I hereby promulgate the Law for Establishment of Social Insurance Council, Social Insurance Medical Treatment Council, Social Insurance Referee and Social Insurance Appeals Committee. Signed:HIROHITO, Seal of the Emperor This thirty-first day of the third month of the twenty-fifth year of Showa (March 31, 1950) Prime Minister YOSHIDA Shigeru Law No.47 Law for Establishment of Social Insurance Council, Social Insurance Medical Treatment Council, Social Insurance Referee and Social Insurance Appeals Committee Contents Chapter I Social Insurance Council (Articles 1-12) Chapter II Social Insurance Medical Treatment Council (Articles 13-21) Chapter III Social Insurance Referee and Social Insurance Appeals Committee Section 1 Social Insurance Referee (Article 22) Section 2 Social Insurance Appeals Committee (Articles 23-30) Supplementary Provisions CHAPTER I Social Insurance Council

(Establishment) Article 1. The Social Insurance Council (hereinafter referred to as the "Council" ) shall be established in the Ministry of Welfare in order to deliberate on matters relative to the administration and operation of Government-managed Health Insurance, Mariners'Insurance and Welfare Pension Insurance.

(Functions) Article 2. The Council shall deliberate and make written recommendations on matters relative to the administration and operation of Government-managed Health Insurance, Mariners'Insurance and Welfare Pension Insurance in response to the request of the Minister of Welfare, and may make such written recommendations on its own initiative to the Minister of Welfare and other Ministers concerned.

(Organization) Article 3. The Council shall consist of 27 members as enumerated below: (1) Members representative of the interests of the insured covered by Government-managed Health Insurance, Mariners'Insurance and Welfare Pension Insurance, 9 persons; (2) Members representative of the interests of the enterprisers and shipowners who employ the insured covered by Government-managed Health Insurance, Mariners'Insurance and Welfare Pension Insurance, 9 persons; (3) Members representative of the public interest, 9 persons. 2 Persons of experience concerning medical care shall be included in the members mentioned in item (3) of the preceding paragraph. 3 If the Minister of Welfare deems it necessary for the deliberation on a technical matter, in the Council expert members not exceeding six in number may be appointed each time in such case. 4 The members and the expert members shal be appointed by the Minister of Welfare. 5 The members and the expert members shal be of part-time service.

Article 4. The term of office of the members shall be two years, and one-half of the members shall be appointed annually. 2 The term of office of a member newly appointed to fill a vacancy in the membership shall be the remainder of the term of office of his predecessor.

Article 5. The Council shall have one Chairman elected by the members from among those members who represent the public interest. 2 The Chairman shall preside over the affairs of the Council and shall represent the Council. 3 In case the Chairman is prevented from performing his duties, a member elected in accordance with the provision of paragraph 1 shall act for him.

Article 6. The Chairman may establish panels in the Council and may have them take charge of a part of functions thereof. 2 The Chairman shall appoint the members and the expert members who are to belong to the panels. 3 Each panel shall have a chairman of the panel. The chairman of the panel shall be appointed by the Chairman from among the members belonging to the panel concerned. 4 The chairman of the panel shall preside over the affairs of the panel. 5 In case the chairman of the panel as prevented from performing his duties, a member appointed by the Chairman from among the members belonging to the panel concerned shall act for him. 6 The Council, as prescribed thereby, may regard the decision of the panel as that of the Council.

(Submittal of Data and Information) Article 7. The Minister of Welfare shall submit such data and information concerning Health Insurance, Mariners'Insurance or Welfare Pension Insurance as the Council may request.

(Meetings) Article 8. The Council shall convene one or more times every three months, unless good reason is shown.

Article 9. The Council shall be convened by the Chairman. 2 Upon the inquiry of the Minister of Welfare or the request for convocation by one-third or more of the members, denoting the matters to deliberate upon, the Chairman shall convene the Council within two weeks of the day of such inquiry or request;provided, however, that if the panel taking charge of a part of the affairs concerning such inquiry or request is placed, the Chairman may make the chairman of the panel concerned convene the panel in lieu of convening the Council.

(Report to the Minister of Welfare) Article 10. Within sixty days after the close of each fiscal year, the Council shall submit a written report to the Minister of Welfare concerning its activities and findings and a summary of its recommendations during the fiscal year concerned.

(Miscellaneous Affairs) Article 11. Miscellaneous affairs of the Council shall be managed by the Insunance Bureau of the Ministry of Welfare.

(Miscellaneous Provision) Article 12. Other than those provided for by this Law, the procedure of proceedings and other necessary administrative matters of meetings of the Council shall be fixed by the Council.

CHAPTER II Social Insurance Medical Treatment Council

(Establishment) Article 13. The Central Social Insurance Medical Treatment Council (hereinafter referred to as "the Central Council" ) shall be established in the Ministry of Welfare in order to deliberate and make recommendations on matters concerning guidance and supervision with respect to appropriate medical care by insurance doctors and pharmacists under Health Insurance and Mariners'Insurance (hereinafter referred to as "insurance doctors and pharmacists" ), and purveyors of medical care benefits under National Health Insurance (hereinafter referred to as "purveyors of medical care benefits" ), and to deliberate and make recommendations on appropriate medical care fees for Health Insurance and Mariners'Insurance and standard for appropriate medical care fees for National Health Insurance. 2 A Prefectural Social Insurance Medical Treatment Council (hereinafter referred to as "the Prefectural Council" ) shall be established in each of To, Do, Fu and prefectures in order to deliberate and make recommendations on matters concerning guidance with respect to appropriate medical care by insurance doctors and pharmacists and purveyors of medical care benefits.

(Functions) Article 14. The Central Council shall deliberate and make written recommendations relative to the following matters in response to the request of the Minister of Welfare, and may make such written recommendations on its own initiative to the Minister of Welfare: (1) Matters concerning the designation and revocation of designation of insurance doctors and pharmacists, and guidance and supervision of medical care by insurance doctors and pharmacists and purveyors of medical care benefits; (2) Matters concerning appropriate medical care fees for Health Insurance and Mariners'Insurance and standards for appropriate medical care fees for National Health Insurance. 2 The Prefectural Council shall deliberate and make written recommendations relative to the matters referred to in item (1) of the preceding paragraph, in response to the request of the governor of To, Do, Fu or prefecture, and may make such written recommendations on its own initiative to the governor of To, Do, Fu or prefecture.

(Organization) Article 15. The Central Council or the Prefectural Council shall each consist of 24 members as enumerated below: (1) Members representative of the interests of the insurers under Health Insurance, Mariners'Insurance and National Health Insurance, six persons; (2) Members representative of the interests of the insured, enterprisers and shipowners under Health Insurance, Mariners'Insurance and National Health Insurance, six persons; (3) Members representative of the interests of doctors, dentists and pharmacists, six persons; (4) Members representative of the public interest, six persons. 2 If the Minister of Welfare, or the governor of To, Do, Fu or prefecture deems it necessary for the deliberation on a technical matter either in the Central Council or in the Prefectural Council, expert members, not exceeding ten in number, may be appointed each time in such case. 3 The members and the expert members shall be appointed by the Minister of Welfare in the case of the Central Council and by the governor of To, Do, Fu or prefecture in the case of the Prefectural Council. 4 The appointment of the members under paragraph 1 items (1) to (3) inclusive shall be made upon the recommendations of the organizations concerned. 5 The members and the expert members shall be of part-time service.

Article 16. The term of office of the members shall be two years, and one-half of the members shall be appointed annually. 2 The term of office of a member newly appointed to fill a vacancy in the membership shall be the remainder of the term of office of his predecessor.

Article 17. The Central Council and each Prefectural Council shall have one Chairman elected by the members from among those members who represent the public interest respectively. 2 The Chairman shall preside over the affairs of the Council and shall represent the Central Council or the Prefectural Council, respectively. 3 In case the Chairman is prevented from performing his duties, a member elected in accordance with the provision of paragraph 1 shall act for him.

(Meetings) Article 18. The Central Council and each Prefectural Council shall convene one or more times every six months unless good reason is shown.

Article 19. The Central Council and each Prefectural Council shall be convened by the Chairman respectively. 2 Upon the inquiry of the Minister of Welfare or the governor or To, Do, Fu or prefecture, or the request for convocation by one-half or more of the members, denoting the matters to be deliberated upon, the Chairman shall convene the Central Council or the Prefectural Council, respectively, within two weeks of the day of such inquiry or request.

(Miscellaneous affairs) Article 20. Miscellaneous affairs of the Central Council shall be managed by the Insurance Bureau of the Ministry of Welfare. 2 Miscellaneous affairs of the Prefectural Council shall be managed by the Welfare Bureau of To or Welfare Department of Do, Fu or prefecture in which the Prefectural Council is established.

(Miscellaneous Provision) Article 21. Other than those provided for by this Law, the procedure of proceedings and other necessary administrative matters of meetings of the Central Council or the Prefectural Council shall be fixed by the Central Council or the Prefectural Council, respectively.

CHAPTER III Social Insurance Referee and Social Insurance Appeals Committee

Section 1 Social Insurance Referee

(Establishment) Article 22. Social Insurance Referees shall be established in To, Do, Fu and prefectures in order to hear and decide appeals on decisions made by the insurer concerning payment of insurance benefits under Health Insurance, Mariners'Insurance or Welfare Pension Insurance. 2 The Minister of Welfare shall appoint the Social Insurance Referees from among the second class secretaries of the prefectural government.

Section 2 Social Insurance Appeals Committee

(Establishment) Article 23. The Social Insurance Appeals Committee (hereinafter referred to as "the Appeals Committee" ) shall be established in the Ministry of Welfare in order to hear and decide appeals on decisions made by Social Insurance Referees concerning payment of insurance benefits and appeals on the disposition of assessment or collection by the insurer of premium or other money levied under the provisions of the Health Insurance Law (Law No.70 of 1922), the Mariners'Insurance Law (Law No.73 of 1939) or the Welfare Pension Insurance Law (Law No.60 of 1941), or the disposition under the provision of Article 11-(2) of the Health Insurance law, Article 12-(2) of the Mariners'Insurance Law or Article 11-(2) of the Welfare Pension Insurance Law.

(Organization) Article 24. The Appeals Committee shall consist of 18 members as enumerated below: (1) Members representative of the interests of the insured covered by Health Insurance, Mariners'Insurance or Welfare Pension Insurance, six persons; (2) Members representative of the interests of the enterprisers and shipowners who employ the insured covered by Health Insurance, Mariners'Insurance or Welfare Pension Insurance, six persons; (3) Members representative of the public interest, six persons. 2 The members shall be appointed by the Minister of Welfare. 3 The members shall be of part-time service.

Article 25. The term of office of the members shall be 3 years, and one-third of the members shall be appointed annually. 2 The term of office of a member newly appointed to fill a vacancy in the membership shall be the remainder of the term of office of his predecessor.

Article 26. The Appeals Committee shall have one Chairman elected by the members from among those members who represent the public interest. 2 The Chairman shall preside over the affairs of the Committee and shall represent the Appeals Committee. 3 In case the Chairman is prevented from performing his duties, a member elected in accordance with the provision of paragraph 1 shall act for him.

(Quorum) Article 27. The Appeals Committee shall not commence proceedings or make a decision without the presence of at least one member representing the interests of the insured covered by Health Insurance, one member representing the interests of the enterprisers who employ the insured covered by Health Insurance and one member representing the public interest, in case of judging the case concerning Health Insurance;one member representing the interests of the insured covered by Mariners'Insurance, one member representing the interests of the shipowners who employ the insured covered by Mariners'Insurance and one member representing the public interest, in case of judging the case concerning Mariners'Insurance;or one member representing the interests of the insured covered by Welfare Pension Insurance, one member representing the interests of the enterprisers who employ the insured covered by Welfare Pension Insurance and one member representing the public interest, in case of judging the case concerning Welfare Pension Insurance.

(Decision in Case of a Tie) Article 28. The proceedings of the Appeals Committee shall be decided by a majority of the members present, and, in case of a tip, the chairman shall make the decision.

(Miscellaneous Affairs) Article 29. Miscellaneous affairs of the Appeals Committee shall be managed by the insurance Bureau of the Ministry of Welfare.

(Miscellaneous Frovision) Article 30. Other than those provided for by this Law, the procedure of proceedings and other necessary administrative matters of meetings of the Appeals Committee shall be fixed by the Appeals Committee.

Supplementary Provisions: (Date of Enforcement) 1. This Law shall come into force as from April 1, 1950. (Amendment and Abolition of Other Law and Orders) 2. The Health Insurance Law shall be partially amended as follows: The following one Article shall be added next to Article 24:

Article 24-(2). The Minister of Welfare shall make inquiries to the Social Insurance Council before acting upon matters involving planning, legislation or major administrative policy concerning the administration and operation of Government-managed Health Insurance.

In Article 43-(4) paragraph 2, "consider the views of the Central Social Insurance Medical Care Council" shall be amended as "consult the Central Social Insurance Medical Treatment Council." Article 43-(5) shall be amended as follows:

Article 43-(5). In determining major policy concerning the designation and revocation of designation of insurance doctors and pharmacists, and the guidance on medical care thereby, the Minister of Welfare shall make inquiries to the Central Social Insurance Medical Treatment Council and the governor of To, Do, Fu or prefecture, of the Prefectural Social Insurance Medical Treatment Council.

In Article 43-(6) paragraph 3, "consider the views of the Social Insurance Medical Fee Calculating Council" shall be amended as "consult the Central Social Insurance Medical Treatment Council." Article 43-(7) shall be deleted. In Article 71-(4) paragraph 2, "the Health Insurance Council" shall be amended as "the Social Insurance Council." Chapter VI shall be deleted, Chapter VII shall be made Chapter VI and Chapter VIII shall be made Chapter VII. In Article 80 paragraph 1, Articles 83-(7) to 83-(32) inclusive, Article 86 paragraph 1 and Article 86-(2), "the insurance Referee" shall be amended as "the Social Insurance Referee" and "the Health Insurance Appeals Committee" as "the Social Insurance Appeals Committee." In Article 81, "the Health Insurance Appeals Committee" shall be amended as "the Social Insurance Appeals Committee." Article 81-(2) shall be deleted and Articles 82 to 83-(5) inclusive shall be amended as follows:

Articles 82 to 83-(5) inclusive. Deleted.

In Article 83-(6), "the Insurance Referee" shall be amended as "the Social Insurance Referee," and "the insurance Referee who is competent" shall be amended as "the competent Social Insurance Referee." Articles 84-(3) and 84-(4) shall be deleted, and Article 85 shall be amended as follows;

Article 85. Deleted.

3. The National Health Insurance Law (Law No.60 of 1938) shall be partially amended as follows: Article 8-(5) shall be amended as follows:

Article 8-(5). The insurer shall determine the appropriate amount of medical care fees, on the basis of the standard amount determined by the Minister of Welfare, after consulting with the purveyors of medical care benefits and shall obtain the approval of the governor of To, Do, Fu or prefecture. The Minister of Welfare, in determining standard amount for medical care fees under the provision of the preceding paragraph, shall make inquiries to the Central Social Insurance Medical Treatment Council. If an ordinary National Health Insurance Association or a juridical person administering National Health Insurance desires to obtain the approval of the governor of To, Do, Fu or prefecture in accordance with the provision of paragraph 1, the application for approval shall be submitted through the mayor or headman of city, town or village concerned.

Article 8-(7) shall be amended as follows:

Article 8-(7). In dispensing medical care to insured persons, purveyors of medical care benefits shall exercise kindness and care and shall observe the directions prescribed by the governor of To, Do, Fu or prefecture in accordance with the regulations determined by the Minister of Welfare. The Minister of welfare, in determining the regulations under the preceding paragraph, shall make inquiries to the Central Social Insurance Medical Treatment Council. In determining major policy concerning the guidance and supervision of medical care by the purveyors of medical care benefits, the governor of To, Do, Fu or prefecture shall make inquiries to the Prefectural Social Insurance Medical Treatment Council.

4. The Mariners'Insurance Law shall be partially amended as follows: The following one Article shall be added next to Article 2:

Article 2-(2). The Minister of welfare shall make inquiries to the Social Insurance Council before acting upon matters involving planning, legislation or major administrative policy concerning the administration and operation of Mariners'Insurance.

In Article 28-(4) paragraph 2, "consider the views of the Central Social Insurance Medical Care Council" shall be amended as "make inquiries to the Central Social Insurance Medical Treatment Council." Article 28-(5) shall be amended as follows:

Article 28-(5). In determining major policy concerning the designation and revocation of designation of insurance doctors and pharmacists, and the guidance of medical care thereby, the Minister of Welfare shall make inquiries to the Central Social Insurance Medical Treatment Council, and the governor of To, Do, Fu or prefecture, to the Prefectural Social Insurance Medical Treatment Council.

In Article 28-(6) paragraph 3, "consider the views of the Social Insurance Medical Fee Calculating Council" shall be amended as "make inquiries to the Central Social Insurance Medical Treatment Council." Article 28-(7) shall be deleted. In Article 33-(13) paragraph 1, Article 33-(14) paragraph 2, Article 52-(2) paragraph 2 and Article 52-(3) paragraph 2, the Seamen's Insurance Council "shall be amended as" the Social Insurance Council." Chapter V shall be deleted, Chapter VI shall be made Chapter V and Chapter VII shall be made Chapter VI. In Article 63 paragraph 1, Articles 65-(9) to 65-(14) inclusive, Article 67 paragraph 1 and Article 67-(2), "the Insurance Referee" shall be amended as "the Social Insurance Referee," and "the Seamen's Insurance Appeals Committee" as "the Social Insurance Appeals Committee." In Article 64, "the Seamen's Insurance Appeals Committee" shall be amended as "the Social Insurance Committee." Articles 65 to 65-(7) inclusive shall be amended as follows:

Articles 65 to 65-(7) inclusive. Deleted.

In Article 65-(8), "the Insurance Referee" shall be amended as "the Social Insurance Referee" and "the Insurance Referee who is competent" shall be amended as "the competent Social Insurance Referee." Articles 65-(16) and 65-(17) shall be deleted and Article 66 shall be amended as follows:

Article 66. Deleted.

5. The Welfare Pension Insurance Law shall be partially amended as follows: The following one Article shall be added next to Article 2:

Article 2-(2). The Minister of Welfare shall make inquiries to the Social Insurance Council before acting upon matters involving planning, legislation or major administrative policy concerning the administration and operation of Welfare Pension Insurance.

Chapter V shall be deleted, Chapter VI shall be made Chapter V and Chapter VII shall be made Chapter VI. In Article 62 paragraph 1, Articles 65-(8) to 65-(13) inclusive, Article 66 and Article 66-(2), "the Insurance Referee" shall be amended as "the Social Insurance Referee," and "the Welfare Pension Insurance Appeals Committee" as "the Social Insurance Appeals Committee." In Article 63, "the Welfare Pension Insurance Appeals Committee" shall be amended as "the Social Insurance Appeals Committee." Articles 64 to 65-(6) inclusive shall be amended as follows:

Articles 64 to 65-(6) inclusive. Deleted.

In Article 65-(7), "the Insurance Referee" shall be amended as "the Social Insurance Referee" and "the Insurance Referee who is competent" shall be amended as "the competent Social Insurance Referee." Articles 65-(15) to 65-(17) inclusive shall be deleted. 6. The Cabinet Order concerning the Social Insurance Medical Care Council (Cabinet Order No.367 of 1949) and the Cabinet Order concerning the Social Insurance Medical Fee Calculating Council (Cabinet Order No.368 of 1949) shall be abolished. (Transitional Provisions) 7. Of the members of the Council appointed for the first time after the enforcement of this Law, the term of office of one-half as designated by the Minister of Welfare at the time of appointment shall be one year, regardless of the provision of Article 4 paragraph 1. 8. Of the members of the Central Council or Prefectural Council appointed for the first time after the enforcement of this Law, the term of office of one-half as designated by the Minister of Welfare or the governor of To, Do, Fu or prefecture at the time of appointment shall be one year, regardless of the provision of Article 16 paragraph 1. 9. At the time of the enforcement of this Law, a person who is actually holding the position of the Insurance Referee under the provision of Article 80 paragraph 1 of the Health Insurance Law, Insurance Referee under the provision of Article 63 paragraph 1 of the Mariners'Insurance Law, or Insurance Referee under the provision of Article 62 paragraph 1 of the Welfare Pension Insurance Law shall be deemed to have been appointed the Social Insurance Referee under the provisions of this Law. 10. Of the members of the Appeals Committee appointed for the first time after the enforcement of this Law, the term of office of one-third shall be one year and that of another one-third shall be two years, regardless of the provision of Article 25 paragraph 1. Such members shall be designated by the Minister of Welfare at the time of appointment. 11. Acceptance of the case and other procedures taken by the Insurance Referee, the Health Insurance Appeals Committee, the Mariners'Insurance Appeals Committee or the Welfare Pension Insurance Appeals Committee prior to the enforcement of this Law, shall be deemed to be the acceptance of the case and other procedures by the Social Insurance Referees or Social Insurance Appeals Committee. Prime Minister YOSHIDA Shigeru Minister of Welfare HAYASHI Joji