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National Health Insurance Act

国民健康保険法(こくみんけんこうほけんほう)

Chapter XII Penal Provisions

The law as Act Partially Amending the Medical Care Act, etc. (Act No. 87 of 2025) 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.

Chapter XII Penal Provisions第十二章 罰則

Article 120-2第百二十条の二

Article 120-2, paragraph (1)

When a current or former officer or employee of an insurer divulges, without a justifiable reason, any confidential information obtained in the course of duties in relation to national health insurance services, said person shall be punished by imprisonment for not more than 1 year or a fine of not more than 1,000,000 yen.

保険者の役員若しくは職員又はこれらの職にあつた者が、正当な理由なしに、国民健康保険事業に関して職務上知得した秘密を漏らしたときは、一年以下の拘禁刑又は百万円以下の罰金に処する。

Article 121第百二十一条

Article 121, paragraph (1)

When a current or former committee member of a Review Committee or an Examination Board or a current or former officer or employee of a Federation divulges, without a justifiable reason, any confidential information obtained in the course of duties, said person shall be punished by imprisonment for not more than 1 year or a fine of not more than 1,000,000 yen.

審査委員会若しくは審査会の委員若しくは連合会の役員若しくは職員又はこれらの職にあつた者が、正当な理由なしに、職務上知得した秘密を漏らしたときは、一年以下の拘禁刑又は百万円以下の罰金に処する。

Article 121, paragraph (2)

The provisions of the preceding paragraph shall also apply when a person who conducts or used to conduct the review of medical bills as specified by the Minister of Health, Labour and Welfare pursuant to the provisions of Article 45, paragraph (7) (including cases where applied mutatis mutandis pursuant to Article 52, paragraph (6), Article 52-2, paragraph (3), Article 53, paragraph (4) and Article 54-2, paragraph (12)) or a current or former officer or employee of a Designated Association divulges, without a justifiable reason, any confidential information obtained in the course of said person's duties.

第四十五条第七項(第五十二条第六項、第五十二条の二第三項、第五十三条第四項及び第五十四条の二第十二項において準用する場合を含む。)の規定により厚生労働大臣の定める診療報酬請求書の審査を行う者若しくはこれを行つていた者又は指定法人の役員、職員若しくはこれらの職にあつた者が、正当な理由なしに、職務上知得した秘密を漏らしたときも、前項と同様とする。

Article 121-2第百二十一条の二

Article 121-2, paragraph (1)

A person who violates an order pursuant to the provisions of Article 111-2, paragraph (6) shall be punished by imprisonment for not more than one year or a fine of not more than 500,000 yen.

第百十一条の二第六項の規定による命令に違反した者は、一年以下の拘禁刑又は五十万円以下の罰金に処する。

Article 122第百二十二条

Article 122, paragraph (1)

A person who, without a justifiable reason and in violation of any action taken pursuant to the provisions of Article 101, paragraph (1), fails to appear or to make a statement or report, or makes any false statement or report or fails to perform diagnosis or examination shall be punished by a fine of not more than 300,000 yen; provided, however, that this shall not apply to an applicant in the examination procedure conducted by the Examination Board or to a Municipality, Society or other interested person that has received notice pursuant to the provisions of Article 100.

正当な理由なしに、第百一条第一項の規定による処分に違反して、出頭せず、陳述をせず、報告をせず、若しくは虚偽の陳述若しくは報告をし、又は診断若しくは検案をしなかつた者は、三十万円以下の罰金に処する。ただし、審査会の行う審査の手続における請求人又は第百条の規定により通知を受けた市町村、組合その他の利害関係人は、この限りでない。

Article 122-2第百二十二条の二

Article 122-2, paragraph (1)

A person who, without a justifiable reason, fails to make a report pursuant to the provisions of Article 111-3, paragraph (1) or makes a false report, or who, without a justifiable reason, fails to reply, or makes a false reply, to any question asked by the relevant personnel pursuant to the provisions of the same paragraph, or who, without a justifiable reason, refuses, obstructs or evades an inspection pursuant to the provisions of the same paragraph, shall be punished by a fine of not more than 300,000 yen.

正当な理由なしに第百十一条の三第一項の規定による報告をせず、若しくは虚偽の報告をし、又は同項の規定による当該職員の質問に対して、正当な理由なしに答弁せず、若しくは虚偽の答弁をし、若しくは正当な理由なしに同項の規定による検査を拒み、妨げ、若しくは忌避した者は、三十万円以下の罰金に処する。

Article 123第百二十三条

Article 123, paragraph (1)

When a current or former insurer fails, without a justifiable reason, to comply with an order to make a report issued pursuant to the provisions of Article 114, paragraph (2) or, without a justifiable reason, fails to reply, or makes a false reply, to any question asked by the relevant personnel pursuant to the provisions of the same paragraph of the same Article, said current or former insurer shall be punished by a fine of not more than 300,000 yen.

被保険者又は被保険者であつた者が、第百十四条第二項の規定により報告を命ぜられ、正当な理由なしにこれに従わず、又は同条同項の規定による当該職員の質問に対して、正当な理由なしに答弁せず、若しくは虚偽の答弁をしたときは、三十万円以下の罰金に処する。

Article 123-2第百二十三条の二

Article 123-2, paragraph (1)

When a representative of a juridical person (including an association or foundation that is not a juridical person that has a representative or manager designated (hereinafter referred to as an "association or foundation without legal personality" in this Article); the same applies hereinafter in this paragraph) (including the manager of an association or foundation without legal personality), or an agent, staff member or other employee of a juridical person or of a person, commits a violation of Article 121-2 or Article 122-2 in connection with the business of that juridical person or person, the fine prescribed in the respective Articles is also imposed on that juridical person or person, in addition to punishing the offender.

法人(法人でない社団又は財団で代表者又は管理人の定めがあるもの(以下この条において「人格のない社団等」という。)を含む。以下この項において同じ。)の代表者(人格のない社団等の管理人を含む。)又は法人若しくは人の代理人、使用人その他の従業者が、その法人又は人の業務に関して、第百二十一条の二又は第百二十二条の二の違反行為をしたときは、行為者を罰するほか、その法人又は人に対しても、各本条の罰金刑を科する。

Article 123-2, paragraph (2)

Where the provisions of the preceding paragraph apply to an association or foundation without legal personality, in addition to the representative or manager of the association or foundation without legal personality representing it in its litigation acts, the provisions of laws and regulations concerning criminal procedure in the case where a juridical person is the accused or suspect apply mutatis mutandis.

人格のない社団等について前項の規定の適用がある場合には、その代表者又は管理人がその訴訟行為につき当該人格のない社団等を代表するほか、法人を被告人又は被疑者とする場合の刑事訴訟に関する法律の規定を準用する。

Article 124第百二十四条

Article 124, paragraph (1)

When a physician, dentist or pharmacist or any person who gave treatment or any person who employs any of the above fails, without a justifiable reason, to comply with an order to make a report or present medical records, the books and other documents or any other article issued pursuant to the provisions of Article 114, paragraph (1) or, without a justifiable reason, fails to reply, or makes a false reply, to any question asked by the relevant personnel pursuant to the provisions of the same paragraph of the same Article, said person shall be punished by a non-criminal fine of not more than 100,000 yen.

医師、歯科医師、薬剤師若しくは手当を行つた者又はこれを使用する者が、第百十四条第一項の規定により報告若しくは診療録、帳簿書類その他の物件の提示を命ぜられ、正当な理由なしにこれに従わず、又は同条同項の規定による当該職員の質問に対して、正当な理由なしに答弁せず、若しくは虚偽の答弁をしたときは、十万円以下の過料に処する。

Article 125第百二十五条

Article 125, paragraph (1)

When a Society or Federation fails make a notification pursuant to, or makes a false notification under, the provisions of Article 27, paragraph (4) (including the cases where applied mutatis mutandis pursuant to Article 86) or, without a justifiable reason, fails to comply with, or makes a false report in response to, an order issued pursuant to the provisions of Article 106, paragraph (1), or violates an order issued pursuant to the provisions of Article 108, paragraph (1), the officers or liquidators of such Society or Federation shall be punished by a non-criminal fine of not more than 200,000 yen.

組合又は連合会が、第二十七条第四項(第八十六条において準用する場合を含む。)の規定による届出をせず、若しくは虚偽の届出をし、第百六条第一項の規定による報告を命ぜられ、正当な理由なしにこれに応ぜず、若しくは虚偽の報告をし、又は第百八条第一項の規定による命令に違反したときは、その役員又は清算人を二十万円以下の過料に処する。

Article 126第百二十六条

Article 126, paragraph (1)

A person who violates the provisions of Article 15, paragraph (2) or Article 83, paragraph (4) shall be punished by a non-criminal fine of not more than 100,000 yen.

第十五条第二項又は第八十三条第四項の規定に違反した者は、十万円以下の過料に処する。

Article 127第百二十七条

Article 127, paragraph (1)

A Municipality may, in its Municipal Ordinance, establish provisions to impose a non-criminal fine of not more than 100,000 yen on a person who fails to make a notification pursuant to, or makes a false notification under, the provisions of Article 9, paragraph (1) or (5).

市町村は、条例で、第九条第一項若しくは第五項の規定による届出をせず、又は虚偽の届出をした者に対し十万円以下の過料を科する規定を設けることができる。

Article 127, paragraph (2)

A Municipality may, in its Municipal Ordinance, establish provisions to impose a non-criminal fine of not more than 100,000 yen when a current or former Householder, without a justifiable reason, fails to comply with an order to submit or present a document or any other article issued pursuant to the provisions of Article 113 or fails to reply, or makes a false reply, to any question asked by the relevant personnel pursuant to the provisions of the same Article.

市町村は、条例で、世帯主又は世帯主であつた者が正当な理由なしに、第百十三条の規定により文書その他の物件の提出若しくは提示を命ぜられてこれに従わず、又は同条の規定による当該職員の質問に対して答弁せず、若しくは虚偽の答弁をしたときは、十万円以下の過料を科する規定を設けることができる。

Article 127, paragraph (3)

A Municipality may, in its Municipal Ordinance, establish provisions to impose on a person who, by means of deception or other wrongful conduct, evades insurance premiums or any other money to be collected pursuant to the provisions of this Act, a non-criminal fine of not more than the amount equal to five times the amount evaded.

市町村は、条例で、偽りその他不正の行為により保険料その他この法律の規定による徴収金の徴収を免かれた者に対し、その徴収を免かれた金額の五倍に相当する金額以下の過料を科する規定を設けることができる。

Article 127, paragraph (4)

The provisions of Article 255-3 of the Local Autonomy Act shall apply mutatis mutandis to any action of non-criminal fine imposed pursuant to the provisions of the three preceding paragraphs.

地方自治法第二百五十五条の三の規定は、前三項の規定による過料の処分について準用する。

Article 128第百二十八条

Article 128, paragraph (1)

The provisions of paragraphs (1) through (3) of the preceding Article shall apply mutatis mutandis to a Society. In this case, the terms "Municipal Ordinance" and "non-criminal fine" in these provisions shall be deemed to be replaced with "constitution" and "penalty," respectively.

前条第一項から第三項までの規定は、組合について準用する。この場合において、これらの規定中「条例」とあるのは「規約」と、「過料」とあるのは「過怠金」と読み替えるものとする。

Article 128, paragraph (2)

A Society or Federation may, pursuant to the provisions of its constitution, collect a penalty of not more than 100,000 yen with respect to the use of its facilities.

組合又は連合会は、規約の定めるところにより、その施設の使用に関し十万円以下の過怠金を徴収することができる。

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