Supplementary Provisions, Article 15
第十五条
The amount of the fixed medical expense contribution for fiscal year 2002 is, notwithstanding Article 56, paragraph (1) of the New Elderly Health Act, to be the sum total of the amounts set forth in the following items.
平成十四年度の確定医療費拠出金の額は、新老健法第五十六条第一項の規定にかかわらず、次の各号に掲げる額の合計額とする。
The amount set forth in (a) or (b), in accordance with the category of Insurer set forth in (a) or (b), respectively;
次のイ又はロに掲げる保険者の区分に応じ、それぞれイ又はロに掲げる額
An insurer exceeding the pre-commencement fixed special adjustment standard (meaning, among Insurers for which the pre-commencement fixed participant adjustment rate exceeds one, an Insurer for which the amount obtained by deducting the amount set forth in (1) from the pre-commencement amount equivalent to the fixed medical expense contribution before special adjustment exceeds the amount set forth in (2); the same applies hereinafter in this Article): the sum total of the amount obtained by deducting the pre-commencement amount subject to special adjustment (meaning the amount obtained by deducting the sum total of the amount set forth in (1) and the amount set forth in (2) from the pre-commencement amount equivalent to the fixed medical expense contribution before special adjustment; the same applies in paragraph (4)) from the pre-commencement amount equivalent to the fixed medical expense contribution before special adjustment, and the pre-commencement special adjustment amount;
An amount equivalent to 7/10 of the pre-commencement elderly medical expenses (meaning the amount of expenses borne by municipalities in fiscal year 2002 and required for medical care, etc. provided before the Effective Date to participants aged 70 or over, etc. pertaining to one Insurer; the same applies hereinafter in this Article) pertaining to the relevant Insurer;
当該保険者に係る施行日前老人医療費額（市町村が平成十四年度において支弁した一の保険者に係る七十歳以上の加入者等に対する施行日前に行われた医療等に要する費用の額をいう。以下この条において同じ。）の十分の七に相当する額
The amount obtained by multiplying the sum total of the following amounts by the special adjustment base rate referred to in paragraph (3) of the preceding Article.
次に掲げる額の合計額に前条第三項の特別調整基準率を乗じて得た額
The pre-commencement amount equivalent to the fixed medical expense contribution before special adjustment;
施行日前特別調整前確定医療費拠出金相当額
Of the amount for fiscal year 2002 of the expenses required for benefits by the relevant insurer, the amount of the expenses required for medical-related benefits provided before the Effective Date.
当該保険者の給付に要する費用の平成十四年度における額のうち施行日前に行われた医療関連給付に要する費用の額
Insurers other than Insurers exceeding the pre-commencement fixed special adjustment standard: the sum total of the pre-commencement amount equivalent to the fixed medical expense contribution before special adjustment and the pre-commencement special adjustment amount.
施行日前確定特別調整基準超過保険者以外の保険者 施行日前特別調整前確定医療費拠出金相当額と施行日前特別調整額との合計額
The amount set forth in (a) or (b), in accordance with the category of Insurer set forth in (a) or (b), respectively.
次のイ又はロに掲げる保険者の区分に応じ、それぞれイ又はロに掲げる額
An insurer exceeding the post-commencement fixed burden adjustment standard (meaning, among Insurers for which the post-commencement fixed participant adjustment rate exceeds one, an Insurer for which the amount obtained by deducting the amount set forth in (1) from the post-commencement amount equivalent to the fixed medical expense contribution before burden adjustment exceeds the amount set forth in (2); the same applies hereinafter in this Article): the sum total of the amount obtained by deducting the post-commencement amount subject to burden adjustment (meaning the amount obtained by deducting the sum total of the amount set forth in (1) and the amount set forth in (2) from the post-commencement amount equivalent to the fixed medical expense contribution before burden adjustment; the same applies in paragraph (7)) from the post-commencement amount equivalent to the fixed medical expense contribution before burden adjustment, and the post-commencement burden adjustment amount;
The sum total of an amount equivalent to 66 percent of the amount obtained by multiplying the post-commencement elderly medical expenses (meaning the amount of expenses borne by municipalities in fiscal year 2002 and required for medical care, etc. provided on or after the Effective Date to participants aged 75 or over, etc. pertaining to one Insurer; the same applies hereinafter in this Article) pertaining to the relevant Insurer by the rate obtained by deducting the post-commencement fixed specified expense rate from one, and the amount obtained by multiplying the post-commencement elderly medical expenses by the post-commencement fixed specified expense rate;
当該保険者に係る施行日以後老人医療費額（市町村が平成十四年度において支弁した一の保険者に係る七十五歳以上の加入者等に対する施行日以後に行われた医療等に要する費用の額をいう。以下この条において同じ。）に、一から施行日以後特定費用確定率を控除して得た率を乗じて得た額の百分の六十六に相当する額と、施行日以後老人医療費額に施行日以後特定費用確定率を乗じて得た額との合計額
The amount obtained by multiplying the sum total of the following amounts by the post-commencement burden adjustment base rate referred to in paragraph (8) of the preceding Article.
次に掲げる額の合計額に前条第八項の施行日以後負担調整基準率を乗じて得た額
The post-commencement amount equivalent to the fixed medical expense contribution before burden adjustment;
施行日以後負担調整前確定医療費拠出金相当額
Of the amount for fiscal year 2002 of the expenses required for benefits by the relevant insurer, the amount of the expenses required for medical-related benefits provided on or after the Effective Date.
当該保険者の給付に要する費用の平成十四年度における額のうち施行日以後に行われた医療関連給付に要する費用の額
Insurers other than Insurers exceeding the post-commencement fixed burden adjustment standard: the sum total of the post-commencement amount equivalent to the fixed medical expense contribution before burden adjustment and the post-commencement burden adjustment amount.
施行日以後確定負担調整基準超過保険者以外の保険者 施行日以後負担調整前確定医療費拠出金相当額と施行日以後負担調整額との合計額
The pre-commencement fixed participant adjustment rate referred to in item (i), (a) of the preceding paragraph is to be a rate calculated for each Insurer, as specified by Order of the Ministry of Health, Labour and Welfare, on the basis of the rate obtained by dividing the ratio of the total number of participants aged 70 or over, etc. to the total number of participants for all Insurers during the period on or after April 1, 2002 and before the Effective Date by the ratio of the number of participants aged 70 or over, etc. to the number of participants for the relevant Insurer during that period (if that ratio exceeds 30 percent, 30 percent, and if it is less than 1.4 percent, 1.4 percent).
前項第一号イの施行日前確定加入者調整率は、厚生労働省令で定めるところにより、平成十四年四月一日以後施行日前の期間におけるすべての保険者に係る加入者の総数に対する七十歳以上の加入者等の総数の割合を当該期間における当該保険者に係る加入者の数に対する七十歳以上の加入者等の数の割合（その割合が百分の三十を超えるときは百分の三十とし、百分の一・四に満たないときは百分の一・四とする。）で除して得た率を基礎として保険者ごとに算定される率とする。
The pre-commencement amount equivalent to the fixed medical expense contribution before special adjustment referred to in paragraph (1), item (i), (a) is to be an amount equivalent to 7/10 of the sum total of the amounts set forth in the following items.
第一項第一号イの施行日前特別調整前確定医療費拠出金相当額は、次の各号に掲げる額の合計額の十分の七に相当する額とする。
The amount obtained by multiplying the amount obtained by deducting the pre-commencement medical expenses outside adjustment (meaning, where the relevant Insurer is an insurer exceeding the fixed pre-commencement standard (meaning an Insurer for which the rate obtained by dividing the amount calculated as specified by Order of the Ministry of Health, Labour and Welfare as the pre-commencement elderly medical expenses per participant aged 70 or over, etc. pertaining to one Insurer by the amount calculated as specified by Order of the Ministry of Health, Labour and Welfare as the average amount of the pre-commencement elderly medical expenses per participant aged 70 or over, etc. pertaining to all Insurers (referred to as "per-person average of elderly medical expenses" in this item) exceeds the rate specified by the Cabinet Order referred to in Article 55, paragraph (1), item (i) of the Former Elderly Health Act), the amount calculated as specified by Order of the Ministry of Health, Labour and Welfare as the portion of the pre-commencement elderly medical expenses pertaining to the relevant Insurer that exceeds the amount obtained by multiplying the per-person average of elderly medical expenses by the rate specified by that Cabinet Order; the same applies in the following item) from the pre-commencement elderly medical expenses pertaining to the relevant Insurer by the pre-commencement fixed participant adjustment rate;
当該保険者に係る施行日前老人医療費額から施行日前調整対象外医療費額（当該保険者が確定施行日前基準超過保険者（一の保険者に係る七十歳以上の加入者等一人当たりの施行日前老人医療費額として厚生労働省令で定めるところにより算定される額をすべての保険者に係る七十歳以上の加入者等一人当たりの施行日前老人医療費額の平均額として厚生労働省令で定めるところにより算定される額（以下この号において「一人平均老人医療費額」という。）で除して得た率が、旧老健法第五十五条第一項第一号の政令で定める率を超える保険者をいう。）である場合における当該保険者に係る施行日前老人医療費額のうち、一人平均老人医療費額に当該政令で定める率を乗じて得た額を超える部分として厚生労働省令で定めるところにより算定される額をいう。次号において同じ。）を控除して得た額に施行日前確定加入者調整率を乗じて得た額
The pre-commencement special adjustment amount referred to in paragraph (1), item (i), (a) is the amount obtained by multiplying the pre-commencement amount equivalent to the fixed medical expense contribution before special adjustment pertaining to the relevant Insurer (for an insurer exceeding the pre-commencement fixed special adjustment standard, the amount obtained by deducting the pre-commencement amount subject to special adjustment from the pre-commencement amount equivalent to the fixed medical expense contribution before special adjustment) by the pre-commencement fixed special adjustment addition rate (meaning the rate determined by the Minister of Health, Labour and Welfare on the basis of the rate obtained by dividing the total amount of the pre-commencement amounts subject to special adjustment pertaining to all Insurers exceeding the pre-commencement fixed special adjustment standard by the amount obtained by deducting the total amount of the pre-commencement amounts subject to special adjustment pertaining to all Insurers exceeding the pre-commencement fixed special adjustment standard from the total amount of the pre-commencement amounts equivalent to the fixed medical expense contribution before special adjustment pertaining to all Insurers).
第一項第一号イの施行日前特別調整額は、当該保険者に係る施行日前特別調整前確定医療費拠出金相当額（施行日前確定特別調整基準超過保険者にあっては、施行日前特別調整前確定医療費拠出金相当額から施行日前特別調整対象額を控除して得た額）に施行日前確定特別調整加算率（すべての施行日前確定特別調整基準超過保険者に係る施行日前特別調整対象額の総額を、すべての保険者に係る施行日前特別調整前確定医療費拠出金相当額の総額からすべての施行日前確定特別調整基準超過保険者に係る施行日前特別調整対象額の総額を控除して得た額で除して得た率を基礎として厚生労働大臣が定める率をいう。）を乗じて得た額とする。
The post-commencement fixed participant adjustment rate referred to in paragraph (1), item (ii), (a) is to be a rate calculated for each Insurer, as specified by Order of the Ministry of Health, Labour and Welfare, on the basis of the rate obtained by dividing the ratio of the total number of participants aged 75 or over, etc. to the total number of participants for all Insurers during the period from the Effective Date through March 31, 2003 by the ratio of the number of participants aged 75 or over, etc. to the number of participants for the relevant Insurer during that period (if that ratio is less than the minimum rate for that period, the minimum rate).
第一項第二号イの施行日以後確定加入者調整率は、厚生労働省令で定めるところにより、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すべての保険者に係る加入者の総数に対する七十五歳以上の加入者等の総数の割合を当該期間における当該保険者に係る加入者の数に対する七十五歳以上の加入者等の数の割合（その割合が当該期間における下限割合に満たないときは、下限割合とする。）で除して得た率を基礎として保険者ごとに算定される率とする。
The post-commencement amount equivalent to the fixed medical expense contribution before burden adjustment referred to in paragraph (1), item (ii), (a) is to be the sum total of the amounts set forth in the following items.
第一項第二号イの施行日以後負担調整前確定医療費拠出金相当額は、次の各号に掲げる額の合計額とする。
An amount equivalent to 66 percent of the amount obtained by multiplying the sum total of the following amounts (referred to as "post-commencement adjusted elderly medical expenses" in the following item) by the rate obtained by deducting the post-commencement fixed specified expense rate from one;
次に掲げる額の合計額（次号において「施行日以後調整後老人医療費額」という。）に、一から施行日以後特定費用確定率を控除して得た率を乗じて得た額の百分の六十六に相当する額
The amount obtained by multiplying the amount obtained by deducting the post-commencement medical expenses outside adjustment (meaning, where the relevant Insurer is an insurer exceeding the fixed post-commencement standard (meaning an Insurer for which the rate obtained by dividing the amount calculated as specified by Order of the Ministry of Health, Labour and Welfare as the post-commencement elderly medical expenses per participant aged 75 or over, etc. pertaining to one Insurer by the amount calculated as specified by Order of the Ministry of Health, Labour and Welfare as the average amount of the post-commencement elderly medical expenses per participant aged 75 or over, etc. pertaining to all Insurers (referred to as "per-person average of elderly medical expenses" in (a)) exceeds the rate specified by the Cabinet Order referred to in Article 55, paragraph (3), item (i), (a) of the New Elderly Health Act), the amount calculated as specified by Order of the Ministry of Health, Labour and Welfare as the portion of the post-commencement elderly medical expenses pertaining to the relevant Insurer that exceeds the amount obtained by multiplying the per-person average of elderly medical expenses by the rate specified by that Cabinet Order; the same applies in (b)) from the post-commencement elderly medical expenses pertaining to the relevant Insurer by the post-commencement fixed participant adjustment rate;
当該保険者に係る施行日以後老人医療費額から施行日以後調整対象外医療費額（当該保険者が確定施行日以後基準超過保険者（一の保険者に係る七十五歳以上の加入者等一人当たりの施行日以後老人医療費額として厚生労働省令で定めるところにより算定される額をすべての保険者に係る七十五歳以上の加入者等一人当たりの施行日以後老人医療費額の平均額として厚生労働省令で定めるところにより算定される額（イにおいて「一人平均老人医療費額」という。）で除して得た率が、新老健法第五十五条第三項第一号イの政令で定める率を超える保険者をいう。）である場合における当該保険者に係る施行日以後老人医療費額のうち、一人平均老人医療費額に当該政令で定める率を乗じて得た額を超える部分として厚生労働省令で定めるところにより算定される額をいう。ロにおいて同じ。）を控除して得た額に施行日以後確定加入者調整率を乗じて得た額
The amount obtained by multiplying the post-commencement adjusted elderly medical expenses by the post-commencement fixed specified expense rate.
施行日以後調整後老人医療費額に施行日以後特定費用確定率を乗じて得た額
The post-commencement burden adjustment amount referred to in paragraph (1), item (ii), (a) is the amount obtained by multiplying the post-commencement amount equivalent to the fixed medical expense contribution before burden adjustment pertaining to the relevant Insurer (for an insurer exceeding the post-commencement fixed burden adjustment standard, the amount obtained by deducting the post-commencement amount subject to burden adjustment from the post-commencement amount equivalent to the fixed medical expense contribution before burden adjustment) by the post-commencement fixed burden adjustment addition rate (meaning the rate determined by the Minister of Health, Labour and Welfare on the basis of the rate obtained by dividing the total amount of the post-commencement amounts subject to burden adjustment pertaining to all Insurers exceeding the post-commencement fixed burden adjustment standard by the amount obtained by deducting the total amount of the post-commencement amounts subject to burden adjustment pertaining to all Insurers exceeding the post-commencement fixed burden adjustment standard from the total amount of the post-commencement amounts equivalent to the fixed medical expense contribution before burden adjustment pertaining to all Insurers).
第一項第二号イの施行日以後負担調整額は、当該保険者に係る施行日以後負担調整前確定医療費拠出金相当額（施行日以後確定負担調整基準超過保険者にあっては、施行日以後負担調整前確定医療費拠出金相当額から施行日以後負担調整対象額を控除して得た額）に施行日以後確定負担調整加算率（すべての施行日以後確定負担調整基準超過保険者に係る施行日以後負担調整対象額の総額を、すべての保険者に係る施行日以後負担調整前確定医療費拠出金相当額の総額からすべての施行日以後確定負担調整基準超過保険者に係る施行日以後負担調整対象額の総額を控除して得た額で除して得た率を基礎として厚生労働大臣が定める率をいう。）を乗じて得た額とする。
The post-commencement fixed specified expense rate referred to in paragraph (1), item (ii), (a), (1) is to be the rate obtained by dividing the post-commencement specified expenses pertaining to each Insurer (meaning the amount of expenses borne by municipalities in fiscal year 2002 and required for medical care, etc. provided on or after the Effective Date to persons pertaining to one Insurer who fall under the case set forth in Article 28, paragraph (1), item (ii) of the New Elderly Health Act) by the post-commencement elderly medical expenses pertaining to each Insurer.
第一項第二号イ（１）の施行日以後特定費用確定率は、各保険者に係る施行日以後特定費用額（市町村が平成十四年度において支弁した一の保険者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に対する施行日以後に行われた医療等に要する費用の額をいう。）を、各保険者に係る施行日以後老人医療費額で除して得た率とする。