Supplementary Provisions

This Act shall come into effect as of January 1, 1959.

For any Municipality which doesn't actually provide any national health insurance program at the time when this Act comes into effect, it shall be sufficient to commence national health insurance services no later than April 1, 1961, notwithstanding the provisions of Article 3, paragraph (1).

Any Municipality as referred to in the preceding Article may, if in special circumstances and upon the approval of the Minister of Health and Welfare, choose to remain with no national health insurance program after April 1, 1961 until otherwise provided for in law, notwithstanding the provisions of Article 3, paragraph (1) and the preceding Article.

The provisions of Article 11 shall not apply to any Municipality which provides no national health insurance program pursuant to the provisions of the two preceding Articles.

In addition to what is provided for in the three preceding Articles, necessary particulars concerning the enforcement of this Act shall be prescribed by law.

①An insured person who is found to have changed domicile to the location of a designated facility covered by public aid providing long-term care to the elderly (meaning a designated facility covered by public aid providing long-term care to the elderly prescribed in Article 48, paragraph (1), item (i) of the Long-Term Care Insurance Act; the same applies hereinafter in this paragraph) by being admitted to that facility, and who is found to have been domiciled within the area of another Municipality (meaning a Municipality other than the Municipality in which that designated facility covered by public aid providing long-term care to the elderly is located) at the time of being admitted to that facility, is deemed, for the purpose of the application of this Act, to be domiciled within the area of the other Municipality while continuously admitted to a Converted Community-Based Facility for the Elderly Covered by Public Aid Requiring Long-Term Care, even where that designated facility covered by public aid providing long-term care to the elderly becomes, due to a reduction of its admission capacity, a community-based facility for the elderly covered by public aid requiring long-term care prescribed in Article 8, paragraph (22) of that Act (limited to one for which the designation under the main clause of Article 42-2, paragraph (1) of that Act has been received with respect to an office that carries out the business of community-based long-term care for residents of facilities for the elderly covered by public aid prescribed in Article 8, paragraph (22) of that Act; hereinafter referred to as a "Converted Community-Based Facility for the Elderly Covered by Public Aid Requiring Long-Term Care" in this Article); provided, however, that this does not apply to an insured person who has been continuously hospitalized, admitted or resident (hereinafter referred to as "hospitalization, etc." in this Article) in two or more hospitals, etc. (meaning the hospitals, etc. prescribed in Article 116-2, paragraph (1); the same applies hereinafter in this Article) including a designated facility covered by public aid providing long-term care to the elderly that has become a Converted Community-Based Facility for the Elderly Covered by Public Aid Requiring Long-Term Care (hereinafter referred to as a "Former Facility Covered by Public Aid Providing Long-Term Care to the Elderly" in this Article) (limited to a person who is continuously admitted to that Converted Community-Based Facility for the Elderly Covered by Public Aid Requiring Long-Term Care), and who is found to have changed domicile sequentially to the locations of the hospital, etc. in which the person was hospitalized, etc. immediately before being admitted to that Former Facility Covered by Public Aid Providing Long-Term Care to the Elderly (hereinafter referred to as the "last hospital, etc." in this paragraph) and of that Former Facility Covered by Public Aid Providing Long-Term Care to the Elderly, respectively, by being hospitalized, etc. in each of the last hospital, etc. and that Former Facility Covered by Public Aid Providing Long-Term Care to the Elderly (referred to as a "specified continuously hospitalized insured person" in the following paragraph).

②Among specified continuously hospitalized insured persons, those listed in the following items are deemed, for the purpose of the application of this Act, to be domiciled within the area of the Municipality specified in the relevant item.

③The provisions of Article 116-2 shall apply to an insured person to whom the provisions of the two preceding paragraphs shall apply, as if the Converted Community-Based Facility for the Elderly Covered by Public Aid Requiring Long-Term Care were a Hospital, etc.

In the case of a Society specified by the Minister of Health, Labour and Welfare pursuant to Article 7, paragraph (3) of the Act on Assurance of Medical Care for Elderly People, in Article 76, paragraph (2), the phrase "a Society" is deemed to be replaced with "a Society specified by the Minister of Health, Labour and Welfare pursuant to Article 7, paragraph (3) of the Act on Assurance of Medical Care for Elderly People", and the phrase ", long-term care payment, contribution for securing medical care in the early phase of an epidemic, etc., and children and child-rearing support levy (including the expenses required for the payment thereof), and, in the case of a Society prescribed in Article 179 of the Health Insurance Act, that Act" is deemed to be replaced with ", long-term care payment, contribution for securing medical care in the early phase of an epidemic, etc., children and child-rearing support levy and the Health Insurance Act".

Until the date specified by the Cabinet Order prescribed in Article 2 of the Supplementary Provisions of the Act on Assurance of Medical Care for Elderly People, in Article 69, the phrase "and old-old aid, contribution for administrative expenses related to the old-old and contribution for administrative expenses related to childbirth and childcare under that Act (hereinafter referred to as "old-old aid, etc.")" is deemed to be replaced with ", old-old aid, contribution for administrative expenses related to the old-old and contribution for administrative expenses related to childbirth and childcare under that Act (hereinafter referred to as "old-old aid, etc."), and bed conversion support payment, etc. under that Act (hereinafter referred to as "bed conversion support payment, etc.")"; in Article 70, paragraph (1), the phrase "and old-old aid under that Act (hereinafter referred to as "old-old aid")" is deemed to be replaced with ", old-old aid under that Act (hereinafter referred to as "old-old aid") and bed conversion support payment under that Act (hereinafter referred to as "bed conversion support payment")"; in item (ii) of that paragraph, the phrase "and old-old aid" is deemed to be replaced with ", old-old aid and bed conversion support payment"; in Article 73, paragraphs (1) and (2), the phrase "and old-old aid" is deemed to be replaced with ", old-old aid and bed conversion support payment"; and in Article 75, Article 75-7, paragraph (1), Article 76, paragraph (1) and paragraph (2) of that Article (including cases where applied with terms replaced pursuant to the preceding Article), and Article 81-2, paragraph (10), items (iv) and (v), the phrase "and old-old aid, etc." is deemed to be replaced with ", old-old aid, etc. and bed conversion support payment, etc.".

A merged Municipality prescribed in Article 2, paragraph (2) of the Act on Special Provisions for the Merger of Municipalities (Act No. 59 of 2004) may, in the case where, owing to a significant imbalance in the assessment of insurance premiums among the Municipalities concerned in the merger prescribed in paragraph (3) of that Article, it is found that assessing uniform insurance premiums over the whole of its area would be significantly inequitable, assess non-uniform insurance premiums to the extent of that inequity, limited to the fiscal year including the day on which the merger of Municipalities (limited to a merger carried out on or before March 31, 2030) took place and the following five fiscal years.

For the time being, notwithstanding the provisions of Article 72, paragraph (2), the total amount of adjusting subsidies prescribed in that paragraph is the amount specified in the budget as the amount obtained by deducting, from the amount calculated pursuant to the provisions of that paragraph, the amount obtained by deducting an amount equal to or less than the amount of the costs from the amount of the costs borne by the national government pursuant to the provisions of Article 70, paragraph (3).

In fiscal year 2024 and fiscal year 2025, in Article 152-4 of the Health Insurance Act as applied mutatis mutandis pursuant to Article 73-2, paragraph (2), the phrase "the amount calculated as specified by Order of the Ministry of Health, Labour and Welfare as the prospective amount of expenses required for payment of the lump-sum allowance for childbirth and childcare, etc. pertaining to the insurer in the relevant fiscal year" is deemed to be replaced with "an amount equivalent to one-half of the amount calculated as specified by Order of the Ministry of Health, Labour and Welfare as the prospective amount of expenses required for payment of the lump-sum allowance for childbirth and childcare, etc. pertaining to the insurer in the relevant fiscal year", and in Article 152-5 of that Act as applied mutatis mutandis pursuant to that paragraph, the phrase "the amount of expenses required for payment of the lump-sum allowance for childbirth and childcare, etc. pertaining to the insurer in the fiscal year before last (limited to the portion pertaining to the amount specified by Cabinet Order in Article 101)" is deemed to be replaced with "an amount equivalent to one-half of the amount calculated as specified by Order of the Ministry of Health, Labour and Welfare as the amount of expenses required for payment of the lump-sum allowance for childbirth and childcare, etc. pertaining to the insurer in the fiscal year before last (limited to the portion pertaining to the amount specified by Cabinet Order in Article 101)".