Supplementary Provisions
附 則
Supplementary Provisions, Article 1Effective Date
第一条（施行期日）
This Act comes into effect on October 1, 2002; provided, however, that the provisions in Article 3 adding one Article after Article 79-2 of the Act on Health and Medical Services for the Elderly come into effect on the date of promulgation, the provisions of Articles 2, 5, and 8 and of Articles 6 through 8, 33, 34, 39, 41, and 48, Article 49, paragraph (3), Article 51, Article 52, paragraph (3), and Articles 54, 67, 69, 71, 73, and 77 of the Supplementary Provisions come into effect on April 1, 2003, and the provisions of Article 61-2 of the Supplementary Provisions come into effect on the date on which the provisions of Article 15 of the Act on the Arrangement of Related Acts for the Enforcement of the Act on the Use of Information and Communications Technology in Administrative Procedures, etc. (Act No. 152 of 2002) come into effect or the date on which this Act comes into effect, whichever is later.
この法律は、平成十四年十月一日から施行する。ただし、第三条中老人保健法第七十九条の二の次に一条を加える改正規定は公布の日から、第二条、第五条及び第八条並びに附則第六条から第八条まで、第三十三条、第三十四条、第三十九条、第四十一条、第四十八条、第四十九条第三項、第五十一条、第五十二条第三項、第五十四条、第六十七条、第六十九条、第七十一条、第七十三条及び第七十七条の規定は平成十五年四月一日から、附則第六十一条の二の規定は行政手続等における情報通信の技術の利用に関する法律の施行に伴う関係法律の整備等に関する法律（平成十四年法律第百五十二号）第十五条の規定の施行の日又はこの法律の施行の日のいずれか遅い日から施行する。
Supplementary Provisions, Article 2Reform of the Medical Insurance System, etc.
第二条（医療保険制度の改革等）
The proportion of benefits pertaining to the medical care of insured persons and dependents prescribed in the individual medical insurance Acts is to be maintained at 70 percent into the future.
医療保険各法に規定する被保険者及び被扶養者の医療に係る給付の割合については、将来にわたり百分の七十を維持するものとする。
In order to ensure the stable operation of the medical insurance system into the future, the government is to formulate, within fiscal year 2002, a basic policy that clarifies the specific content, procedures and annual plan for the following matters. The government is to take required measures based on that basic policy as promptly as possible (for the matter set forth in item (ii), with a target of about two years).
政府は、将来にわたって医療保険制度の安定的運営を図るため、平成十四年度中に、次に掲げる事項について、その具体的内容、手順及び年次計画を明らかにした基本方針を策定するものとする。政府は、当該基本方針に基づいて、できるだけ速やかに（第二号に掲げる事項についてはおおむね二年を目途に）、所要の措置を講ずるものとする。
the structure of the medical insurance system, including the integration and reorganization of insurers;
保険者の統合及び再編を含む医療保険制度の体系の在り方
the creation of a new medical system for the elderly;
新しい高齢者医療制度の創設
the review of the medical fee schedule.
診療報酬の体系の見直し
The government is to clarify the specific content, procedures and annual plan for the following matters, and take required measures, with a target of about two years.
政府は、おおむね二年を目途に、次に掲げる事項について、その具体的内容、手順及び年次計画を明らかにし、所要の措置を講ずるものとする。
a review of the hospitals established by the government as the insurer of health insurance;
健康保険の保険者である政府が設置する病院の在り方の見直し
streamlining of the operations and rationalization of the administrative affairs of the Social Insurance Agency.
社会保険庁の業務運営の効率化及び事務の合理化
The government is to clarify the specific content, procedures and annual plan for the following matters, and take required measures, with a target of about three years.
政府は、おおむね三年を目途に、次に掲げる事項について、その具体的内容、手順及び年次計画を明らかにし、所要の措置を講ずるものとする。
the unification of the collection affairs pertaining to social insurance and labor insurance for which the government is the insurer;
政府が保険者である社会保険及び労働保険に係る徴収事務の一元化
the creation of a mechanism for reducing the burden accompanying benefits under the provisions of the individual medical insurance Acts, the Act on Health and Medical Services for the Elderly and the Long-Term Care Insurance Act where the total amount of that burden in a household becomes extremely high;
医療保険各法、老人保健法及び介護保険法の規定による給付に伴う負担の家計における合計額が著しく高額になる場合の当該負担の軽減を図る仕組みの創設
the review of the system for handling affairs pertaining to the examination and payment of medical fees by the Social Insurance Medical Fee Payment Fund and the Federations of National Health Insurance Associations.
社会保険診療報酬支払基金及び国民健康保険団体連合会による診療報酬の審査及び支払に関する事務処理の体制の見直し
The government is to review the health insurance services administered by the government and the organizational form of those services, with a target of about five years, and take required measures based on the results.
政府は、おおむね五年を目途に、政府が管掌する健康保険事業及び当該事業の組織形態の在り方の見直しについて検討を行い、その結果に基づいて所要の措置を講ずるものとする。
The government is to review the following matters and take required measures based on the results.
政府は、次に掲げる事項について検討を行い、その結果に基づいて所要の措置を講ずるものとする。
the development of a system for handling complaints by experts in order to respond promptly and appropriately to accidents related to medical care;
医療に係る事故に迅速かつ適切に対応するための専門家による苦情の処理体制の整備
the development of a system for the collection, analysis, evaluation and provision of information on medical care and the costs required for medical care;
医療及び医療に要する費用に関する情報の収集、分析、評価及び提供に係る体制の整備
the content and scope of insurance benefits under the provisions of the individual medical insurance Acts and the Act on Health and Medical Services for the Elderly.
医療保険各法及び老人保健法の規定による保険給付の内容及び範囲の在り方
The government is to promptly commence review of the matters prescribed in paragraph (2) through the preceding paragraph, reach conclusions, and implement them in sequence.
政府は、第二項から前項までに規定する事項の検討に早急に着手し結論を得、逐次実施するものとする。
Supplementary Provisions, Article 22Transitional Measures Accompanying the Partial Amendment of the National Health Insurance Act
第二十二条（国民健康保険法の一部改正に伴う経過措置）
With regard to the payment of medical expenses, special medical expenses, exceptional medical expenses or high-cost medical expenses under the provisions of the National Health Insurance Act before the amendment by this Act, pertaining to medical treatment or the provision of medication conducted before the date on which this Act (or, for the provisions prescribed in the proviso to Article 1 of the Supplementary Provisions, those provisions; the same applies hereinafter in this Article) comes into effect, and the payment of the difference under Article 43 of that Act and the payment of the difference under Article 56 of that Act, the provisions then in force continue to govern.
この法律（附則第一条ただし書に規定する規定については、当該規定。以下この条において同じ。）の施行の日前に行われた療養又は薬剤の支給に係るこの法律による改正前の国民健康保険法の規定による療養費、特別療養費、特例療養費又は高額療養費の支給並びに同法第四十三条の規定による差額の支給及び同法第五十六条の規定による差額の支給については、なお従前の例による。
Supplementary Provisions, Article 23
第二十三条
In the case of applying the provisions of Article 70, paragraph (3) of the National Health Insurance Act as amended by the provisions of Article 4 (hereinafter referred to as the "Revised National Health Insurance Act") to a Municipality that has been designated, for fiscal years 2000 and 2001, pursuant to Article 68-2, paragraph (1) of the National Health Insurance Act, the amount prescribed in item (ii), (b) of that paragraph is, notwithstanding the provisions of (b) of that item, the amount obtained by deducting the amount set forth in item (ii) from the amount set forth in item (i).
the amount calculated, pursuant to Cabinet Order, as an amount equivalent to 7/10 of the amount obtained by multiplying the total sum of the amounts obtained, for each age bracket, by multiplying the average amount of medical expenses for the elderly per person pertaining to that age bracket by the number of insured persons of that Municipality belonging to that age bracket (limited to persons who can receive medical care under the provisions of the Act on Health and Medical Services for the Elderly) by the finalized enrollee adjustment rate under Article 56, paragraph (2) of that Act for the designated fiscal year pertaining to that Municipality
政令で定めるところにより、年齢階層ごとに、当該年齢階層に係る平均一人当たり老人医療費額に当該市町村の当該年齢階層に属する被保険者（老人保健法の規定による医療を受けることができる者に限る。）の数を乗じて得た額の合算額に、当該市町村に係る指定年度の同法第五十六条第二項の確定加入者調整率を乗じて得た額の十分の七に相当する額として算定した額
the amount equivalent to 1/2 of the amount obtained by multiplying the amount set forth in the preceding item by the ratio, calculated pursuant to Cabinet Order, of the total number of retired insured persons and their dependents (hereinafter referred to as "retired insured persons, etc.") to the total number of insured persons of that Municipality (hereinafter referred to as the "enrolment ratio of retired insured persons, etc.")
前号に掲げる額に当該市町村に係る被保険者の総数に対する退職被保険者及びその被扶養者（以下「退職被保険者等」という。）の総数の割合として政令で定めるところにより算定した割合（以下「退職被保険者等加入割合」という。）を乗じて得た額の二分の一に相当する額
Supplementary Provisions, Article 24
第二十四条
In the case of applying the provisions of Article 70, paragraph (3) of the Revised National Health Insurance Act to a Municipality that has been designated, for fiscal year 2002, pursuant to Article 68-2, paragraph (1) of the National Health Insurance Act, the amount prescribed in item (ii), (b) of that paragraph is, notwithstanding the provisions of (b) of that item, the amount obtained by deducting the total sum of the amounts set forth in items (iv) and (v) from the total sum of the amounts set forth in items (i) through (iii).
平成十四年度につき国民健康保険法第六十八条の二第一項の規定により指定を受けた市町村について新国保法第七十条第三項の規定を適用する場合においては、同項第二号ロに規定する額については、同号ロの規定にかかわらず、第一号から第三号までに掲げる額の合算額から第四号及び第五号に掲げる額の合算額を控除した額とする。
the amount calculated, pursuant to Cabinet Order, as an amount equivalent to 7/10 of the amount obtained by multiplying the amount equivalent to 7/12 of the total sum of the amounts obtained, for each age bracket, by multiplying the average amount of medical expenses for the elderly per person pertaining to that age bracket by the number of insured persons of that Municipality belonging to that age bracket (limited to persons who can receive medical care under the provisions of the Act on Health and Medical Services for the Elderly) by the finalized enrollee adjustment rate before the effective date prescribed in Article 15, paragraph (2) of the Supplementary Provisions pertaining to that Municipality
政令で定めるところにより、年齢階層ごとに、当該年齢階層に係る平均一人当たり老人医療費額に当該市町村の当該年齢階層に属する被保険者（老人保健法の規定による医療を受けることができる者に限る。）の数を乗じて得た額の合算額の十二分の七に相当する額に、当該市町村に係る附則第十五条第二項に規定する施行日前確定加入者調整率を乗じて得た額の十分の七に相当する額として算定した額
the amount calculated, pursuant to Cabinet Order, as an amount equivalent to 66 percent of the amount obtained by multiplying the amount equivalent to 5/12 of the total sum of the amounts obtained, for each age bracket, by multiplying the average amount of medical expenses for the elderly per person for persons falling under the cases set forth in Article 28, paragraph (1), item (i) of the Revised Elderly Health Act pertaining to that age bracket by the number of insured persons of that Municipality belonging to that age bracket (limited to persons falling under the cases set forth in that item) by the finalized enrollee adjustment rate from the effective date prescribed in Article 15, paragraph (5) of the Supplementary Provisions pertaining to that Municipality (hereinafter simply referred to as the "finalized enrollee adjustment rate from the effective date")
政令で定めるところにより、年齢階層ごとに、当該年齢階層に係る新老健法第二十八条第一項第一号に掲げる場合に該当する者の平均一人当たり老人医療費額に当該市町村の当該年齢階層に属する被保険者（同号に掲げる場合に該当する者に限る。）の数を乗じて得た額の合算額の十二分の五に相当する額に、当該市町村に係る附則第十五条第五項に規定する施行日以後確定加入者調整率（以下単に「施行日以後確定加入者調整率」という。）を乗じて得た額の百分の六十六に相当する額として算定した額
the amount calculated, pursuant to Cabinet Order, as the amount obtained by multiplying the amount equivalent to 5/12 of the total sum of the amounts obtained, for each age bracket, by multiplying the average amount of medical expenses for the elderly per person for persons falling under the cases set forth in Article 28, paragraph (1), item (ii) of the Revised Elderly Health Act pertaining to that age bracket by the number of insured persons of that Municipality belonging to that age bracket (limited to persons falling under the cases set forth in that item) by the finalized enrollee adjustment rate from the effective date pertaining to that Municipality
政令で定めるところにより、年齢階層ごとに、当該年齢階層に係る新老健法第二十八条第一項第二号に掲げる場合に該当する者の平均一人当たり老人医療費額に当該市町村の当該年齢階層に属する被保険者（同号に掲げる場合に該当する者に限る。）の数を乗じて得た額の合算額の十二分の五に相当する額に、当該市町村に係る施行日以後確定加入者調整率を乗じて得た額として算定した額
the amount equivalent to 1/2 of the amount obtained by multiplying the amount set forth in item (i) by the retired insured persons' enrollment share before the effective date pertaining to that Municipality (meaning the enrolment ratio of retired insured persons, etc. in the period on or after April 1, 2002 and before the Effective Date; the same applies hereinafter)
第一号に掲げる額に当該市町村に係る施行日前退職被保険者等加入割合（平成十四年四月一日以後施行日前の期間における退職被保険者等加入割合をいう。以下同じ。）を乗じて得た額の二分の一に相当する額
the amount obtained by multiplying the total sum of the amounts set forth in items (ii) and (iii) by the retired insured persons' enrollment share from the effective date pertaining to that Municipality (meaning the enrolment ratio of retired insured persons, etc. in the period from the Effective Date through March 31, 2003; the same applies hereinafter)
第二号及び第三号に掲げる額の合算額に、当該市町村に係る施行日以後退職被保険者等加入割合（施行日以後平成十五年三月三十一日までの期間における退職被保険者等加入割合をいう。以下同じ。）を乗じて得た額
Supplementary Provisions, Article 25
第二十五条
In the case of applying the provisions of Article 70, paragraph (3) of the Revised National Health Insurance Act to a Municipality that has been designated, for fiscal year 2003, pursuant to Article 68-2, paragraph (1) of the National Health Insurance Act, the amount prescribed in item (ii), (b) of that paragraph is, notwithstanding the provisions of (b) of that item, the amount obtained by deducting the amount set forth in item (v) from the total sum of the amounts set forth in items (i) through (iv).
平成十五年度につき国民健康保険法第六十八条の二第一項の規定により指定を受けた市町村について新国保法第七十条第三項の規定を適用する場合においては、同項第二号ロに規定する額については、同号ロの規定にかかわらず、第一号から第四号までに掲げる額の合算額から第五号に掲げる額を控除した額とする。
the amount calculated, pursuant to Cabinet Order, as an amount equivalent to 66 percent of the amount obtained by multiplying the amount equivalent to 7/12 of the total sum of the amounts obtained, for each age bracket, by multiplying the average amount of medical expenses for the elderly per person for persons falling under the cases set forth in Article 28, paragraph (1), item (i) of the Revised Elderly Health Act pertaining to that age bracket by the number of insured persons of that Municipality belonging to that age bracket (limited to persons falling under the cases set forth in that item) by the earlier-period finalized enrollee adjustment rate prescribed in Article 17, paragraph (2) of the Supplementary Provisions pertaining to that Municipality (hereinafter simply referred to as the "earlier-period finalized enrollee adjustment rate")
政令で定めるところにより、年齢階層ごとに、当該年齢階層に係る新老健法第二十八条第一項第一号に掲げる場合に該当する者の平均一人当たり老人医療費額に当該市町村の当該年齢階層に属する被保険者（同号に掲げる場合に該当する者に限る。）の数を乗じて得た額の合算額の十二分の七に相当する額に、当該市町村に係る附則第十七条第二項に規定する前期確定加入者調整率（以下単に「前期確定加入者調整率」という。）を乗じて得た額の百分の六十六に相当する額として算定した額
the amount calculated, pursuant to Cabinet Order, as the amount obtained by multiplying the amount equivalent to 7/12 of the total sum of the amounts obtained, for each age bracket, by multiplying the average amount of medical expenses for the elderly per person for persons falling under the cases set forth in Article 28, paragraph (1), item (ii) of the Revised Elderly Health Act pertaining to that age bracket by the number of insured persons of that Municipality belonging to that age bracket (limited to persons falling under the cases set forth in that item) by the earlier-period finalized enrollee adjustment rate pertaining to that Municipality
政令で定めるところにより、年齢階層ごとに、当該年齢階層に係る新老健法第二十八条第一項第二号に掲げる場合に該当する者の平均一人当たり老人医療費額に当該市町村の当該年齢階層に属する被保険者（同号に掲げる場合に該当する者に限る。）の数を乗じて得た額の合算額の十二分の七に相当する額に、当該市町村に係る前期確定加入者調整率を乗じて得た額として算定した額
the amount calculated, pursuant to Cabinet Order, as an amount equivalent to 62 percent of the amount obtained by multiplying the amount equivalent to 5/12 of the total sum of the amounts obtained, for each age bracket, by multiplying the average amount of medical expenses for the elderly per person for persons falling under the cases set forth in Article 28, paragraph (1), item (i) of the Revised Elderly Health Act pertaining to that age bracket by the number of insured persons of that Municipality belonging to that age bracket (limited to persons falling under the cases set forth in that item) by the later-period finalized enrollee adjustment rate prescribed in Article 17, paragraph (6) of the Supplementary Provisions pertaining to that Municipality (hereinafter simply referred to as the "later-period finalized enrollee adjustment rate")
政令で定めるところにより、年齢階層ごとに、当該年齢階層に係る新老健法第二十八条第一項第一号に掲げる場合に該当する者の平均一人当たり老人医療費額に当該市町村の当該年齢階層に属する被保険者（同号に掲げる場合に該当する者に限る。）の数を乗じて得た額の合算額の十二分の五に相当する額に、当該市町村に係る附則第十七条第六項に規定する後期確定加入者調整率（以下単に「後期確定加入者調整率」という。）を乗じて得た額の百分の六十二に相当する額として算定した額
the amount calculated, pursuant to Cabinet Order, as the amount obtained by multiplying the amount equivalent to 5/12 of the total sum of the amounts obtained, for each age bracket, by multiplying the average amount of medical expenses for the elderly per person for persons falling under the cases set forth in Article 28, paragraph (1), item (ii) of the Revised Elderly Health Act pertaining to that age bracket by the number of insured persons of that Municipality belonging to that age bracket (limited to persons falling under the cases set forth in that item) by the later-period finalized enrollee adjustment rate pertaining to that Municipality
政令で定めるところにより、年齢階層ごとに、当該年齢階層に係る新老健法第二十八条第一項第二号に掲げる場合に該当する者の平均一人当たり老人医療費額に当該市町村の当該年齢階層に属する被保険者（同号に掲げる場合に該当する者に限る。）の数を乗じて得た額の合算額の十二分の五に相当する額に、当該市町村に係る後期確定加入者調整率を乗じて得た額として算定した額
the amount obtained by multiplying the total sum of the amounts set forth in the preceding items by the enrolment ratio of retired insured persons, etc. pertaining to that Municipality
前各号に掲げる額の合算額に、当該市町村に係る退職被保険者等加入割合を乗じて得た額
Supplementary Provisions, Article 26
第二十六条
In the case of applying the provisions of Article 70, paragraph (3) of the Revised National Health Insurance Act to a Municipality that has been designated, for a fiscal year listed in the left column of the following table, pursuant to Article 68-2, paragraph (1) of the National Health Insurance Act, the provisions of the preceding Article apply mutatis mutandis to the amount prescribed in item (ii), (b) of that paragraph, notwithstanding the provisions of (b) of that item. In this case, in addition to the phrase "Article 17, paragraph (2) of the Supplementary Provisions" in item (i) of that Article being deemed to be replaced with "Article 17, paragraph (2) of the Supplementary Provisions as applied mutatis mutandis with terms replaced pursuant to Article 19 of the Supplementary Provisions", and the phrase "Article 17, paragraph (6) of the Supplementary Provisions" in item (iii) of that Article with "Article 17, paragraph (6) of the Supplementary Provisions as applied mutatis mutandis with terms replaced pursuant to Article 19 of the Supplementary Provisions", the phrases listed in the middle column of the table in the provisions of that Article are deemed to be replaced with the phrases listed in the right column of the table, respectively, according to the category of fiscal year listed in the left column.
| Fiscal year 2004 | Fiscal year 2003 | Fiscal year 2004 |
| 66 percent | 62 percent | |
| 62 percent | 58 percent | |
| Fiscal year 2005 | Fiscal year 2003 | Fiscal year 2005 |
| 66 percent | 58 percent | |
| 62 percent | 54 percent | |
| Fiscal year 2006 | Fiscal year 2003 | Fiscal year 2006 |
| 66 percent | 54 percent | |
| 62 percent | 1/2 |
次の表の上欄に掲げる年度につき国民健康保険法第六十八条の二第一項の規定により指定を受けた市町村について新国保法第七十条第三項の規定を適用する場合においては、同項第二号ロに規定する額については、同号ロの規定にかかわらず、前条の規定を準用する。この場合において、同条第一号中「附則第十七条第二項」とあるのは「附則第十九条において読み替えて準用される附則第十七条第二項」と、同条第三号中「附則第十七条第六項」とあるのは「附則第十九条において読み替えて準用される附則第十七条第六項」と読み替えるほか、同欄に掲げる年度の区分に応じ、同条の規定中同表の中欄に掲げる字句は、それぞれ同表の下欄に掲げる字句に読み替えるものとする。
| 平成十六年度 | 平成十五年度 | 平成十六年度 |
| 百分の六十六 | 百分の六十二 | |
| 百分の六十二 | 百分の五十八 | |
| 平成十七年度 | 平成十五年度 | 平成十七年度 |
| 百分の六十六 | 百分の五十八 | |
| 百分の六十二 | 百分の五十四 | |
| 平成十八年度 | 平成十五年度 | 平成十八年度 |
| 百分の六十六 | 百分の五十四 | |
| 百分の六十二 | 二分の一 |