①If the establisher or administrator of a clinic has received a request from the prefectural governor pursuant to the provisions of Article 30-18-6, paragraph (6) of the Medical Care Act but did not comply with it, has received a recommendation from the prefectural governor pursuant to the provisions of paragraph (9) of that Article, or has received that recommendation but did not comply with it, the Minister of Health, Labour and Welfare may, notwithstanding the provisions of paragraph (1) of the preceding Article and pursuant to Order of the Ministry of Health, Labour and Welfare, attach a time limit of three years or less when making the designation referred to in Article 63, paragraph (3), item (i).

②With regard to a designation referred to in Article 63, paragraph (3), item (i) to which a time limit has been attached pursuant to the provisions of the preceding paragraph, the provisions of paragraph (2) of the preceding Article do not apply.

In the case where a clinic or pharmacy has been established by a physician, dentist or pharmacist, and only the establisher (excluding a person who received a request from the prefectural governor under Article 30-18-6, paragraph (6) of the Medical Care Act but did not comply with it) who is that physician, dentist or pharmacist is engaged in medical care or prescription, if a registration under Article 64 has been made with respect to the physician, dentist or pharmacist, it is deemed that a designation referred to in Article 63, paragraph (3), item (i) has been made with regard to the clinic or pharmacy; provided, however, this does not apply when the clinic or pharmacy meets the requirements prescribed in Article 65, paragraph (3) or (4) but the Minister of Health, Labour and Welfare finds it inappropriate to deem that the designation referred to in Article 63, paragraph (3), item (i) has been made.

①A medical institution providing services covered by health insurance or a pharmacy providing services covered by health insurance must put physicians providing health insurance treatment who are engaging in medical care at the institution or pharmacists filling health insurance prescriptions who are engaging in prescription at the pharmacy in charge of medical care or prescription pursuant to Order of the Ministry of Health, Labour and Welfare referred to in Article 72, paragraph (1) and must be responsible for benefits for medical treatment pursuant to Order of the Ministry of Health, Labour and Welfare.

②Beyond the provisions of the preceding paragraph (including when applied mutatis mutandis to Article 85, paragraph (9), Article 85-2, paragraph (5), Article 86, paragraph (4), Article 110, paragraph (7), and Article 149), a medical institution providing services covered by health insurance or a pharmacy providing services covered by health insurance is responsible for benefits for medical treatment pursuant to the provisions of the Seamen's Insurance Act, National Health Insurance Act, National Public Employees Mutual Aid Association Act (Act No. 128 of 1958; including when this is applied mutatis mutandis to other laws and the same rule governs), or Local Public Employees Mutual Aid Association Act (hereinafter referred to as "medical insurance laws other than this act") as well as medical treatment for insured persons and dependents, benefits for medical treatment pursuant to the provisions of the Act on Assurance of Medical Care for Elderly People, and treatment pertaining to dietary treatment expenses for inpatients, living support expenses for inpatients, and medical expenses combined with treatment outside insurance coverage.

③A medical institution providing services covered by health insurance which is an advanced treatment hospital prescribed by Article 4-2 of the Medical Care Act or otherwise specified by Order of the Ministry of Health, Labour and Welfare is to take measures specified by Order of the Ministry of Health, Labour and Welfare as measures for sharing functions and for operational cooperation between medical institutions providing services covered by health insurance, for instance, by referring patients to medical institutions providing services covered by health insurance appropriate for the patients' symptoms or other circumstances.

④A medical institution providing services covered by health insurance or a pharmacy providing services covered by health insurance is to cooperate with measures taken by the national government or a local government for the provision of the medical care listed in the items of Article 37, paragraph (1) of that Act and other necessary medical care concerning pandemic influenza or similar infectious disease prescribed in Article 6, paragraph (7) of the Act on the Prevention of Infectious Diseases and Medical Care for Patients with Infectious Diseases and other infectious diseases.

①The administrator of a medical institution providing services covered by health insurance must be a person who satisfies all of the following requirements.

②In order to provide appropriate medical care efficiently, the administrator of a medical institution providing services covered by health insurance must, as specified by Order of the Ministry of Health, Labour and Welfare, supervise the physicians, dentists, pharmacists and other employees working at that medical institution providing services covered by health insurance, and exercise necessary care in the management and operation of that medical institution providing services covered by health insurance.

①Registration under Article 64 is made upon an application by a physician, dentist or pharmacist.

②If an application referred to in the preceding paragraph that corresponds to any of the following items is filed, the Minister of Health, Labour and Welfare may not make a registration under Article 64:

③If the Minister of Health, Labour and Welfare determines not to make a registration referred to in Article 64 pertaining to a physician providing health insurance treatment or a pharmacist filling health insurance prescriptions, the Minister must undergo discussion at the relevant local social insurance medical council.

④Beyond what is provided for in paragraphs (1) and (2), necessary matters concerning registration referred to in Article 64 pertaining to physicians providing insurance treatment and pharmacists filling insurance prescriptions are specified by Cabinet Order.

①A physician providing health insurance treatment at a medical institution providing services covered by health insurance or a pharmacist filling health insurance prescriptions at a pharmacy providing services covered by health insurance must provide medical care or prescription services covered by health insurance pursuant to Order of the Ministry of Health, Labour and Welfare.

②A physician providing health insurance treatment at a medical institution providing services covered by health insurance or a pharmacist filling health insurance prescriptions at a pharmacy providing services covered by health insurance is to be in charge of medical care or prescription pursuant to the provisions of the preceding paragraph (including when applied mutatis mutandis pursuant to Article 85, paragraph (9), Article 85-2, paragraph (5), Article 86, paragraph (4), Article 110, paragraph (7), and Article 149) and pursuant to medical insurance laws other than this act and the Act on Assurance of Medical Care for Elderly People.

①A medical institution providing services covered by health insurance or a pharmacy providing services covered by health insurance, and the physician providing health insurance treatment or the pharmacist filling health insurance prescriptions, must receive guidance from the Minister of Health, Labour and Welfare with respect to benefits for medical treatment and with respect to medical care or prescription services provided under a national health insurance program, respectively.

②When the guidance referred to in the preceding paragraph is provided, and the Minister of Health, Labour and Welfare finds it necessary, the Minister is to have persons with knowledge and experience concerning medical care or prescription services attend during the guidance pursuant to designation by related organizations; provided, however, that this does not apply if related organizations make no designation or the designated persons do not attend.

①A person who receives benefits for medical treatment from a medical institution providing services covered by health insurance or a pharmacy providing services covered by health insurance pursuant to the provisions of Article 63, paragraph (3) must pay, in accordance with the classifications listed in the following items, an amount obtained by multiplying the amount calculated pursuant to the provisions of Article 76, paragraph (2) or (3) with respect to the benefit by the ratio specified in the relevant item below, as the person's co-payment to the medical institution or the pharmacy when receiving the benefit:

②A medical institution providing services covered by health insurance or a pharmacy providing services covered by health insurance is to receive the co-payment referred to in the preceding paragraph (if the reduction referred to in Article 75-2, paragraph (1), item (i) is made, the co-payment after the reduction) and, when a person who received the relevant benefit for medical treatment fails to make all or part of the co-payment despite the efforts of the medical institution or pharmacy to receive the payment with the same level of care as the due care of a prudent manager, the insurer may impose a disposition on the person pursuant to the same rules as those for the money to be collected pursuant to the provisions of this Act, at the request of the medical institution or pharmacy.

When co-payment is made pursuant to the provisions of paragraph (1) of the preceding Article, if the amount of co-payment referred to in the same paragraph is a figure with less than five, it is to be rounded down to the nearest ten yen, whereas if it is a figure with at least five yen but less than ten yen, it is to be rounded up to the nearest ten yen.

①An insurer may take any of the following measures with respect to an insured person who is in a disaster or other special circumstances specified by Order of the Ministry of Health, Labour and Welfare and regarding whom it is found difficult to make co-payment to a medical institution providing services covered by health insurance or pharmacy providing services covered by health insurance pursuant to the provisions of Article 74, paragraph (1):

②Notwithstanding the provisions of Article 74, paragraph (1), if the measure referred to in item (i) of the preceding paragraph has been taken with respect to an insured person, it is sufficient for the person to pay the amount of co-payment so reduced to the relevant medical institution or pharmacy providing services covered by health insurance, and if the measure referred to in item (ii) or (iii) has been taken with respect to an insured person, the person is not required to make co-payment to the relevant medical institution providing services covered by health insurance or pharmacy providing services covered by health insurance.

③The provisions of the preceding Article apply mutatis mutandis to co-payment in the case referred to in the preceding paragraph.