This Act comes into effect on April 1, 2018; provided, however, that the provisions set forth in the following items come into effect as of the days specified respectively in those items.

After the promulgation of this Act, from the perspective of building a sustainable medical insurance system, the government is to conduct a review of optimizing the costs required for medical care, the scope of insurance benefits of medical insurance, and how the costs required for medical care are to be shared in accordance with the ability of subscribers, etc. to bear costs, and to take necessary measures based on the results.

With regard to the amount of the national subsidy to Japan Health Insurance Association in each fiscal year from fiscal year 2010 through fiscal year 2014, the provisions then in force continue to govern.

①The standard monthly remuneration amount of those, among persons who acquired eligibility as an insured person covered by health insurance (excluding specially-insured day laborers; the same applies hereinafter in this paragraph) before the date on which the provisions set forth in Article 1, item (ii) of the Supplementary Provisions come into effect (hereinafter referred to as the "item (ii) Effective Date") and have continuously held that eligibility until the item (ii) Effective Date (excluding persons whose standard monthly remuneration amount is to be revised from April 2016), whose standard monthly remuneration amount for March of that year is 1,210,000 yen (excluding persons whose monthly remuneration amount that was the basis of that standard monthly remuneration amount is less than 1,235,000 yen), is revised by the insurer, etc. (meaning the insurer, etc. prescribed in Article 39, paragraph (1) of the Health Insurance Act), deeming the monthly remuneration amount that was the basis of that standard monthly remuneration amount to be the monthly remuneration amount that is the basis of the standard monthly remuneration amount under the provisions of Article 40, paragraph (1) of the Health Insurance Act as amended by the provisions of Article 5 (referred to as the "item (ii) Amended Health Insurance Act" in the following Article and Article 18 of the Supplementary Provisions).

②The standard monthly remuneration amount revised pursuant to the provisions of the preceding paragraph is the standard monthly remuneration amount of each month from April 2016 until August of that year.

The provisions of Article 45, paragraph (1) of the item (ii) Amended Health Insurance Act apply to the standard bonus amount of a bonus received by an insured person covered by health insurance in a month on or after the month that includes the item (ii) Effective Date, and with regard to the standard bonus amount of a bonus received by that insured person in a month before the month that includes the item (ii) Effective Date, the provisions then in force continue to govern.

When intending to establish the Order of the Ministry of Health, Labour and Welfare referred to in Article 70, paragraph (3) of the item (ii) Amended Health Insurance Act, the Minister of Health, Labour, and Welfare may, even before the item (ii) Effective Date, consult with the Central Social Insurance Medical Council in the same manner as under the provisions of Article 82, paragraph (1) of the item (ii) Amended Health Insurance Act.

With regard to the amount of the injury and sickness allowance or childbirth allowance paid for the period before the item (ii) Effective Date to a person who, before the item (ii) Effective Date, was receiving or was to receive injury and sickness allowance or childbirth allowance under the Health Insurance Act prior to its amendment by the provisions of Article 5, the provisions then in force continue to govern.

With regard to the amount of the national subsidy to the Japan Health Insurance Association in each of fiscal year 2015 and fiscal year 2016, the provisions then in force continue to govern.

With regard to the application of penal provisions to conduct engaged in before this Act (or, for the provisions set forth in the items of Article 1 of the Supplementary Provisions, those respective provisions; the same applies hereinafter in this Article) comes into effect and to conduct engaged in after this Act comes into effect in the case where the provisions then in force are to remain applicable pursuant to the provisions of these Supplementary Provisions, the provisions then in force continue to govern.

Beyond what is provided for in these Supplementary Provisions, transitional measures necessary in connection with the enforcement of this Act (including transitional measures concerning penal provisions) are specified by Cabinet Order.