Article 85Dietary Treatment Expenses for Inpatients

①Dietary treatment expenses for inpatients are paid to an insured person (excluding insured persons undergoing special long-term hospitalization) who, pursuant to Order of the Ministry of Health, Labour and Welfare, has received from a hospital or clinic that the person selected from those listed in the items of Article 63, paragraph (3) confirmation of being an insured person by electronic eligibility confirmation, etc., for expenses required for dietary treatment that the person received along with benefits for medical treatment listed in Article 63, paragraph (1), item (v).

②The amount of dietary treatment expenses for inpatients is the amount obtained by deducting the amount specified by the Minister of Health, Labor and Welfare taking into consideration the status of food expenses for an average household budget and the average amount of expenses required to provide meals at a specified facility for insured long-term care (meaning the specified facilities for insured long-term care prescribed in Article 51-3, paragraph (1) of the Long-Term Care Insurance Act) from the amount calculated based on standards specified by the Minister of Health, Labour and Welfare taking into account the average amount of expenses required for the dietary treatment (if the calculated amount exceeds the amount of expenses actually incurred in the dietary treatment, the amount of expenses actually incurred in the dietary treatment) (for a person specified by Order of Health, Labor and Welfare in consideration of income status and other circumstances, a separately determined amount; hereinafter referred to as "standard co-payment for dietary treatment").

③When intending to specify the standards referred to in the preceding paragraph, the Minister of Health, Labour, and Welfare is to consult with the Central Social Insurance Medical Council.

④If the circumstances to be taken into consideration have changed significantly since the Minister of Health, Labour, and Welfare determines the amount of standard co-payment for dietary treatment, the Minister must promptly revise the amount.

⑤When an insured person (excluding insured persons undergoing special long-term hospitalization; the same applies hereinafter in this Article) has received dietary treatment at or from a hospital or clinic listed in Article 63, paragraph (3), item (i) or (ii), the insurer may, on behalf of the insured person, pay to the hospital or clinic the expenses incurred for the dietary treatment payable by the insured person to the hospital or clinic within the limit of the amount payable to the insured person as expenses for dietary treatment for inpatients.

⑥When a payment pursuant to the provisions of the preceding paragraph is paid, it is deemed that the relevant dietary treatment expenses for inpatients are paid to the insured person.

⑦When an insured person receives dietary treatment from a hospital or clinic listed in Article 63, paragraph (3), item (iii), if the insurer exempts the insured person from payment of an amount equivalent to the amount to be paid as dietary treatment expenses for inpatients among the expenses required for dietary treatment to be paid by the insured person, it is deemed that dietary treatment expenses for inpatients are paid to the insured person.

⑧Upon acceptance of a payment of expenses incurred for dietary treatment, the hospital or clinic listed in the items of Article 63, paragraph (3) must issue a receipt therefor to the relevant insured person who makes the payment, pursuant to Ordinance of the Ministry of Health, Labour and Welfare.