The National Health Insurance Law (Law No.60 of 1938) shall be partially amended as follows:
In Article 2, "a city, town or village (including a special district;hereinafter the same)" shall be amended as "a city, town or village, or special ward, or association thereof (hereinafter referred to as city, town or village)" .
The following one paragraph shall be added next to Article 2-(2) paragraph 1:
When the householders and persons belonging to their households in an area of the city have been made the insured according to the provision of Article 8-(15) paragraph 3, the provision of the preceding paragraph shall not forbid an association to administer the National Health Insurance program outside of such area of the city concerned.
The following one Article shall be added next to Article 4:
Article 4-(2). No registration tax shall be imposed on the registration of the acquisition of right or the preservation of ownership of a building or land used exclusively by an association as an office or as a facility as provided for in Article 8-(10).
Article 8-(2) shall be made Article 8-(3), and the numbering of Article 8-(3) and its succeeding Articles through Article 8-(22) shall be moved down by one respectively, and the following one Article shall be added next to Article 8 in Chapter I:
Article 8-(2). The provisions of Articles 19 and 20 of the Local Tax Law (Law No.226 of 1950) shall apply mutatis mutandis to the sending of documents pertaining contributions and other charges prescribed by this Law.
In the former part of Article 8-(5), "the purveyors of medical and allied care" shall be amended as "the purveyors of medical care benefits (hereinafter referred to as the medical purveyors)" , and in the latter part of the same Article, Article 8-(6) paragraph 1, Article 8-(7), Article 8-(8) paragraphs 1 and 3, Article 50, Article 51 and Article 52-(3) paragraph 2, "the purveyors of medical and allied care" shall be amended as "the medical purveyors" .
In Article 8-(9) paragraph 1, "part of the expense" shall be amended as "part of the expense (hereinafter referred to as the partial liability), and next to" the person who receives the care "," or make him pay it to the medical purveyor"shall be added. And, the following one paragraph shall be added at the bottom of the same Article:
The insurer may reduce an amount of the partial liability or postpone the collection or payment thereof in behalf of a person who has special reason.
In Article 8-(10), "medical care, maternity care" shall be amended as "medical care, maternity or funeral benefit" .
In Article 8-(11) paragraph 1, "The insurer" shall be amended as "The insurer (excluding a city, town or village where the National Health Insurance Tax is imposed according to the provisions of the Local Tax Law)" .
Article 8-(12) shall be amended as follows:
Article 8-(12). The kind, scope, term and amount of payment of the insurance benefits;amount, method of collection, and reduction and exemption of the contribution;rate of the share, method of collection or payment, and reduction and exemption of the partial liability;and other necessary matters pertaining to the insurance benefits, contributions and partial liabilities shall be determined by the by-laws of a city, town or village, the agreement of an association, or the regulations of a corporate juridical person concerned.
Article 8-(14) item 3 shall be amended as follows:
3. Matters concerning the National Health Insurance Tax or contribution, and the partial liability.
In Article 8-(15) paragraph 2, "Article 8-(8) and Article 8-(10)" shall be amended as "Articles 8-(9) and 8-(11)" , and the following one paragraph shall be added at the bottom of the same Article:
Regardless of the provision of the main sentence of paragraph 1, any city with special reason and circumstances, and which is determined by the Minister of Welfare, may make the householders and persons belonging to their households within an area of the city the insured.
In Article 25-(3) item 2, "or quasi-incompetent persons" shall be deleted.
In Article 37-(4) paragraph 2, "Article 8-(8) and Article 8-(10)" shall be amended as "Article 8-(9) and Article 8-(11)" .
In Article 42, "8-(9)" shall be amended as "8-(10)" .
Chapter VIII shall be made Chapter IX, and Chapter IX shall be made Chapter X, and the following one Chapter shall be added next to Chapter VII as Chapter VIII:
CHAPTER VIII Reviewing of the Medical Care Bills
Article 47-(2). An insurer may request the Social Insurance Medical Fee Payment Fund or the National Health Insurance Medical Fee Reviewing Council to review the medical care bills submitted by the medical purveyors.
The provision of the preceding paragraph shall not forbid an insurer to make a reviewing or to entrust a reviewing to a federation covering To, Do, Fu or prefecture as its area.
The reviewing as provided for in the preceding two paragraphs shall be made for the purpose of checking propriety of the medical fee claims concerned according to the determinations of the Minister of Welfare as provided for in Article 8-(8) paragraph 1.
Article 47-(3). One or more of the National Health Insurance Medical Fee Reviewing Council (hereinafter referred to as the Reviewing Council) shall be established in To, Do, Fu or prefecture according to the determination of the governor of To, Do, Fu or prefecture in order to perform the reviewing under paragraph 1 of the preceding Article.
Article 47-(4). The Reviewing Council shall be organized by the members representing medical purveyors, insurers and the public interest, in equal number of seven or less for each group, and the governor of To, Do, Fu or prefecture shall appoint them.
The appointment of the members representing the medical purveyors and the insurers under the preceding paragraph shall be made upon the recommendation of each organization where such member belongs.
Article 47-(5). Whenever the Reviewing Council considers it necessary for the reviewing of a medical care bill, it may, with the approval of the governor of To, Do, Fu or prefecture, call the medical purveyor concerned and request him for an explanation or report, or order him to submit medical records and other documents or papers.
The governor of To, Do, Fu or prefecture shall pay travel expense, daily allowance and hotel fee to the medical purveyor who has appeared upon the request of the Reviewing Council according to the provision of the preceding paragraph. However, this shall not apply to a medical purveyor who is called by the Reviewing Council due to a defect or improper statement in a medical care bill, medical care record or other documents or papers submitted by him.
Article 47-(6). To, Do, Fu or prefecture may collect fees from the insurers for the reviewings to be performed by the Reviewing Council.
Article 47-(7). Other necessary matters for the Reviewing Council than those provided for by this Law shall be determined by the governor of To, Do, Fu or prefecture.
Article 47-(8). Upon performing the reviewing under Article 47-(2) paragraph 2, an insurer shall cause the persons representing medical purveyors and the public interest, in equal member of seven or less for each group, to participate therein.
A federation covering To, Do, Fu or prefecture as its area shall, for the purpose of performing the reviewing under Article 47-(2) paragraph 2, have such organ as is organized by the persons representing medical purveyors, insurers and the public interest, in equal member of seven or less for each group.
In Article 51, "Article 8-(6)" shall be amended as "Article 8-(7)" .
Article 52-(18) shall be amended as follows:
Article 52-(18). Deleted.
In Article 54, "Article 8-(12)" shall be amended as "Article 8-(13)" , and the following one paragraph shall be added next to paragraph 2:
When the approval is given for establishment of a by-law which makes householders and persons belonging to their households in an area of the city the insured according to the provision of Article 8-(15) paragraph 3, such area in the city concerned shall be deemed to be the district of the city as for the application of the provisions of the preceding two paragraphs. However, this shall not apply to a corporate juridical person who administers the National Health Insurance program.
In Article 56, paragraph 1 shall be amended as follows, and paragraph 2 be deleted, and in paragraph 3, "or administrative fine" shall be deleted and "5,000 yen" shall be amended as "30,000 yen" :
Whenever a member of the Reviewing Council or of the National Health Insurance Appeals Committee, or one who formerly held such a position reveals without good cause the business or private secrets of doctors of medicine or dentistry which he learned in performing the official duty, he shall be subject to a penal serviture not exceeding six months or a fine not exceeding 30,000 yen".