12 provisions changed · 11 provisions added · 5 provisions removed · 3 provisions in the supplementary provisions
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Article 4 · Responsibilities of the National Government, Prefectures and Municipalities第四条（国、都道府県及び市町村の責務）
A Municipality is to appropriately implement national health insurance services, including matters concerning the acquisition and loss of eligibility as an insured person, the collection of national health insurance premiums (including national health insurance tax under the Local Tax Act (Act No. 226 of 1950); the same applies in Article 11, paragraph (2), Article 54-3, paragraphs (1), (2) and (5), Article 63-2, Article 81-2, paragraph (1), each item, and paragraph (1011), items (ii) and (iii), and Article 82-2, paragraph (2), items (ii) and (iii), and paragraph (6)), and the implementation of health services.
Each Municipality must, pursuant to Cabinet Order provisions, transfer from its general fund to the special account of that Municipality for its national health insurance program, an amount calculated, pursuant to Cabinet Order provisions, based on the total amount of insurance premiums relating to insured persons or the national health insurance tax under the provisions of the Local Tax Act, in each case after reductions have been made through reduced assessments of insurance premiums with respect to insured persons who have not yet passed the first March 31 on or after the day they reach the age of six18 pursuant to a Municipal Ordinance or through any reduction of national health insurance tax as set forth in Article 703-5, paragraph (2) of the same Act and by taking into consideration the financial condition of the national health insurance program and other circumstances.
The national government may, pursuant to Cabinet Order provisions, provide assistance to each Society in the total sum of the amounts listed in the following items with respect to the cost incurred in providing benefits for medical treatment, etc. and the expenses incurred in paying young-old payments and old-old aid, long-term care payments, contributions for securing medical care in the early phase of an epidemic and children and child-rearing support levies (referred to as "expenses required for benefits for medical treatment, etc." in paragraph (6)):
the amount obtained by deducting, from (1) the total sum of: (i) the amount calculated by deducting, from the expenses incurred in providing benefits for medical treatment, the amount of co-payment relating to such benefits; and (ii) the amount of expenses incurred in paying the expenses for Dietary Treatment for inpatients, Living Support expenses for inpatients, medical expenses combined with treatment outside insurance coverage, medical expenses, medical expenses for home-nursing, special medical expenses, transport expenses, high-cost medical expenses and expenses for high-cost medical treatment combined with long-term care, (2) an amount calculated pursuant to Cabinet Order provisions as the amount of such portion of said total sum as relating to the Society's Specified Insured Persons (meaning persons who are insured persons covered by such Society as a result of not being eligible as insured persons under the Health Insurance Act upon the approval undermaking the provisions ofapplication under item (viii) of paragraph (1) of Article 3 of that Act or upon the approval under the proviso of paragraph (2) of the samethat Article of the same Act as well as insured persons covered by such Society who belong to the above insured persons' respective families; the same shall apply in (b)) (hereinafter referred to as the "Specified Benefit Amount" in this Article);
When a Society falls under all of the following requirements, the national government may, notwithstanding the provisions of paragraph (1), as provided by Cabinet Order, provide that Society with assistance, with respect to the expenses required for benefits for medical treatment, etc., in the amount of the total sum of the amount obtained by multiplying the total sum of the amount listed in paragraph (1), item (i), (a) and the amount listed in (b) of that item by a ratio specified by Cabinet Order within the range of ten hundredths or more and less than thirteen hundredths in consideration of the financial capability of that Society, and the total sum of the amounts obtained by multiplying each of the Specified Benefit Amount and the Specified Amount of Payment Cost by the specified ratio:
the financial capability of the Society falls under the standards specified by Cabinet Order;
組合の財政力が政令で定める基準に該当すること。
AddedArticle 73, paragraph (6), item (ii)
the state of the financial management of the Society falls under the standards specified by Cabinet Order;
組合の財政運営の状況が政令で定める基準に該当すること。
AddedArticle 73, paragraph (6), item (iii)
the status of efforts to maintain and promote the health of the Society's insured persons, promote the efficient provision of medical care, and other efforts for the optimization of medical expenses, etc. falls under the standards specified by Cabinet Order.
The provisions of paragraphs (2) through (5) apply mutatis mutandis to the case of providing assistance under the provisions of the preceding paragraph. In this case, the phrase "item (ii) of the preceding paragraph" in paragraph (2) is deemed to be replaced with "paragraph (6)" and "thirty-two hundredths" with "thirteen hundredths"; the phrase "the provisions of paragraph (1) to" in paragraph (3) is deemed to be replaced with "the provisions of paragraph (6) to" and "(a) of item (1) of the same paragraph" with "(a) of item (1) of paragraph (1)"; the phrase "paragraph (1)" in paragraph (4) is deemed to be replaced with "paragraph (6)"; and the phrase "the preceding paragraph" in paragraph (5) is deemed to be replaced with "the preceding paragraph as applied mutatis mutandis by replacing terms pursuant to paragraph (7)" and "paragraph (3)" with "paragraph (3) as applied mutatis mutandis by replacing terms pursuant to paragraph (7)".
When a prefecture has drawn down Within the range that does not interfere with the financial stabilization fund pursuant todrawing down and transfer under the provisions of the preceding paragraph, when it must, is found particularly necessary for ensuring the stable financial management of the national health insurance program provided by prefectures, etc., such as restraining a significant rise in the payments for national health insurance services expenses, taking into consideration the outlook for the expenses required for medical care and the finances of national health insurance, a prefecture is, as provided by Cabinet Order, transfer to draw down the financial stabilization fund within the range of an amount equivalent to calculated as provided by Cabinet Order as the amount drawn down required therefor, and transfer that amount to the financial stabilization fundspecial account of the prefecture relating to national health insurance.
In addition to the case prescribed in paragraph (2), when it is found necessary for ensuringWhen a prefecture has drawn down the stable financial management of the national health insurance program provided by prefectures, etc., such as restraining a significant rise in the payments for national health insurance services expenses, taking into consideration the outlook forstabilization fund pursuant to the expenses required for medical care andprovisions of the finances of national health insurance, a prefecture maypreceding two paragraphs, it must, as provided by Cabinet Order, draw down the financial stabilization fund within the range oftransfer an amount calculated as provided by Cabinet Order asequivalent to the amount required therefor, and transfer itdrawn down to the special account of the prefecture relating to national health insurancefinancial stabilization fund.
In orderaddition to fund the cases where it makes withdrawals and transfers under the financial stabilization fundprovisions of paragraph (2) or (3), a prefecture may, as provided by Cabinet Order, in cases where it is found necessary to collect ensure the stable financial stabilization fund contributions from management of the national health insurance program provided by prefectures, etc., taking into account the Municipalities withinoutlook for the prefecture, expenses required for medical care under national health insurance and for its finances, draw down the financial stabilization fund within the amount calculated as provided by Cabinet Order as the amount required therefor, and transfer it to the special account for national health insurance of that prefecture.
Municipalities must pay In order to fund the financial stabilization fund, a prefecture is to collect financial stabilization fund contributions underfrom the preceding paragraphMunicipalities within the prefecture, as provided by Cabinet Order.
A prefectureMunicipalities must, as provided by Cabinet Order, transfer to the financial stabilization fund an amount equivalent to three times pay the total amount of financial stabilization fund contributions collected from the Municipalities within the prefecture pursuant tounder the provisions ofpreceding paragraph (5).
The national government is to bearA prefecture must, as provided by Cabinet Order, transfer to the financial stabilization fund an amount equivalent to one-third ofthree times the total amount transferred by a of financial stabilization fund contributions collected from the Municipalities within the prefecture pursuant to the provisions of the preceding paragraph (6).
All income arising from The national government is to bear, as provided by Cabinet Order, an amount equivalent to one-third of the financial stabilization fund must be appropriatedamount transferred by a prefecture pursuant to the financial stabilization fundprovisions of the preceding paragraph.
The meanings of the terms listed in the following items, amongAll income arising from the terms used in this Article, are as prescribed respectively in those itemsfinancial stabilization fund must be appropriated to the financial stabilization fund.
Municipality with a shortfall in premium collection: a Municipality for which the amount of insurance premiums collected subject to fund projects falls short of the amount of insurance premiums required subject to fund projects;
収納不足市町村 基金事業対象保険料収納額が基金事業対象保険料必要額に不足する市町村
RemovedArticle 81-2, paragraph (10), item (ii)
amount of insurance premiums collected subject to fund projects: the amount calculated as provided by Cabinet Order as having been applied to the amount of expenses incurred in paying payments for national health insurance services expenses, the amount of expenses incurred in paying the financial stabilization fund contribution, the amount of expenses incurred in repaying loans from the prefecture under the project set forth in paragraph (1), item (i) (referred to as "financial stabilization fund loans" in the following item) and other amounts of expenses specified by Cabinet Order, out of the amount of insurance premiums collected by a Municipality during the relevant fiscal year;
amount of insurance premiums required subject to fund projects: the amount calculated as provided by Cabinet Order as being applied to the amount of expenses required for paying payments for national health insurance services expenses, the amount of expenses required for paying the financial stabilization fund contribution, the amount of expenses required for repaying financial stabilization fund loans and other amounts of expenses specified by Cabinet Order, out of the amount of insurance premiums that a Municipality needs to collect during the relevant fiscal year;
amount of revenue subject to fund projects: the amount calculated as provided by Cabinet Order as being applied to the total sum of the amount obtained by deducting the amount equivalent to the co-payment relating to the benefits from the amount of costs spent on benefits for medical treatment by the Municipalities within the prefecture and the amount of costs spent on paying expenses for Dietary Treatment for inpatients, Living Support expenses for inpatients, medical expenses combined with treatment outside insurance coverage, medical expenses, medical expenses for home-nursing, special medical expenses, transport expenses, high-cost medical expenses and expenses for high-cost medical treatment combined with long-term care by the Municipalities within the prefecture (referred to as "amount of costs spent on benefits for medical treatment, etc." in the following item), to the amount of expenses incurred in paying the contribution for the special high-cost medical expenses joint project, young-old payments, etc., old-old aid, etc., the long-term care payment, the contribution for securing medical care in the early phase of an epidemic, etc. and the children and child-rearing support levy, to the amount of expenses incurred in making the transfer under the provisions of paragraph (3) and the transfer under the provisions of paragraph (7) (referred to as "financial stabilization fund transfer" in the following item), and to other amounts of expenses specified by Cabinet Order, out of the total of the amounts received during the relevant fiscal year in the special account of the prefecture relating to national health insurance (excluding the amount transferred in pursuant to the provisions of paragraph (2));
amount of expenses subject to fund projects: the amount calculated as provided by Cabinet Order as the total of the amount of expenses incurred in granting subsidies for national health insurance benefit expenses, etc. borne during the relevant fiscal year by the special account of the prefecture relating to national health insurance (limited to those pertaining to the amount of costs spent on benefits for medical treatment, etc.), the amount of expenses incurred in paying the contribution for the special high-cost medical expenses joint project, young-old payments, etc., old-old aid, etc., the long-term care payment, the contribution for securing medical care in the early phase of an epidemic, etc. and the children and child-rearing support levy, the amount of expenses incurred in making the transfer under the provisions of paragraph (3) and the financial stabilization fund transfer, and other amounts of expenses specified by Cabinet Order.
The meanings of the terms listed in the following items, among the terms used in this Article, are as prescribed respectively in those items.
この条における用語のうち次の各号に掲げるものの意義は、当該各号に定めるところによる。
AddedArticle 81-2, paragraph (11), item (i)
Municipality with a shortfall in premium collection: a Municipality for which the amount of insurance premiums collected subject to fund projects falls short of the amount of insurance premiums required subject to fund projects;
収納不足市町村 基金事業対象保険料収納額が基金事業対象保険料必要額に不足する市町村
AddedArticle 81-2, paragraph (11), item (ii)
amount of insurance premiums collected subject to fund projects: the amount calculated as provided by Cabinet Order as having been applied to the amount of expenses incurred in paying payments for national health insurance services expenses, the amount of expenses incurred in paying the financial stabilization fund contribution, the amount of expenses incurred in repaying loans from the prefecture under the project set forth in paragraph (1), item (i) (referred to as "financial stabilization fund loans" in the following item) and other amounts of expenses specified by Cabinet Order, out of the amount of insurance premiums collected by a Municipality during the relevant fiscal year;
amount of insurance premiums required subject to fund projects: the amount calculated as provided by Cabinet Order as being applied to the amount of expenses required for paying payments for national health insurance services expenses, the amount of expenses required for paying the financial stabilization fund contribution, the amount of expenses required for repaying financial stabilization fund loans and other amounts of expenses specified by Cabinet Order, out of the amount of insurance premiums that a Municipality needs to collect during the relevant fiscal year;
amount of revenue subject to fund projects: the amount calculated as provided by Cabinet Order as being applied to the total sum of the amount obtained by deducting the amount equivalent to the co-payment relating to the benefits from the amount of costs spent on benefits for medical treatment by the Municipalities within the prefecture and the amount of costs spent on paying expenses for Dietary Treatment for inpatients, Living Support expenses for inpatients, medical expenses combined with treatment outside insurance coverage, medical expenses, medical expenses for home-nursing, special medical expenses, transport expenses, high-cost medical expenses and expenses for high-cost medical treatment combined with long-term care by the Municipalities within the prefecture (referred to as "amount of costs spent on benefits for medical treatment, etc." in the following item), to the amount of expenses incurred in paying the contribution for the special high-cost medical expenses joint project, young-old payments, etc., old-old aid, etc., the long-term care payment, the contribution for securing medical care in the early phase of an epidemic, etc. and the children and child-rearing support levy, to the amount of expenses incurred in making the transfer under the provisions of paragraph (4) and the transfer under the provisions of paragraph (8) (referred to as "financial stabilization fund transfer" in the following item), and to other amounts of expenses specified by Cabinet Order, out of the total of the amounts received during the relevant fiscal year in the special account of the prefecture relating to national health insurance (excluding the amount transferred in pursuant to the provisions of paragraph (2));
amount of expenses subject to fund projects: the amount calculated as provided by Cabinet Order as the total of the amount of expenses incurred in granting subsidies for national health insurance benefit expenses, etc. borne during the relevant fiscal year by the special account of the prefecture relating to national health insurance (limited to those pertaining to the amount of costs spent on benefits for medical treatment, etc.), the amount of expenses incurred in paying the contribution for the special high-cost medical expenses joint project, young-old payments, etc., old-old aid, etc., the long-term care payment, the contribution for securing medical care in the early phase of an epidemic, etc. and the children and child-rearing support levy, the amount of expenses incurred in making the transfer under the provisions of paragraph (4) and the financial stabilization fund transfer, and other amounts of expenses specified by Cabinet Order.
Until the date specified by the Cabinet Order prescribed in Article 2 of the Supplementary Provisions of the Act on Assurance of Medical Care for Elderly People, in Article 69, the phrase "and old-old aid, contribution for administrative expenses related to the old-old and contribution for administrative expenses related to childbirth and childcare under that Act (hereinafter referred to as "old-old aid, etc.")" is deemed to be replaced with ", old-old aid, contribution for administrative expenses related to the old-old and contribution for administrative expenses related to childbirth and childcare under that Act (hereinafter referred to as "old-old aid, etc."), and bed conversion support payment, etc. under that Act (hereinafter referred to as "bed conversion support payment, etc.")"; in Article 70, paragraph (1), the phrase "and old-old aid under that Act (hereinafter referred to as "old-old aid")" is deemed to be replaced with ", old-old aid under that Act (hereinafter referred to as "old-old aid") and bed conversion support payment under that Act (hereinafter referred to as "bed conversion support payment")"; in item (ii) of that paragraph, the phrase "and old-old aid" is deemed to be replaced with ", old-old aid and bed conversion support payment"; in Article 73, paragraphsparagraph (1) and paragraph (2) of that Article (including cases where applied mutatis mutandis with terms replaced pursuant to paragraph (7) of that Article), the phrase "and old-old aid" is deemed to be replaced with ", old-old aid and bed conversion support payment"; and in Article 75, Article 75-7, paragraph (1), Article 76, paragraph (1) and paragraph (2) of that Article (including cases where applied with terms replaced pursuant to the preceding Article), and Article 81-2, paragraph (1011), items (iv) and (v), the phrase "and old-old aid, etc." is deemed to be replaced with ", old-old aid, etc. and bed conversion support payment, etc.".
Supplementary Provisions, Article 47 · Transitional Measures and Points to Note Concerning Introduction of Children and Child-rearing Support Levy附則第四十七条（子ども・子育て支援納付金の導入に当たっての経過措置及び留意事項）
the amount of the share of the national treasury under Article 70, paragraph (1) of the National Health Insurance Act as amended by the provisions of Article 8 (hereinafter in this item referred to as the "New National Health Insurance Act"), the amount of the adjusting subsidy under Article 72, paragraph (1) of the New National Health Insurancethat Act and the amount to be transferred under Article 72-2, paragraph (1) of the New National Health Insurancethat Act (limited to the part pertaining to the costs required for payment of the children and child-rearing support levy), the amounts to be transferred under Article 72-3, paragraph (1), Article 72-3-2, paragraph (1), Article 72-3-3, paragraph (1) and Article 72-4, paragraph (1) of the New National Health Insurancethat Act, and the amount of the subsidy under Article 73, paragraphparagraphs (1) of the New National Health Insuranceand (6) of that Act (limited to the part specified by Cabinet Order as the part pertaining to the costs required for payment of the children and child-rearing support levy);
the provisions of Article 6 (excluding, within that Article, the provision amending Article 3, paragraph (2), item (iv) of the Act on Promotion of Comprehensive Securing of Medical and Long-Term Care in Communities (limited to the part replacing "the medical care plan prescribed in Article 30-4, paragraph (1) of the Medical Care Act" with "the regional medical care vision prescribed in Article 30-3-3, paragraph (1) of the Medical Care Act (hereinafter referred to as the ‘regional medical care vision’) and the medical care plan prescribed in Article 30-4, paragraph (1) of that Act", and "）及び" (and) with "）並びに" (and, joining the larger group)), the provision amending Article 4, paragraph (2), item (ii) and paragraph (3) of that Act, and the provision deleting Article 7-2 and Article 7-3 of that Act); the provision, in Article 7, amending the Table of Contents of the Health Insurance Act, the provision amending Article 7-2, paragraph (3), Article 77, paragraph (3), and Article 150-2, paragraph (1) of that Act, the provision amending Article 150-10 of that Act (excluding the amending provision listed in item (v)), the provision, in Chapter VI, renumbering that Article as Article 150-13 of that Act, the provision amending Article 150-9 of that Act (excluding the amending provision listed in that item), the provision renumbering that Article as Article 150-12 of that Act, the provision amending Article 150-8 of that Act, the provision renumbering that Article as Article 150-11 of that Act, the provision amending Article 150-7, paragraph (1) of that Act, the provision renumbering that Article as Article 150-10 of that Act, the provision adding three Articles after Article 150-6 of that Act, and the provision amending Article 151, Article 153, Article 154, paragraph (1), Article 155, paragraph (1), Article 160, paragraph (3) and paragraph (14), Article 173, paragraph (1), Article 176, Article 207-3, and Article 213-2 of that Act, and the provision amending Article 2, paragraph (1) and Article 4-2 of the Supplementary Provisions of that Act; the provision, in Article 8, amending Article 112, paragraph (2), Article 114, paragraph (1), and Article 121, paragraph (2) of the Mariners Insurance Act, and the provision amending Article 7 of the Supplementary Provisions of that Act; the provision, in Article 9, amending Article 69, Article 70, paragraph (1), Article 73, paragraphs (1) and (2), Article 75, Article 75-7, paragraph (1), Article 76, paragraphs (1) and (2), and Article 81-2, paragraph (1011) of the National Health Insurance Act; the provisions of Article 10 (excluding the amending provision listed in item (iii)); the provision, in Article 11, amending Article 16-2, paragraph (1) and Article 16-8 of the Act on Assurance of Medical Care for Elderly People, the provision renumbering that Article as Article 16-11 of that Act, the provision amending Article 16-7, paragraph (1) of that Act, the provision renumbering that Article as Article 16-10 of that Act, the provision adding three Articles after Article 16-6 of that Act, the provision amending Article 17 of that Act (limited to the part replacing "use or provision under the provisions of Article 16-2, paragraph (1)" with "use and provision under the provisions of Article 16-2, paragraph (1) and Article 16-7, paragraphs (1) and (2)"), the provision adding two paragraphs to that Article, the provision amending Article 17-2, paragraph (1) of that Act (limited to the part replacing "the preceding Article" with "paragraph (1) of the preceding Article"), the provision adding one paragraph to that Article, the provision amending Article 34, paragraphs (1), (3), (4), and (6), Article 35, paragraphs (1), (3), (4), and (6), Article 38, paragraphs (1) and (2), Article 39, paragraphs (1) and (2), Article 61, paragraph (3), Article 72, paragraph (2), Article 81, paragraph (2), and Article 93, paragraphs (1) and (2) of that Act, the provision amending Article 100, paragraph (1) of that Act (excluding the amending provision listed in item (v)), the provision amending paragraph (2) of that Article and Article 104, paragraphs (1) and (3), Article 116, paragraph (2), Article 120, paragraph (1), Article 134, paragraph (3), Article 137, paragraph (3), Article 152, paragraph (2), and Article 161-3, paragraph (2) of that Act, and the provision amending Article 167-2 and Article 168, paragraph (3) of that Act; the provision, in Article 12, amending Article 115-47, paragraph (10) of the Long-Term Care Insurance Act (limited to the part replacing "Article 118-10 and Article 118-11" with "Article 118-13 and Article 118-14"), the provision amending Article 118-3, paragraph (1) of that Act, the provision amending Article 118-11 of that Act (excluding the amending provision listed in that item), the provision renumbering that Article as Article 118-14 of that Act, the provision amending Article 118-10 of that Act (excluding the amending provision listed in that item), the provision renumbering that Article as Article 118-13 of that Act, the provision amending Article 118-9 of that Act, the provision renumbering that Article as Article 118-12 of that Act, the provision amending Article 118-8, paragraph (1) of that Act, the provision renumbering that Article as Article 118-11 of that Act, the provision adding three Articles after Article 118-7 of that Act, and the provision amending Article 205-3 and Article 206-2 of that Act; the provisions of Article 14 (excluding the amending provisions listed in that item and item (vi)); the provision, in Article 15, amending Article 24, paragraph (1) of the Immunization Act, the provision adding three Articles after Article 28 of that Act, the provision amending Article 29, paragraph (1) and Article 30 of that Act, the provision amending Article 31 of that Act (limited to the part replacing "use or provision of anonymized information related to immunization, etc. under the provisions of Article 24, paragraph (1)" with "use and provision of anonymized information related to immunization, etc. under the provisions of Article 24, paragraph (1), and the use and provision of pseudonymized information related to immunization, etc. under the provisions of Article 28-2, paragraphs (1) and (2)"), the provision adding two paragraphs to that Article, the provision amending Article 32, paragraph (1) of that Act (limited to the part replacing "the preceding Article" with "paragraph (1) of the preceding Article"), the provision adding one paragraph to that Article, the provision amending Article 33, item (i) and Article 43, item (i) of that Act, and the provision amending Article 48 and Article 59 of that Act; the provisions of Article 20; the provision, in Article 22, amending Article 89-2-3, paragraph (1) and Article 89-2-11 of the Act on Providing Comprehensive Support for the Daily Life and Life in Society of Persons with Disabilities, the provision renumbering that Article as Article 89-2-14 of that Act, the provision amending Article 89-2-10 of that Act, the provision renumbering that Article as Article 89-2-13 of that Act, the provision amending Article 89-2-9 of that Act, the provision renumbering that Article as Article 89-2-12 of that Act, the provision amending Article 89-2-8, paragraph (1) of that Act, the provision renumbering that Article as Article 89-2-11 of that Act, the provision adding three Articles after Article 89-2-7 of that Act, and the provision amending Article 109-2 and Article 109-3 of that Act; the provisions of Article 26; the provisions of Article 27 (excluding the amending provisions listed in item (v) and item (vi)), the provisions of Article 28 (excluding the amending provision listed in item (v)), and the provisions of Article 11, Article 15, Article 17, Article 27, and Article 29 of the Supplementary Provisions; the provisions of Article 35 (excluding the amending provisions listed in that item and item (vi)), Article 38 (excluding the amending provisions listed in item (v) and item (vi)), and Article 39 (excluding the amending provisions listed in item (v) and item (vi)) of the Supplementary Provisions; and the provisions of Article 43, Article 46, Article 47, and Article 52 of the Supplementary Provisions, and the provisions of Article 59 of the Supplementary Provisions (excluding the amending provision listed in the following item): the date specified by Cabinet Order within a period not exceeding three years from the date of promulgation;