When there is a person who has received insurance benefits by means of deception or other wrongful conduct, Municipalities and Societies may collect all or part of the amount of such benefits from that person.
偽りその他不正の行為によつて保険給付を受けた者があるときは、市町村及び組合は、その者からその給付の価額の全部又は一部を徴収することができる。
In the case referred to in the preceding paragraph, when the insurance benefit is granted because a health insurance-covered physician who is engaged in medical care at a health insurance-covered medical institution or an attending physician as set forth in Article 88, paragraph (1) of the Health Insurance Act has made a false entry on the medical certificate which is to be submitted to a Municipality or Society, the Municipality or Society may order said health insurance-covered physician or attending physician to pay the money to be collected pursuant to the preceding paragraph jointly and severally with the person who received said insurance benefit.
前項の場合において、保険医療機関において診療に従事する保険医又は健康保険法第八十八条第一項に規定する主治の医師が、市町村又は組合に提出されるべき診断書に虚偽の記載をしたため、その保険給付が行われたものであるときは、市町村又は組合は、当該保険医又は主治の医師に対し、保険給付を受けた者に連帯して前項の徴収金を納付すべきことを命ずることができる。
When a health insurance-covered medical institution, etc. or a designated home-nursing provider receives, by means of deception or other wrongful conduct, any payment of expenses relating to benefits for medical treatment or any payment pursuant to the provisions of Article 52, paragraph (3) (including cases where applied mutatis mutandis pursuant to Article 52-2, paragraph (3) and Article 53, paragraph (3)) or Article 54-2, paragraph (5), Municipalities and Societies may cause said health insurance-covered medical institution, etc. or designated home-nursing provider to refund the amount so paid and to pay, in addition, the amount obtained by multiplying the amount to be refunded by forty hundredths.
市町村及び組合は、保険医療機関等又は指定訪問看護事業者が偽りその他不正の行為によつて療養の給付に関する費用の支払又は第五十二条第三項（第五十二条の二第三項及び第五十三条第三項において準用する場合を含む。）若しくは第五十四条の二第五項の規定による支払を受けたときは、当該保険医療機関等又は指定訪問看護事業者に対し、その支払つた額につき返還させるほか、その返還させる額に百分の四十を乗じて得た額を支払わせることができる。
A prefecture may, upon entrustment from a Municipality, carry out, of the affairs of collecting or receiving the amounts that the Municipality causes a health insurance-covered medical institution, etc. or designated home-nursing provider to refund and to pay pursuant to the provisions of the preceding paragraph, those that require a wide-area response or are highly specialized.
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