Social Insurance Medical Fee Paymant Fund Law
法令番号: 法律第129号
公布年月日: 昭和23年7月10日
法令の形式: 法律
I hereby promulgate the Social Insurance Medical Fee Payment Fund Law.
Signed:HIROHITO, Seal of the Emperor
This tenth day of the seventh month of the twenty-third year of Showa (July 10, 1948)
Prime Minister ASHIDA Hitoshi
Law No.129
Social Insurance Medical Fee Paymant Fund Law
Chapter I. General Provisions
Article 1. The Social Insurance Medical Fee Paymant Fund (hereinafter referred to as "Fund" ) shall be provided for the prompt and appropriate payment of medical care claims (hereinafter referred to as "Medical claim" ) as submitted by the persons in charge of the medical care benefits or persons who employ them (hereinafter referred to as "person in charge of the medical care" ), in regard to the medical care benefits and other expenses corresponding with the benefits which are award in accordance with the provisions of the Health Insurance Law (Law No.70 of 1922), the Seamen's Insurance Law (Law No.73 of 1940), the National Health Insurance Law (Law No.60 of 1938) or the Law concerning the Mutual Aid Association, by the Government or the Health Insurance Associations, by the cities, towns and villages which exercise the National Health Insurance, the National Health Insurance Association or by the juridical persons who exercise the National Health Insurance or the Mutual Aid Associations organized by law (hereinafter referred to as "insurer" ). The Fund, in addition, shall provide for audit and review of all the medical claims submitted by persons in charge of the medical care.
Article 2. The Fund shall be the iuridical person.
Article 3. The Fund shall establish the main office in Tokyo Metropolis and branch offices in Tokyo Metropolis, Hokkaido and every prefecture.
2. The Fund, in addition to the aforementioned offices, may establish sub-branch offices of the branch offices in necessary localities.
Article 4. The foundation of the Fund shall be 1,000,000 yen.
2. For the foundation as stated in the preceding paragraph, the Government shall contribute 400,000 yen, and the additional sum of 600,000 yen shall be contributed by other insurers in accordance with the determinations made by the competent Minister.
Article 5. The Fund shall regulate the following matters in its articles of incorporation:
1) Purpose;
2) Legal name;
3) Residence of the offices;
4) The matter concerning the amount of the foundation and properties;
5) The matter concerning the officials;
6) T he matter concerning the business and its execution;
7) The matter concerning the agreement for participation by the insurer;
8) The matter concerning the account;
9) The method for publication.
2. The articles of incorporation may be made with the approval of the competent Minister.
Article 6. The Fund shall be registered with the judicial Affairs Bureau or its branch offices at a place where the main office, the branches or the sub-branches of the Fund come under the jurisdiction of the said office, in accordance with the provisions prescribed in the Cabinet Order.
2. Necessary matters which shall have to be registered in accordance with the preceding paragraph shall not be opposed by a third person until the registration has been completed.
Article 7. No income tax or iuridical persons tax shall be levied on the Fund.
Chapter II. Officials
Article 8. There shall be one chief director, eight or more but not more than sixteen directors and four inspectors as the officials of the Fund.
Article 9. The chief director shall represent the Fund and shall be responsible for the general administration and operation of the business of the Fund.
2. The directors, according to the regulations prescribed in the article of incorporation shall represent the Fund, administer and operate the business of the Fund in assisting the chief director, act for or take over the office of the chief director in case he is absent.
3. The inspectors shall inspect the business of the Fund and compiles the fiscal and statistical reports concerned.
Article 10. The chief director shall be elected by mutual vote of the directors.
2. The directors, shall be appointed by the competent Minister in equal number respectively from among the representatives of insurers, insured, persons in charge of medical care, and of the public interest, respectively.
3. The appointment of the representatives of insurers, insured, and of persons in charge of medical care shall be upon the recommendations of the organizations concerned.
4. The competent Minister, in appointing the directors in accordance with the preceding two paragraphs, shall fix a peried of not less than one month for the respective organizations concerned to recommend, at least twice the number of candidates to be appointed directors, as the representatives of insurers, insured and persons in charge of medical care respectively. But, in case no recommendation is made within the prescribed period, the competent Minister shall appoint such representatives, irrespective of the provisions of the preceding paragraph.
5. The provisions of the preceding three paragraphs shall apply mutatis mutandis in the case of the appointment of the inspectors.
Article 11. There shall be eight secretaries appointed in the branch offices and four secretaries in the sub-branch offices of the Fund.
2. The secretaries shall be appointed by the chief director in equal number respectively, from among the representatives of insurers, insured, persons in charge of medical care and of the public interest.
3. When the secretaries are appointed by the chief director in accordance with the preceding paragraph, the provisions of the third and fourth paragraph of the preceding Article shall apply mufatis mutandis.
Article 12. One of the secretaries prescribed in the preceding Article shall be appointed chief secretary.
2. The chief secretary shall be appointed to or released from office by the chief director.
3. The chief secretary, in accordance with the regulations of the articles of incorporation, shall have the right to exercise full administrative authority for accomplishing the business of the branch and or the sub-branch offices.
Chapter III. Business
Article 13. The Fund shall operate the following business to achieve the purposes prescribed in Article 1:
1) Have on deposit from the insurers at all times amounts equal to the highest sum of medical claims disbursed during any one of the past 3 months;
2) Payment of the sum for the medical claims submitted by the person in charge of medical care shall be made in accordance with the calculation based upon the fee schedule determined by the Welfare Minister;
3) Establishment of the auditing and reviewing committee for audit and review of medical claims submitted by the person in charge of medical care;
4) Additional matters for implementing the preceding items.
2. The Fund, in dealing with the matters mentioned in the preceding paragraph, shall make a contract with each insurer, as provided for in the articles of incorporation.
Article 14. The Fund shall appoint not more than five persons respectively from among the representatives of the persons in charge of medical care and the insurers in each branch and sub-branch office to audit and review medical claims as prescribed in Par.1, Item 3 of the preceding Article.
2, The appointment of the preceding paragraph regarding the persons who represent the persons in charge of medical care shall be made upon the recommendation of the organizations concerned.
3. The necessary matters concerning the methods of the audit and review shall be provided for by Order.
Chapter IV. Accounting
Article 15. The business year of the Fund shall start from April 1 and end on March 31 of the next year.
Article 16. The Fund shall prepare the list of properties and the statement of business and financial conditions at the end of each business year, and shall submit then to the competent Minister for his approval within two months after the close of the business year.
2. Upon the approval of the competent Minister in accordance with the provision prescribed in the preceding paragraph, the Fund shall make public notice of the list of properties and the statement of the business and financial conditions, and shall keep copies thereof for attachment to the articles of incorporation at each office of the Fund.
Article 17. The Fund shall not be authorized to raise any loans.
Article 18. The foundation of the Fund shall not be used for administrative expenses unless a deficit occurs in the payment of medical claims for an inevitable reason.
Article 19. The administrative expenses of the Fund shall be borne proportionately by the insurers and paid to the Fund based upon their number of medical claims.
Chapter V. Supervision
Article 20. The competent Minister shall require the Fund to submit financial report on facts and conditions of its business and property, or have the officials concerned audit and inspect conditions of its business, property, account books or other articles.
2. The competent Minister may entrust the governor of Tokyo Metropolis, Hokkaido and prefectures, within whose jurisdiction the branch or sub-branch offiees of the Fund are located, with the right to supervise the officials of the branch or sub-branch offices of the Fund as prescribed in the preceding paragraph.
3. In case the government official or public official concerned is required to make the inspection in accordance with the preceding two paragraphs, he shall carry with him the identification card which shows his official post, and, on the request of the person concerned, he shall show it to such person, as provided for by Order.
Article 21. The competent Minister, in case he deems it necessary for the appropriate operation of the Fund, may order the revision of the articles of incorporation or other matters necessary for supervision.
2. The provisions of Paragraph 2 of the preceding Article shall apply correspondingly to the cases as provided for in the preceding paragraph excepting those cases wherein the revision of the articles of incorporation is to be required.
Article 22. The competent Minister may dismiss the chief director, directors or inspectors of the Fund, whenever they violate the laws and ordinances, the articles of incorporation or the orders prescribed in Paragraph 1 of the preceding Article.
Chapter VI. Penal Provisions
Article 23. Any representatives, deputies, employees or orher workers of the Fund who neglect the reporting or makes fates informations upon the report or refuse, disturb or evade the inspection by the government official or public official concerned as prescribed in Article 20, shall be liable to a fine not more than 10,000 yen.
2. Any directors, including the chief director, or inspector of the Fund or any secretaries, including the chief secretary, of the branch or sub-branch offices of the Fund who perform any other business not provided for in Article 13, under the name of the business of the Fund shall be liable to a fine as prescribed in the preceding paragraph.
Article 24. Any directors, including the chief director, or inspectors of the Fund or any secretaries, including the chief, secretary, of the branch or sub-branch offices of the Fund who neglect the registration or make illegal registration in violation of this Law or the orders based upon this Law shall be liable to an administrative fine not more than 5,000 yen.
Supplementary Provisions:
Article 25. The present Law shall come into force as from August 1, 1948.
Article 26. The Government shall order the Organization Committee to execute the preperatory works for the establishment of the Fund.
Article 27. The Organization Committee shall make the articles of incorporation of the Fund and obtain the approval of the competent Minister.
2. In case the approval of the preceding paragraph is obtained, the Organization Committee shall, without delay, request the contribution of the whole amount of foundation.
Article 28. With the contributions having been made to the foundation, Organization Committee shall, without delay, hand over the business to the chief director of the Fund.
2. When the chief director has taken over the business in accordance with the preceding paragraph, the chief director, all directors and inspectors shall without delay, register for the establishment.
3. The Fund shall be established upon the completion of the registration.
Article 29. The local public body prescribed in Article 1 of the Local Autonomy Law (Law No.67 of 1947) shall have no authority to levy the local tax on the undertakings of the Fund.
Minister of Finance KITAMURA Tokutaro
Minister of Welfare TAKEDA Giichi
Prime Minister ASHIDA Hitoshi