2, Article 54-2-2 and the household preceding Article of a householder, etc. in arrears with insurance premiums who is subject this Act, and Article 64 of the Health Insurance Act shall apply mutatis mutandis to the application of paragraph (1) medical treatment or designated home nursing covered by special medical expenses received at or the main clause of paragraph (2) if the insured person were not subjectfrom a health insurance-covered medical institution, etc. or a designated home-nursing provider and to the applicationpayment of those provisions, Municipalities and Societies may pay medical expensesspecial medical expenses associated with such medical treatment or designated home nursing. In this case, any technical replacement of terms necessary for these provisions shall be specified by Cabinet Order.
第一項又は第二項本文の規定の適用を受けている保険料滞納世帯主等の世帯に属する被保険者がこれらの規定の適用を受けていないとすれば第五三十六条第三項、第四十条、第四十一条、第四十五条第三項、第四十五条の二、第五十二条第五項、第五十四条の二第三項、第八項及び第十項、第五十四条の二の二並びに前条並びに健康保険法第六十四条第一項の規定が適用されることとなるときは、市町村及び組合は、は、保険医療機関等又は指定訪問看護事業者について受けた特別療養費に係る療養又は指定訪問看護及びこれらに伴う特別療養費を支給することができの支給について準用する。この場合において、これらの規定に関し必要な技術的読替えは、政令で定める。
Where When the provisions of Article 54, paragraph (1) would apply to an insured person belonging to the household of a householder, etc. in arrears with insurance premiums who is subject to the application of paragraph (1) or the main clause of paragraph (2) has received any medical care or medication at or from a health insurance-covered medical institution, etc. without receiving confirmation of being anif the insured person by electronic eligibility confirmation, etc., and when it is found that the failure to receive such confirmation was duewere not subject to an emergency situation or any other unavoidable reasonthe application of those provisions, Municipalities and Societies shallmay pay medical expenses.
第一項又は第二項本文の規定の適用を受けている保険料滞納世帯主等の世帯に属する被保険者が電子資格確認等により被保険者であることの確認を受けないで保険医療機関等について診療又は薬剤の支給を受け、当該確認これらの規定の適用を受けなかつたことが、緊急その他やむを得ない理由によるものと認めていないとすれば第五十四条第一項の規定が適用されることとなるときは、市町村及び組合は、療養費を支給するものとすことができる。
The provisions Where an insured person belonging to the household of Article 54, paragraphs (3) and (4) shall apply mutatis mutandis to the medical expenses under the preceding two paragraphs. In this case, the phrase "shall be received" in paragraph (4) of a householder, etc. in arrears with insurance premiums who is subject to the application of paragraph (1) or the main clause of paragraph (2) has received any medical care or medication at or from a health insurance-covered medical institution, etc. without receiving confirmation of being an insured person by electronic eligibility confirmation, etc., and when it is found that Article shall be deemed the failure to receive such confirmation was due to be replaced with "can be received"an emergency situation or any other unavoidable reason, Municipalities and Societies shall pay medical expenses.
第五十四条第三項及び第四項の規定は、前二項一項又は第二項本文の規定による療養費について準用する。この場合において、同条第四項中「受けるべき場合」とあるのは、「受けるの適用を受けている保険料滞納世帯主等の世帯に属する被保険者が電子資格確認等により被保険者であることの確認を受けないで保険医療機関等について診療又は薬剤の支給を受け、当該確認を受けなかつたことができる場合」と読み替え、緊急その他やむを得ない理由によるものと認めるときは、市町村及び組合は、療養費を支給するものとする。
The provisions of Article 54, paragraphs (3) and (4) shall apply mutatis mutandis to the medical expenses under the preceding two paragraphs. In this case, the phrase "shall be received" in paragraph (4) of that Article shall be deemed to be replaced with "can be received".
第五十四条第三項及び第四項の規定は、前二項の規定による療養費について準用する。この場合において、同条第四項中「受けるべき場合」とあるのは、「受けることができる場合」と読み替えるものとする。