National Health Insurance Act

In order to review medical bills as entrusted pursuant to the provisions of Article 45, paragraph (5) or review bills for delivery expenses as entrusted pursuant to the provisions of Article 45, paragraph (5) as applied mutatis mutandis pursuant to Article 54-5, paragraph (7), a Federation whose district covers the area of a prefecture (excluding any such Federation that has not been joined by two-thirds or more of the prefectures or Municipalities, or Societies within its district) shall have a National Health Insurance Medical Fees Review Committee (hereinafter referred to as the "Review Committee").

A Federation may, as far as not hindering the carrying out of the affairs set forth in the preceding paragraph, have the Review Committee conduct the review of medical bills to be conducted as entrusted pursuant to the provisions of Article 76, paragraph (5) of the Health Insurance Act or the review of bills for delivery expenses to be conducted as entrusted pursuant to the provisions of Article 98-2, paragraph (8) of that Act.

When the Review Committee finds it necessary in order to review medical bills or review bills for delivery expenses, it may, upon the approval of the prefectural governor, request the relevant Health Insurance-Covered Medical Institutionhealth insurance-covered medical institution, etc. or, the relevant office providing designated home-nursing home nursing or the relevant designated birthing center to make a report or submit or present medical records , birth records or other books and documents, or may request any of the establishers or administrators of such Health Insurance-Covered Medical Institutionhealth insurance-covered medical institution, etc., the designated home-nursing provider, any of the establishers or administrators of such designated birthing center, any of the health insurance-covered physicians or health insurance-covered pharmacists who are in charge of medical treatment at such Health Insurance-Covered Medical Institutionhealth insurance-covered medical institution, etc., or any of the health insurance-covered physicians (limited to physicians) or registered midwives who are in charge of delivery care at the relevant delivery-handling medical institution providing services covered by health insurance or designated birthing center to appear or provide an explanation.

The Federation must pay travel expenses, daily expenses and accommodation expenses to any person who appeared at the Review Committee pursuant to the provisions of the preceding paragraph; provided, however, that this shall not apply to any person who appeared in response to a request for appearance issued due to defective or misleading entries in medical bills or bills for delivery expenses or medical records , birth records or other books and documents submitted by the relevant Health Insurance-Covered Medical Institutionhealth insurance-covered medical institution, etc. or, the relevant office providing designated home-nursinghome nursing or the relevant designated birthing center.