Article 53Examination and Payment of Medical Expenses

①A prefectural governor may examine the contents of medical treatment provided by and the claims for medical treatment fees made by a designated medical care provider as needed and decide the amount of the medical treatment fees that the designated medical care provider may claim pursuant to the provisions of the preceding Article.

②A designated medical care provider shall follow the decision under the preceding paragraph made by a prefectural governor.

③When a prefectural governor decides on the amount of medical treatment fees that a designated medical care provider may claim pursuant to the provisions of paragraph (1), he/she shall hear the opinion of an examination committee prescribed in the Act on the Medical Information Infrastructure and Medical Fee Examination and Payment Organization (Act No. 129 of 1948) or an examination organ related to medical care that has been specified by Cabinet Order.

④A prefecture, city, or a town or village with a welfare office may entrust affairs concerning the payment of medical treatment fees to designated medical care providers to the Medical Information Infrastructure and Medical Fee Examination and Payment Organization or a person specified by an Order of the Ministry of Health, Labour and Welfare.

⑤No request for review may be made with regard to a decision on the amount of the medical treatment fees under the provisions of paragraph (1).