Medical Care Act (Any data that the title of a law indicates to be a "Tentative translation" has not yet been proofread or corrected by a native English speaker or legal translation expert; this data may be revised in the future.Tentative translation)
Act No. 205 of July 30, 1948
Table of Contents
Chapter I General Provisions (Articles 1to 6)
Chapter II Supporting Choices in Medical Care
Section 1 Providing Information on Medical Care (Articles 6-2 to 6-4-2)
Section 2 Advertisement of Medical Practices, Dental Practices, or Midwifery Services (Articles 6-5 to 6-8)
Chapter III Ensuring Safety in Medical Care
Section 1 Measures for Ensuring Safety in Medical Care (Articles 6-9 to 6-14)
Section 2 Medical Accident Investigation and Support Center (Articles 6-15 to 6-27)
Chapter IV Hospitals, Clinics, and Birthing Centers
Section 1 Foundation (Articles 7 to 9)
Section 2 Management (Articles 10 to 23)
Section 3 Supervision (Articles 23-2 to 30)
Section 4 Miscellaneous Provisions (Article 30-2)
Chapter V Ensuring the Medical Care Delivery System
Section 1 Basic Policy (Article 30-2 and 30-3-2)
Section 2 Medical Care Plans (Articles 30-4 to 30-12)
Section 3 Promotion of differentiation and coordination of the bed functions in the community (Articles 30-13 to 30-18)
Section 4 Securing the Medical Care Delivery System for Outpatient Medical Care in the Region (Article 30-18-2)
Section 5 Measures to Ensure the Availability of Medical Care Professionals, etc. (Articles 30-19 to 30-27)
Section 6 Public Medical Institutions (Articles 31 to 38)
Chapter VI Medical Corporations
Section 1 General Rules (Articles 39 to 43)
Section 2 Establishment (Articles 44 to 46)
Section 3 Organizations
Subsection 1 Establishment of Organizations (Article 46-2)
Subsection 2 General Meeting of Members (Articles 46-3 to 46-3-6)
Subsection 3 Councilors and Board of Councilors (Articles 46-4 to 46-4-7)
Subsection 4 Election and Dismissal of Officers (Articles 46-5 to 46-5-4)
Subsection 5 Directors (Articles 46-6 to 46-6-4)
Subsection 6 Board of Directors (Articles 46-7 to 46-7-2)
Subsection 7 Auditors (Articles 46-8 to 46-8-3)
Subsection 8 Liability for Damages of Officers, etc. (Articles 47 to 49-3)
Section 4 Accounting (Articles 50 to 54)
Section 5 Social Medical Corporation Bonds (Articles 54-2 to 54-8)
Section 6 Changes to Articles of Incorporation and Act of Endowment (Article 54-9)
Section 7 Dissolution and Liquidation (Articles 55 to 56-16)
Section 8 Merger and Split
Subsection 1 Merger
Division 1 General Rules (Article 57)
Division 2 Absorption-Type Merger (Articles 58 to 58-6)
Division 3 Consolidation-Type Merger (Articles 59 to 59-5)
Subsection 2 Split
Division 1 Absorption-Type Split (Articles 60 to 60-7)
Division 2 Incorporation-Type Split (Articles 61 to 61-6)
Division 3 Miscellaneous Provisions (Article 62 and 62-2)
Subsection 3 Miscellaneous Provisions (Article 62-3)
Section 9 Supervision (Articles 63 to 69)
Chapter VII Regional Medical Coordination Promotion Corporation
Section 1 Approval (Articles 70 to 70-6)
Section 2 Business, etc. (Articles 70-7 to 70-16)
Section 3 Supervision (Articles 70-17 to 70-23)
Section 4 Miscellaneous Provisions (Article 71)
Chapter VIII Miscellaneous Provisions (Articles 72 to 76)
Chapter IX Penal Provisions (Articles 77 to 94)
Supplementary Provisions
Chapter I General Provisions
Article 1 The purpose of this Act is to contribute to the protection of the health of the nation by safeguarding the interests of the recipients of medical care and ensuring a system that efficiently delivers good quality and well-suited medical care, by means of providing for the necessary matters to support well-suited choices about medical care by the recipients thereof, the necessary matters to ensure the safety of medical care, the necessary matters concerning the establishment and management of hospitals, clinics, and birthing centers, and the necessary matters to develop such facilities and promote the sharing of functions and cooperation between medical institutions.
Article 1-2 (1) Medical care shall be carried out in accordance with the physical and mental state of the recipient of medical care, based on a relationship of trust between the physician, dentist, pharmacist, nurse, or other medical care professional and the recipient of medical care, in a way which respects life and ensures the dignity of the individual, and shall be of good quality and well-suited, including, in addition to medical treatment, measures to prevent illness and rehabilitation measures.
(2) Medical care shall be provided as a basis for efforts to ensure and improve the health of the nation, placing proper regard on the wishes of the recipients of medical care, and seeking efficiency and organic coordination among associated services such as welfare services, in accordance with the functions of the medical institutions (hereinafter referred to as "medical institutions"), in hospitals, clinics, long-term care health facilities, integrated facilities for medical and long-term care, dispensing pharmacies, and other facilities that deliver medical care, and in the homes of the recipients of medical care (meaning a home and other place specified by an Ordinance of the Ministry of Health, Labour and Welfare; the same shall apply hereinafter).
Article 1-3 The national and local governments shall endeavor to ensure a system that will efficiently provide good quality and well-suited medical care to the nation based on the concepts provided in the preceding Article.
Article 1-4 (1) Physicians, dentists, pharmacists, nurses, and other medical care professionals shall endeavor to deliver good quality and well-suited medical care to the recipients of medical care, based on the concepts provided for in Article 1-2.
(2) In the delivery of medical care, a physician, dentist, pharmacist, nurse or other medical care professional shall give appropriate explanations and endeavor to foster understanding in the recipients of medical care.
(3) Physicians and dentists practicing at a medical institution shall, when necessary, refer recipients of medical care to other medical institutions, provide information concerning diagnoses or prescriptions as required for the treatment of recipients of medical care to physicians, dentists, or pharmacists engaged in diagnoses or prescriptions at other medical institutions, and shall undertake other measures as required to contribute to a sharing of functions and cooperation among medical institutions.
(4) In the case that a patient leaving a hospital or clinic requires further recuperation, the administrator of said hospital or clinic shall seek cooperation with providers of health and medical services or welfare services, and have the consideration to enable said patient to continue recuperation in an appropriate environment.
(5) The organizers and administrators of a medical institution shall have the consideration to allow physicians, dentists, pharmacists, nurses, and other medical care professionals who do not work at said medical institution to use the buildings or equipment thereof in order to carry out their practices, research, or training, to foster the dissemination of medical care techniques, and to efficiently provide medical care.
Article 1-5 (1) The term "hospital" as used in this Act means a facility for the hospitalization of not less than 20 patients, where physicians or dentists carry out medical practices or dental practices for the public or other specific groups of people. A hospital shall be organized and operated primarily for offering facilities that enable the scientific and proper treatment of the sick and injured.
(2) The term "clinic" as used in this Act shall mean a facility with no in-patient capacity, or a facility for the hospitalization of no more than 19 patients, where physicians or dentists carry out medical practices or dental practices for the public or other specific groups of people.
Article 1-6 (1) The term "long-term care health facility" as used in this Act shall mean a long-term care health facility pursuant to the provisions of the Long-Term Care Insurance Act (Act No. 123 of 1997).
(2) The term "integrated facility for medical and long-term care" as used in this Act shall mean an integrated facility for medical and long-term care pursuant to the provisions of the Long-Term Care Insurance Act.
Article 2 (1) The term "birthing center" as used in this Act shall mean a place where midwives perform services (excluding those carried out in a hospital or clinic) for the public or other specific groups of people.
(2) A birthing center shall have in-patient facilities for not less than 10 pregnant women, women in labor, or women resting after childbirth.
Article 3 (1) No place that carries out the medical treatment of illnesses (including birthing assistance) and that is not a hospital or clinic shall bear a name that includes the term "hospital," "branch hospital," "maternity hospital," "sanatorium," "clinic," "dispensary," "doctor's office," or any other name that may cause it to be mistaken for a hospital or clinic.
(2) No clinic shall bear a name that includes the term "hospital," "branch hospital," "maternity hospital," or any other name that may cause it to be mistaken for a hospital.
(3) A facility which is not a birthing center shall not bear a name that includes the term "birthing center" or any other name that may cause it to be mistaken for a place where midwifes perform services.
Article 4 (1) A hospital established by the national government, a prefecture, municipality, a social medical corporation as provided for in Article 42-2 (1), or any other party as prescribed by the Minister of Health, Labour and Welfare, and that meets the following conditions concerning the necessary support to ensure community medical care, may bear a name that includes the term "regional medical care support hospital" for its area, with the approval of the prefectural governor:
(i) Medical care is provided to patients who have been referred from other hospitals or clinics, and a system is in place that allows physicians, dentists, pharmacists, nurses, and other medical care professionals who do not work at said hospital to use all or part of its buildings, equipment, instruments, or tools for their practices, research, or training.
(ii) It is capable of providing emergency medical care.
(iii) It is capable of carrying out training to enhance the quality of community medical care professionals.
(iv) It has facilities for not less than the number of in-patients prescribed by an Ordinance of the Ministry of Health, Labour and Welfare.
(v) It has the facilities provided for in Article 21 (1)(ii) through (viii) and (x) through (xii), and Article 22 (i), and (iv) through (ix).
(vi) The buildings and equipment of the facility meet the requirements prescribed by the Ordinance of the Ministry of Health, Labour and Welfare set forth in Article 21 (1) and Article 22 and Prefectural Ordinances set forth therein.
(2) In granting approval as set forth in the preceding paragraph, the prefectural governor shall hear the opinions of the Prefectural Council on Medical Service Facilities in advance.
(3) A facility that is not a regional medical care support hospital shall not bear a name that includes the term "regional medical care support hospital" or a name that may cause it to be mistaken for such.
Article 4-2 (1) A hospital that meets the following requirements may bear the name "advanced treatment hospital," with the approval of the Minister of Health, Labour and Welfare:
(i) It is capable of providing advanced medical care.
(ii) It is capable of carrying out the development and evaluation of advanced medical care techniques.
(iii) It is capable of carrying out training on advanced medical care.
(iv) It is capable of ensuring a high level of medical safety.
(v) It has, amongst its clinical departments, clinical departments as prescribed by an Ordinance of the Ministry of Health, Labour and Welfare, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour and Welfare.
(vi) It has facilities for not less than the number of in-patients prescribed by an Ordinance of the Ministry of Health, Labour and Welfare.
(vii) Its personnel meet the requirements prescribed by the Ordinance of the Ministry of Health, Labour and Welfare set forth in Article 22-2.
(viii) It has the facilities provided for in Article 21 (1)(ii) through (viii) and (x) through (xii), and Article 22-2 (ii), and (v) through (vi).
(ix) The buildings and equipment of the facility meet the requirements prescribed by the Ordinance of the Ministry of Health, Labour and Welfare set forth in Article 21 (1) and Article 22-2 and Prefectural Ordinances set forth therein.
(2) In granting approval as set forth in the preceding paragraph, the Minister of Health, Labour and Welfare shall hear the opinions of the Social Security Council in advance.
(3) A facility that is not an advanced treatment hospital shall not bear the name "advanced treatment hospital" or a name that may cause it to be mistaken for such.
Article 4-3 (1) A hospital that meets the following requirements for playing a central role in the implementation of clinical research may bear the name "core hospital for clinical research," with the approval of the Minister of Health, Labour and Welfare:
(i) It is capable of planning and implementing a project on specified clinical research (which means clinical research conducted in accordance with the standards specified by an Ordinance of the Ministry of Health, Labour and Welfare; the same shall apply hereinafter).
(ii) In the case where specified clinical research is to be implemented jointly with other hospitals or clinics, it is capable of playing a leading role in the implementation of the specified clinical research.
(iii) It is capable of providing consultation, necessary information, advice and other assistance to other hospitals or clinics concerning the implementation of specified clinical research.
(iv) It is capable of providing training on specified clinical research.
(v) It has, amongst its clinical departments, clinical departments as prescribed by an Ordinance of the Ministry of Health, Labour and Welfare.
(vi) It has facilities for not less than the number of in-patients prescribed by an Ordinance of the Ministry of Health, Labour and Welfare.
(vii) Its personnel meet the requirements prescribed by the Ordinance of the Ministry of Health, Labour and Welfare set forth in Article 22-3.
(viii) It has the facilities provided for in Article 21 (1)(ii) through (viii) and (x) through (xii), and Article 22-3 (ii), (v) and (vi).
(ix) The buildings and equipment of the facility meet the requirements prescribed by the Ordinance of the Ministry of Health, Labour and Welfare set forth in Article 21 (1) and Article 22-3 and Prefectural Ordinances set forth therein.
(x) In addition to what is listed in each of the preceding items, it meets the requirements specified by an Ordinance of the Ministry of Health, Labour and Welfare concerning the implementation of specified clinical research.
(2) In granting approval as set forth in the preceding paragraph, the Minister of Health, Labour and Welfare shall hear the opinions of the Social Security Council in advance.
(3) A facility that is not a core hospital for clinical research shall not bear the name "core hospital for clinical research" or a name that may cause it to be mistaken for such.
Article 5 (1) A physician or dentist who practices solely through house calls for the public or other specific groups of people, or a midwife who engages in services solely through out-calls shall consider each such address as his/her clinic or birthing center with regards the applicability of the provisions set forth in Article 6-4-2, Article 6-5, or Article 6-7, Article 8 and Article 9.
(2) A prefectural governor, a mayor of a city as prescribed by the Cabinet Order as set forth in Article 5 (1) of the Community Health Act (Act No. 101 of 1947) (hereinafter referred to as a "city with a public health center"), or a mayor of a special ward of Tokyo may, when he/she finds it necessary, order a physician, dentist, or midwife as provided for in the preceding paragraph to report as required, or may order the submission of medical records, birth records, accounting books and documents, and other articles for inspection.
Article 5-2 (1) The Minister of Health, Labour and Welfare may, based on an application from a clinically trained physician prescribed in Article 7 (1), certify that said physician has the experience necessary to have knowledge concerning the provision of medical care in an acute physician shortage area (meaning an area prescribed in Article 30-4 (6) and other areas specified by an Ordinance of the Ministry of Health, Labour and Welfare; the same shall apply hereinafter) and other experience specified by an Ordinance of the Ministry of Health, Labour and Welfare.
(2) The Minister of Health, Labour and Welfare who has granted certification under the preceding paragraph shall issue a certificate.
(3) The Minister of Health, Labour and Welfare may rescind the certification when a physician who has obtained the certification under paragraph (1) falls under any of the following items:
(i) When the physician has had his/her license revoked or has been ordered to suspend his/her medical practice.
(ii) When it is found that the certification under paragraph (1) was obtained by deception or other wrongful means.
(iii) When the physician was sentenced to a fine or severer punishment.
(4) Necessary matters concerning the certification set forth in paragraph (1) and the rescission of such certification shall be provided for by Cabinet Order.
Article 6 The applicability of the provisions of this Act to hospitals, clinics, and birthing centers established by the national government may be prescribed separately by Cabinet Order.
Chapter II Supporting Choices in Medical Care
Section 1 Providing Information on Medical Care
Article 6-2 (1) National government and local governments shall endeavor to undertake the necessary measures to enable recipients of medical care to easily acquire the necessary information for choosing a hospital, clinic, or birthing center.
(2) Organizers and administrators of medical institutions shall endeavor to provide accurate and well-suited information on the medical care provided thereby, and to appropriately respond to queries from patients or their families, to enable recipients of medical care to choose appropriate health and medical services.
(3) Citizens shall, in order to contribute to the efficient provision of high-quality and appropriate medical care, endeavor to deepen their understanding of the importance of the sharing of functions and the coordination of operations among medical institutions, and to choose and receive medical care appropriately according to the functions of medical institutions.
Article 6-3 (1) The administrator of a hospital, clinic, or birthing center (hereinafter referred to as "hospital, etc." in this Article) shall report the matters prescribed by an Ordinance of the Ministry of Health, Labour and Welfare as necessary information for enabling recipients of medical care to choose an appropriate hospital, etc. to the prefectural governor of the location of said hospital, etc., pursuant to the provisions of an Ordinance of the Ministry of Health, Labour and Welfare, and shall make documents describing such matters available for inspection within said hospital, etc.
(2) If a change arises with regard to matters reported pursuant to the provisions of the preceding paragraph, the administrator of a hospital, etc. shall report promptly to the prefectural governor of the location of said hospital, etc., and amend the details of the documents provided for in the preceding paragraph, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour and Welfare.
(3) In lieu of making documents pursuant to the provisions of paragraph (1) available for inspection, the administrator of a hospital, etc. may, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour and Welfare, provide the matters that should be stated in said documents by electromagnetic means (which means a method using an electronic data processing system or other information communication technology; the same shall apply in paragraph (2) of the following Article and Article 6-4-2 (2)) specified by an Ordinance of the Ministry of Health, Labour and Welfare.
(4) If a prefectural governor finds it necessary in order to confirm the details of a report pursuant to the provisions of paragraph (1) or paragraph (2), he/she may request the necessary information concerning a hospital, etc. situated within the boundaries of said prefecture from a municipality or other public agency.
(5) A prefectural governor shall make public the matters reported thereto pursuant to the provisions of paragraph (1) and paragraph (2), pursuant to the provisions of an Ordinance of the Ministry of Health, Labour and Welfare.
(6) If the administrator of a hospital, etc. fails to report pursuant to the provisions of paragraph (1) or paragraph (2) or has made a false report, the prefectural governor may order the organizer of said hospital, etc. to have said administrator give said report or correct the details of said report within a period that he/she prescribes.
Article 6-4 (1) When a patient has been admitted, the administrator of a hospital or clinic shall have the physician or dentist responsible for his/her treatment prepare documents describing the following matters, deliver them to said patient or his/her family, and give an appropriate explanation thereof, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour and Welfare; provided, however, that this shall not apply where the patient is expected to be discharged from the hospital in a short period of time or where prescribed by an Ordinance of the Ministry of Health, Labour and Welfare:
(i) The name, date of birth, and gender of the patient.
(ii) The name of the physician or dentist primarily responsible for said patient's treatment.
(iii) The name of the illness and major symptoms leading to hospitalization.
(iv) A plan for examinations, surgeries, medication, and other treatments to be undertaken during hospitalization (including nursing and dietary management during hospitalization).
(v) Other matters as prescribed by an Ordinance of the Ministry of Health, Labour and Welfare.
(2) In lieu of delivering the documents as set forth in the preceding paragraph, the administrator of a hospital or clinic may, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour and Welfare, provide the matters that should be stated in said documents by electromagnetic means specified by an Ordinance of the Ministry of Health, Labour and Welfare, with the consent of the patient or his/her family.
(3) When a patient is being discharged from the hospital, the administrator of said hospital or clinic shall endeavor to have documents that describe the matters related to health and medical services or welfare services that will be necessary for his/her treatment after being discharged from the hospital prepared, delivered, and appropriately explained.
(4) In preparing the documents as set forth in paragraph (1), the administrator of a hospital or clinic shall endeavor to properly reflect the opinions of the physicians, dentists, pharmacists, nurses, and other employees who work at said hospital or clinic, and to appropriately provide medical care during hospitalization through organic coordination between these parties, based on the contents of said documents.
(5) In preparing the documents set forth in paragraph (3), the administrator of a hospital or clinic shall endeavor to seek cooperation with providers of the health and medical services or welfare services that are necessary for said patient's treatment after he/she is discharged from the hospital.
Article 6-4-2 (1) The administrator of a birthing center (or in the case of a midwife who only does home visits, said midwife; the same shall apply in the following paragraph) shall, when he/she has promised to provide midwifery services to a pregnant woman or a woman in labor (hereinafter referred to as "pregnant woman, etc." in this Article and Article 19 (2)), ensure pursuant to the provisions of an Ordinance of the Ministry of Health, Labour and Welfare that the midwife in charge of providing midwifery services to said pregnant woman, etc. delivers a document stating the following matters and provides appropriate explanation to said pregnant woman, etc. or her family;
(i) The name and date of birth of the pregnant woman, etc.
(ii) The name of the midwife who is in charge of providing midwifery services to said pregnant woman, etc.
(iii) Policies concerning midwifery and health guidance for said pregnant woman, etc.
(iv) The name, address and contact information of said birthing center.
(v) The name, address and contact information of the hospital or clinic that responds to the abnormality of said pregnant woman, etc.
(vi) Other matters specified by an Ordinance of the Ministry of Health, Labour and Welfare.
(2) In lieu of delivering the documents as set forth in the preceding paragraph, the administrator of a birthing center may, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour and Welfare, provide the matters that should be stated in said documents by electromagnetic means specified by an Ordinance of the Ministry of Health, Labour and Welfare, with the consent of the pregnant woman, etc. or her family.
Section 2 Advertisement of Medical Practices, Dental Practices, or Midwifery Services
Article 6-5 (1) No party shall, when placing any advertisement or making any other representation as a means of inducing medical care recipients (hereinafter simply referred to as "advertisement" in this Section) with regard to medical practice or dental practice, or hospitals or clinics, run false advertisement, regardless of whether it is made in writing or by any other means.
(2) In the case prescribed in the preceding paragraph, the contents and methods of the advertisement shall conform to the following standards so as not to hinder appropriate selection of medical care by medical care recipients:
(i) No advertisement shall be placed to the effect that the hospital or clinic is superior to other hospitals or clinics.
(ii) No exaggerated advertisement shall be placed.
(iii) No advertisement that undermines public order or corrupt good morals shall be placed.
(iv) Other standards specified by an Ordinance of the Ministry of Health, Labour and Welfare as necessary for appropriate selection of medical care.
(3) In the case prescribed in paragraph (1), no advertisement of matters other than those listed below shall be placed, except in cases specified by an Ordinance of the Ministry of Health, Labour and Welfare as cases where there is little risk of hindering appropriate selection of medical care by medical care recipients even if advertisement of matters other than those listed below is placed:
(i) That the person is a physician or dentist.
(ii) The clinical department name.
(iii) The name, telephone number, information that indicates the location of said hospital or clinic, and the name of the administrator of said hospital or clinic.
(iv) The days and hours of practice, or whether an appointment can be booked.
(v) For a hospital, clinic, physician, or dentist that is designated to undertake standard medical care as set forth in the provisions of laws and regulations, a statement to that effect.
(vi) In the case of a physician who has obtained the certification under Article 5-2 (1), a statement to that effect.
(vii) In the case of a participating hospital, etc. (meaning a participating hospital, etc. prescribed in Article 70-2 (2)(ii)) of a regional medical coordination promotion corporation (meaning a regional medical coordination promotion corporation prescribed in Article 70-5 (1); the same shall apply in Article 30-4 (12)), a statement to that effect.
(viii) Whether there are in-patient facilities, the number of each type of bed provided for in Article 7 (2), the number of physicians, dentists, pharmacists, nurses, and other employees, and other matters related to the facilities, equipment, or employees at said hospital or clinic.
(ix) The names, ages, genders, positions, and brief personal records of medical care professionals practicing at said hospital or clinic, and other matters related to said medical care professionals that are prescribed by the Minister of Health, Labour and Welfare as matters that contribute to recipients of medical care making appropriate choices with regard to their medical care.
(x) Measures for responding to queries concerning medical care from patients or their families, measures to ensure the safety of medical care, measures to ensure the appropriate handling of personal information, and other matters related to the management or operation of said hospital or clinic.
(xi) Matters related to cooperation with other hospitals, clinics, or health and medical service or welfare service providers, such as the names of the hospitals, clinics, or other health and medical service or welfare service providers to which patients may be referred, or the shared use of facilities, equipment, or tools between such parties and said hospital or clinic.
(xii) Matters concerning the provision of information in medical records and other records related to treatment, delivery of documents provided for in Article 6-4 (3), and provision of other information on medical care at said hospital or clinic.
(xiii) Matters related to the details of medical care provided at said hospital or clinic (limited to the details of examinations, surgery, and other medical treatment methods that are prescribed by the Minister of Health, Labour and Welfare as matters that contribute to recipients of medical care making appropriate choices with regard to their medical care).
(xiv) Matters related to the average number of days of hospitalization, average out-patient or in-patient numbers, and other matters related to the results of the medical care that is provided at said hospital or clinic and that are prescribed by the Minister of Health, Labour and Welfare as matters that contribute to recipients of medical care making appropriate choices with regard to their medical care.
(xv) Other matters prescribed by the Minister of Health, Labour and Welfare shall be dealt with in the same manner as matters listed in each of the previous items.
(4) When the Minister of Health, Labour and Welfare intends to plan the enactment, revision or abolition of an Ordinance of the Ministry of Health, Labour and Welfare set forth in item (iv) of paragraph (2) or the preceding paragraph, or to prepare a draft of the matters listed in item (viii) or items (xii) through (xiv) of the preceding paragraph, he/she shall hear the opinions of groups of persons with the relevant knowledge and experience in medical practice in order to plan or prepare based on expert scientific opinions on medical care.
Article 6-6 (1) Clinical department names pursuant to the provisions of paragraph (3)(ii) of the preceding Article shall be the clinical department names of medical practices and dental practices prescribed by a Cabinet Order, or clinical department names other than such clinical department names in which the practicing physician or dentist has been given permission by the Minister of Health, Labour and Welfare.
(2) The Minister of Health, Labour and Welfare shall hear the opinions of academic societies of medicine and medical science and the Medical Ethics Council, when planning to enact, amend, or abolish the Cabinet Order set forth in the preceding paragraph.
(3) In granting the permission set forth in paragraph (1), the Minister of Health, Labour and Welfare shall hear the opinions of the Medical Ethics Council in advance.
(4) If an advertisement of a clinical department name that is related to the permission under the provisions of paragraph (1) is placed, the name of the physician or dentist who received that permission shall be advertised alongside said clinical department name.
Article 6-7 (1) No party shall, when placing any advertisement with regard to midwifery services or birthing centers, run false advertisement, regardless of whether it is made in writing or by any other means.
(2) In the case prescribed in the preceding paragraph, the contents and methods of the advertisement shall conform to the following standards so as not to hinder appropriate selection of medical care by medical care recipients:
(i) No advertisement shall be placed to the effect that the birthing center is superior to other birthing centers.
(ii) No exaggerated advertisement shall be placed.
(iii) No advertisement that undermines public order or corrupt good morals shall be placed.
(iv) Other standards specified by an Ordinance of the Ministry of Health, Labour and Welfare as necessary for appropriate selection of medical care.
(3) In the case prescribed in paragraph (1), no advertisement of matters other than those listed below shall be placed, except in cases specified by an Ordinance of the Ministry of Health, Labour and Welfare as cases where there is little risk of hindering appropriate selection of medical care by medical care recipients even if advertisement of matters other than those listed below is placed:
(i) That the person is a midwife.
(ii) The name, telephone number, information that indicates the location of the birthing center, and the name of the administrator of the birthing center.
(iii) Business days and hours or whether services can be booked.
(iv) Whether there are in-patient facilities, the admission capacity, number of midwives and other employees, and other matters related to the facilities, equipment or employees of said birthing center.
(v) The names, ages, positions, and brief personal records of the midwives engaged in services at said birthing center, and other matters related to midwives, as prescribed by the Minister of Health, Labour and Welfare as matters that contribute to recipients of medical care making appropriate choices with regard to their medical care.
(vi) Measures for responding to queries on medical care from patients or their families, measures to ensure the safety of medical care, measures to ensure the appropriate handling of personal information, and other matters related to the management or operation of said birthing center.
(vii) Matters related to cooperation with the services of said birthing center, such as the names of the contract physicians provided for in Article 19 (1), or the names of hospitals or clinics.
(viii) Matters related to the provision of information on birth records and the provision of information on medical care at said birthing center.
(ix) Other matters prescribed by the Minister of Health, Labour and Welfare as equivalent to the matters listed in each of the previous items.
Article 6-8 (1) A prefectural governor, a mayor of a city with a public health center, or a mayor of a special ward of Tokyo may, if he/she finds that the advertisement related to a medical practice, a dental practice, or midwifery services, or to a hospital, clinic, or birthing center violates the provisions of Article 6-5 (1) through (3) or the preceding Article, order the party that placed said advertisement to report as required, or may have the relevant official enter the offices of the party that placed said advertisement, and inspect documents or other articles related to said advertisement.
(2) A prefectural governor, a mayor of a city with a public health center, or a mayor of a special ward of Tokyo may, if he/she finds that the advertisement related to a medical practice, a dental practice, or midwifery services, or to a hospital, clinic or birthing center violates the provisions of Article 6-5 (2) or (3), or paragraph (2) or (3) of the preceding Article, order the party that placed said advertisement to discontinue said advertisement or correct its contents by a set deadline.
(3) An official who enters and inspects pursuant to the provisions of paragraph (1) shall carry a certificate for identification and present it when requested by the concerned parties.
(4) The authority granted pursuant to the provisions of paragraph (1) shall not be construed as approval for criminal investigation.
Chapter III Ensuring Safety in Medical Care
Section 1 Measures for Ensuring Safety in Medical Care
Article 6-9 The national government, prefectures, cities with public health centers and special wards of Tokyo shall endeavor to undertake the necessary measures to ensure safety in medical care, including the provision of information on safety in medical care, training, and raising awareness on compliance.
Article 6-10 (1) The administrator of a hospital, clinic, or birthing center (hereinafter referred to as "hospital, etc." in this Chapter) shall, when a medical accident (meaning a death or stillbirth caused or suspected to be caused by medical care provided by medical care professionals working in said hospital, etc. and determined by an Ordinance of the Ministry of Health, Labour and Welfare as a death or stillbirth which said administrator did not expect; the same shall apply hereinafter in this Chapter) has occurred, immediately report the date, time, place and circumstances of said medical accident and other matters specified by an Ordinance of the Ministry of Health, Labour and Welfare to the medical accident investigation and support center set forth in Article 6-15 (1), pursuant to an Ordinance of the Ministry of Health, Labour and Welfare.
(2) Prior to the submission of a report pursuant to the provision of the preceding paragraph, the administrator of the hospital, etc. shall explain to the bereaved family of the deceased pertaining to the medical accident or the parents of the stillborn baby pertaining to the medical accident and other persons specified by an Ordinance of the Ministry of Health, Labour and Welfare (hereinafter simply referred to as "bereaved family" in this Chapter) about the matters specified by an Ordinance of the Ministry of Health, Labour and Welfare; provided, however, that this shall not apply when there is no bereaved family or the whereabouts of the bereaved family are unknown.
Article 6-11 (1) In the event of a medical accident, the administrator of a hospital, etc. shall, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour and Welfare, immediately conduct an investigation necessary to clarify the cause of the accident (hereinafter referred to as "medical accident investigation" in this Chapter).
(2) The administrator of a hospital, etc. shall seek the support necessary for conducting medical accident investigations from an academic organization related to medicine and medical science or any other organization specified by the Minister of Health, Labour and Welfare (in the case of an organization that is not a corporation, it shall be limited to an organization with a designated representative or administrator; referred to as "medical accident investigation support organization" in the following paragraph and Article 6-22).
(3) When a medical accident investigation support organization is requested to provide support in accordance with the provision of the preceding paragraph, it shall provide the necessary support for medical accident investigation.
(4) When the administrator of a hospital, etc. has completed a medical accident investigation, he/she shall immediately report the results to the medical accident investigation and support center set forth in Article 6-15 (1), pursuant to an Ordinance of the Ministry of Health, Labour and Welfare.
(5) Prior to the submission of a report pursuant to the provision of the preceding paragraph, the administrator of the hospital, etc. shall explain to the bereaved family about the matters specified by an Ordinance of the Ministry of Health, Labour and Welfare; provided, however, that this shall not apply when there is no bereaved family or the whereabouts of the bereaved family are unknown.
Article 6-12 In addition to what is provided for in the preceding two Articles, the administrator of a hospital, etc. shall, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour and Welfare, take measures to ensure the safety of medical care in said hospital, etc., such as formulating guidelines to ensure the safety of medical care and providing training for employees.
Article 6-13 (1) Prefectures, cities with public health centers, and special wards (hereinafter referred to as "prefectures, etc." in this Article and the following Article) shall endeavor to provide facilities (hereinafter such a facility is referred to as a "medical care safety support center") for the implementation of the following operations, in order to undertake the measures provided for in Article 6-9:
(i) Handling complaints and responding to queries from patients or their families concerning medical care at the hospitals, etc. situated within the boundaries of said prefecture, etc., and giving advice as required to said patients or their families and the administrators of said hospitals, etc.
(ii) Providing information as required to ensure safety in medical care to the organizers, administrators, and employees of the hospitals, etc. situated within the boundaries of said prefecture, etc., patients or their families, or citizens.
(iii) Implementing training on safety in medical care for the administrators and employees of the hospitals, etc. situated within the boundaries of said prefecture, etc.
(iv) Providing support in addition to that listed in the preceding three items as required to ensure safety in medical care within the boundaries of said prefecture, etc.
(2) When a medical care safety support center has been established pursuant to the provisions of the preceding paragraph, the prefecture, etc. shall provide public notice of its name and location.
(3) A prefecture, etc. may entrust the operations of a medical care safety support center to a general incorporated association, general incorporated foundation, or to another party prescribed by an Ordinance of the Ministry of Health, Labour and Welfare.
(4) Personnel (including parties to whom operations have been entrusted pursuant to the provisions of the preceding paragraph (and their officers in the case that such a party is a juridical person) and their personnel) who are or have been engaged in the operations of a medical care safety support center shall not divulge any secret acquired in relation to said operations without justifiable grounds.
Article 6-14 The national government shall, in addition to providing information on safety in medical care, provide advice and other support on the management of medical care safety support centers to prefectures, etc., to contribute to the appropriate implementation of operations in medical care safety support centers.
Section 2 Medical Accident Investigation and Support Center
Article 6-15 (1) The Minister of Health, Labour and Welfare may, upon application, designate as a medical accident investigation and support center a general incorporated association or general incorporated foundation whose purpose is to contribute to ensuring the safety of medical care by conducting medical accident investigations and providing support for medical accident investigations conducted by the administrators of hospitals, etc. in which medical accidents have occurred, and which is found to be capable of appropriately and reliably performing the services prescribed in the following Article.
(2) When the Minister of Health, Labor and Welfare has made a designation under the provision of the preceding paragraph, he/she shall publicly notify the name, address, and office location of said medical accident investigation and support center.
(3) When a medical accident investigation and support center intends to change its name, address, or the location of its office, it shall notify the Minister of Health, Labour and Welfare to that effect in advance.
(4) When the Minister of Health, Labour and Welfare has received a notification under the preceding paragraph, he/she shall publicly notify the matters pertaining to said notification.
Article 6-16 The medical accident investigation and support center shall perform the following services:
(i) To organize and analyze the information collected through the report under the provision of Article 6-11 (4).
(ii) To report the results of the organization and analysis of the information under the preceding item to the administrators of hospitals, etc. that have made a report under the provisions of Article 6-11 (4).
(iii) To conduct the investigation set forth in paragraph (1) of the following Article and report the results to the administrator and the bereaved family set forth in the same paragraph.
(iv) To provide training on knowledge and skills pertaining to medical accident investigation to those engaged in medical accident investigation.
(v) To provide consultation on the implementation of medical accident investigation and provide necessary information and support.
(vi) To promote dissemination of information and awareness-raising about prevention of recurrence of medical accidents.
(vii) In addition to what is listed in each of the preceding items, to perform services necessary to ensure the safety of medical care.
Article 6-17 (1) The medical accident investigation and support center may conduct necessary investigations when the administrator of a hospital, etc. where a medical accident has occurred or a bereaved family requests an investigation of said medical accident.
(2) When the medical accident investigation and support center finds it necessary to conduct the investigation set forth in the preceding paragraph, it may request the administrator set forth in the same paragraph to provide written or oral explanations or submit materials or other forms of necessary cooperation.
(3) The administrator prescribed in paragraph (1) shall not refuse a request made by the medical accident investigation and support center pursuant to the preceding paragraph.
(4) When the administrator prescribed in paragraph (1) refuses a request under the provision of paragraph (2), the medical accident investigation and support center may make a public announcement to that effect.
(5) When the medical accident investigation and support center has completed the investigation under paragraph (1), it shall report the results of the investigation to the administrator and the bereaved family prescribed in the same paragraph.
Article 6-18 (1) When the medical accident investigation and support center performs the services listed in each item of Article 6-16 (hereinafter referred to as "investigation services, etc."), it shall, prior to performance of such services, establish rules for investigation services, etc. covering matters concerning the implementation method of investigation services, etc. and other matters specified by an Ordinance of the Ministry of Health, Labour and Welfare (referred to as the "service rules" in the following paragraph and Article 6-26 (1)(iii)), and obtain approval from the Minister of Health, Labour and Welfare. The same shall apply when the medical accident investigation and support center intends to change said rules.
(2) When the Minister of Health, Labour and Welfare finds that the service rules approved under the preceding paragraph have become inappropriate for the proper and reliable implementation of the investigation services, etc., he/she may order that said service rules be changed.
Article 6-19 (1) Each business year, the medical accident investigation and support center shall, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour and Welfare, prepare a business plan and a budget for income and expenditure with respect to the investigation services, etc. and obtain the approval from the Minister of Health, Labour and Welfare. The same shall apply when the medical accident investigation and support center intends to change said business plan and budget.
(2) The medical accident investigation and support center shall, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour and Welfare, prepare and submit to the Minister of Health, Labour and Welfare a business report and a statement of income and expenditure with respect to the investigation services, etc. after the end of each business year.
Article 6-20 The medical accident investigation and support center shall not suspend or abolish all or part of the investigation services, etc. without obtaining approval from the Minister of Health, Labour and Welfare.
Article 6-21 No officer or employee of the medical accident investigation and support center, or any former officer or employee thereof shall divulge any secret obtained in connection with the investigation services, etc. without justifiable grounds.
Article 6-22 (1) The medical accident investigation and support center may entrust a part of the investigation services, etc. to a medical accident investigation support organization.
(2) An officer or employee of a medical accident investigation support organization entrusted with the investigation services, etc. under the preceding paragraph, or a person who used to be such an officer or employee shall not divulge any secret obtained in connection with said investigation services, etc. entrusted to him/her without justifiable grounds.
Article 6-23 The medical accident investigation and support center shall, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour and Welfare, keep books, describe matters specified by an Ordinance of the Ministry of Health, Labour and Welfare concerning the investigation services, etc. therein, and preserve them.
Article 6-24 (1) The Minister of Health, Labour and Welfare may, when he/she finds it necessary in order to ensure the proper operation of investigation services, etc., order the medical accident investigation and support center to make necessary reports on the status of the investigation services, etc. or assets, or have the relevant officials enter the office of the medical accident investigation and support center and inspect the status of the investigation services, etc. or books, documents or other objects.
(2) The official who enters and inspects under the provision of the preceding paragraph shall carry a certificate for identification and present it to the persons concerned.
(3) The authority under the provision of paragraph (1) shall not be construed as being granted for the purpose of criminal investigation.
Article 6-25 The Minister of Health, Labour and Welfare may, to the extent necessary to enforce the provisions of this Section, issue to the medical accident investigation and support center orders necessary for the supervision of the investigation services, etc.
Article 6-26 (1) When the medical accident investigation and support center falls under any of the following items, the Minister of Health, Labour and Welfare may rescind the designation under the provision of Article 6-15 (1) (hereinafter referred to as "designation" in this Article):
(i) When the medical accident investigation and support center is found to be unable to perform investigation services, etc. appropriately and reliably.
(ii) When there has been a wrongful act with regard to the designation.
(iii) When the medical accident investigation and support center has violated the provisions of this Section or an order or disposition thereunder, or has performed investigation services, etc. without complying with the service rules approved under Article 6-18 (1).
(2) When the Minister of Health, Labour and Welfare has rescinded a designation pursuant to the provision of the preceding paragraph, he/she shall make a public announcement to that effect.
Article 6-27 In addition to what is provided for in this Section, necessary matters concerning the medical accident investigation and support center shall be specified by an Ordinance of the Ministry of Health, Labour and Welfare.
Chapter IV Hospitals, Clinics, and Birthing Centers
Section 1 Foundation
Article 7 (1) When a person wishes to establish a hospital, when a person who is neither a person registered pursuant to the provisions of Article 16-6 (1) of the Medical Practitioners Act (Act No. 201 of 1948) (limited to persons registered pursuant to the provisions of paragraph (2) of the same Article who have been issued an order by the Minister of Health, Labour and Welfare pursuant to the provisions of Article 7-2 (1) of the same Act; hereinafter referred to as a "clinically trained physician") nor a person registered pursuant to the provisions of Article 16-4 (1) of the Dentists Act (Act No. 202 of 1948) (limited to persons registered pursuant to the provisions of paragraph (2) of the same Article who have been issued an order by the Minister of Health, Labour and Welfare pursuant to the provisions of Article 7-2 (1) of the same Act; hereinafter referred to as a "clinically trained dentist") wishes to establish a clinic, and when a person who is not a midwife (limited to persons who have been issued an order by the Minister of Health, Labour and Welfare pursuant to the provisions Article 15-2 (1) of the Act on Public Health Nurses, Midwives and Nurses (Act No. 203 of 1948) and who are registered pursuant to the provisions of paragraph (3) of the same Article; hereinafter the same shall apply in this Article, Article 8 and Article 11) wishes to establish a birthing center, he/she shall first acquire permission to do so from the prefectural governor for the location of said facility (the mayor of a city with a public health center or the mayor of a special ward in the case that the location of said clinic or birthing center is within such a city with a public health center or a special ward; the same shall apply in Article 8 through Article 9, Article 12, Article 15, Article 18, Article 24, Article 24-2, Article 27, and Article 28 through Article 30).
(2) When a person who has established a hospital wishes to alter the number of beds, the classification of beds described in each of the following items (hereinafter referred to as "bed classifications"), or other matters prescribed by an Ordinance of the Ministry of Health, Labour and Welfare, when a person who is neither a clinically trained physician nor a clinically trained dentist but has established a clinic or a person who is not a midwife but has established a birthing center, wishes to alter the number of beds or other matters prescribed by an Ordinance of the Ministry of Health, Labour and Welfare, the same shall apply as in the preceding paragraph, except where prescribed by an Ordinance of the Ministry of Health, Labour and Welfare:
(i) Psychiatric hospital beds (meaning hospital beds for the hospitalization of persons with psychiatric disorders; the same shall apply hereinafter).
(ii) Infectious disease hospital beds (meaning hospital beds for the hospitalization of patients (including persons regarded as patients with Class I infectious diseases, Class II infectious diseases, infectious diseases including novel influenza A, and designated infections pursuant to the provisions of Article 8 of the Act on the Prevention of Infectious Diseases and Medical Care for Patients Suffering from Infectious Diseases (Act No. 114 of 1998) (including where Article 7 of the same Act applies mutatis mutandis)) with Class I infectious diseases provided for in Article 6 (2) of the same Act, Class II infectious diseases provided for in paragraph (3) of the same Article (except tuberculosis), infections including novel influenza A provided for in paragraph (7) of the same Article, and designated infections provided for in paragraph (8) of the same Article (limited to those infections to which the provisions of Article 19 or Article 20 of the same Act apply mutatis mutandis under the provisions of Article 7 of the same Act), and persons found to have new infectious diseases provided for in Article 6 (9) of the same Act; the same shall apply hereinafter).
(iii) Tuberculosis hospital beds (meaning hospital beds for the hospitalization of tuberculosis patients; the same shall apply hereinafter).
(iv) Long-term care beds (meaning hospital or clinic beds other than those described in the above three items that are primarily for the hospitalization of patients requiring long-term recuperation; the same shall apply hereinafter).
(v) General beds (meaning hospital or clinic beds other than those described in each of the above items; the same shall apply hereinafter).
(3) When a person wishes to provide beds in a clinic, or when he/she wishes to alter the number of beds in a clinic, the bed classifications, or other matters prescribed by an Ordinance of the Ministry of Health, Labour and Welfare, he/she shall first acquire permission to do so from the prefectural governor of the area in which said clinic is situated, except where prescribed by an Ordinance of the Ministry of Health, Labour and Welfare.
(4) Where there has been an application for permission as set forth in the preceding three paragraphs, the prefectural governor, mayor of a city with a public health center or mayor of a special ward shall grant permission as set forth in the preceding three paragraphs if the buildings, equipment, and personnel of the facility pertaining to said application comply with the requirements prescribed by the Ordinance of the Ministry of Health, Labour and Welfare set forth in Article 21 and Article 23 and the prefectural ordinance set forth in Article 21.
(5) When a prefectural governor grants permission for an application for permission to establish a hospital, or permission to increase the number of beds or alter bed classifications in a hospital, or permission to set up new beds in a clinic, or permission to increase the number of beds or alter bed classifications in a clinic, he/she may, in the case where with regard to the beds pertaining to said application, out of the functional classification of beds prescribed in Article 30-13 (1) (hereinafter referred to as "functional classification of beds" in this paragraph), the number of existing beds according to the functional classification of beds in the vision area (meaning the "vision area" prescribed in Article 30-4 (2)(vii), which is specified in a medical care plan prescribed in Article 30-4 (1) (hereinafter referred to as "medical care plan" in this paragraph, the following Article and Article 7-3 (1)); the same shall apply in Article 7-3 (1)) including the location of the hospital or clinic pertaining to said application has not reached the future requirements for the number of beds prescribed in (a) of the same item in said vision area specified in the medical care plan, attach conditions specified by an Ordinance of the Ministry of Health, Labour and Welfare as necessary for the provision of medical care pertaining to such a case and for the promotion of the achievement of the other regional medical care vision prescribed in the same item specified in the medical care plan.
(6) Notwithstanding the provisions of paragraph (4), the permission set forth in paragraph (1) may be refused to a person who wishes to establish a hospital, clinic or birthing center for profit.
Article 7-2 (1) Where the following persons have applied for permission to establish a hospital, to increase the number of beds, or to alter bed classifications in a hospital, notwithstanding the provisions of paragraph (4) of the preceding Article, the prefectural governor may refuse the permission set forth in paragraph (1) or paragraph (2) of the same Article when, in the area that includes the hospital to which said application relates (where the beds to which said application relates are recuperation or general beds only (hereinafter referred to as "long-term care beds, etc." in this Article and paragraph (1) of the following Article), this shall be the area provided for in Article 30-4 (2)(xiv) as prescribed by the medical care plan; where the beds to which said application relates are psychiatric beds, infectious disease beds, or tuberculosis beds only (hereinafter referred to as "psychiatric beds, etc." in this paragraph), this shall be the prefectural area; and where the beds to which said application relates are long-term care beds, etc. and psychiatric beds, etc., this shall be the area provided for in Article 30-4 (2)(xiv) and the prefectural area), the number of hospital or clinic beds that correspond to the classifications of the beds that said application relates to (or the number of long-term care beds and general beds in said area, where the beds that said application relates to are long-term care beds, etc. only) has already reached the target number of beds for said area, as prescribed in a medical care plan that is in accordance with the requirements prescribed by the Ordinance of the Ministry of Health, Labour and Welfare set forth in paragraph (8) of the same Article, or if it is considered that establishing a hospital, increasing the number of beds, or altering the bed classifications as per said application would exceed said target:
(i) A person as provided for in Article 31.
(ii) Mutual aid associations and federations thereof formed under the provisions of the National Public Officers Mutual Aid Association Act (Act No. 128 of 1958).
(iii) Mutual aid associations formed under the provisions of the Local Public Officers, etc. Mutual Aid Association Act (Act No. 152 of 1962).
(iv) In addition to what is listed in the preceding two items, mutual aid associations and federations thereof formed under laws and regulations prescribed by Cabinet Order.
(v) The Promotion and Mutual Aid Corporation for Private Schools of Japan which administers the private school mutual aid system pursuant to the provisions of the Private School Personnel Mutual Aid Association Act (Act No. 245 of 1953).
(vi) The National Federation of Health Insurance Societies and its federations formed under the provisions of the Health Insurance Act (Act No. 70 of 1922).
(vii) The National Health Insurance Association and national health insurance organizations formed under the provisions of the National Health Insurance Act (Act No. 192 of 1958).
(viii) Japan Community Health care Organization.
(2) Where a person listed in any of the items of the preceding paragraph has applied for permission to establish beds in a clinic or to increase the number of beds in a clinic, the prefectural governor may, notwithstanding the provisions of paragraph (4) of the preceding Article, refuse the permission set forth in paragraph (3) of the same Article, when, in the area that includes the clinic to which said application relates (an area provided for in Article 30-4 (2)(xiv) as prescribed by the medical care plan) the number of long-term care beds and general beds has already reached the target number of long-term care beds and general beds for said area as prescribed in a medical care plan that is in accordance with the requirements prescribed by the Ordinance of the Ministry of Health, Labour and Welfare as set forth in paragraph (8) of the same Article, or if it is considered that establishing beds or increasing the number of beds as per said application would exceed said target.
(3) Where the number of long-term care beds and general beds in the area (an area provided for in Article 30-4 (2)(xiv) as prescribed by a medical care plan) in which a hospital (limited to those with long-term care beds, etc.) or clinic (limited to those with beds permitted as set forth in paragraph (3) of the preceding Article) established by a person listed in any of the items of paragraph (1) has already reached the target number for long-term care beds and general beds in said area as specified in a medical care plan that is in accordance with the requirements prescribed by the Ordinance of the Ministry of Health, Labour and Welfare, as set forth in paragraph (8) of the same Article, when said hospital or clinic is not engaging in all or some of the services related to long-term care beds, etc. under the permission set forth in paragraph (1) or paragraph (2) of the preceding Article or beds for which the permission set forth in paragraph (3) of the same Article has been received, without justifiable grounds, the prefectural governor may order the organizer or administrator of said hospital or clinic to adopt measures to amend such permission so as to reduce the number of beds, up to and including the number of beds which are not used for said services.
(4) In the cases set forth in the preceding three paragraphs, in calculating the number of existing beds in the relevant area and the number of beds to which the relevant application relates, the prefectural governor shall carry out any necessary adjustments in consideration of the function and nature of the hospital or clinic, pursuant to the provisions of the prefectural ordinance in accordance with the requirements prescribed by the Ordinance of the Ministry of Health, Labour and Welfare set forth in Article 30-4 (8).
(5) The prefectural governor shall hear the opinions of the Prefectural Council on Medical Service Facilities in advance, when he/she wishes to refuse permission as set forth in paragraph (1) through paragraph (3) of the preceding Article pursuant to the provisions of paragraph (1) or paragraph (2) or if he/she wishes to issue an order pursuant to the provisions of paragraph (3).
(6) When a prefectural governor has issued an order as prescribed in paragraph (3) and the organizer or administrator of the hospital or clinic that has received said order fails to comply with it, the prefectural governor may make a public announcement to that effect.
(7) When an incorporated administrative agency (an incorporated administrative agency as provided for in Article 2 (1) of the Act on General Rules for Independent Administrative Agencies (Act No. 103 of 1999)) that has been specified by a Cabinet Order wishes to establish a hospital, increase bed numbers, or alter bed classifications at a hospital it has established, or where it wishes to establish beds in a clinic or increase bed numbers or alter bed classifications at a clinic, it shall consult (or give notice where specially prescribed by Cabinet Order) with the Minister of Health, Labour and Welfare in advance regarding such plans. The same shall apply when it wishes to amend such plans.
Article 7-3 (1) Where a prefectural governor has received an application for permission to establish a hospital or permission to increase the number of beds in a hospital (limited to those related to long-term care beds, etc.), he/she may, if he/she finds that the total number of long-term care beds and general beds in the vision area including the location of the hospital pertaining to said application has already reached the total number of beds required in the future prescribed in Article 30-4 (2)(vii)(a) in said vision area as specified in the medical care plan, or will exceed the total number of beds required due to the establishment of the hospital or the increase in the number of beds in the hospital pertaining to said application, request the person who has filed said application (hereinafter referred to as the "applicant" in this Article) to submit a document stating the reason why it is necessary to establish a hospital or increase the number of beds in the hospital in said vision area and other matters specified by an Ordinance of the Ministry of Health, Labour and Welfare (hereinafter referred to as the "reasons, etc." in this Article).
(2) The prefectural governor may, when he/she finds that the reasons, etc. are not sufficient, request the applicant to participate in the consultation at the place of consultation prescribed in Article 30-14 (1).
(3) The applicant shall, when requested by the prefectural governor pursuant to the provision of the preceding paragraph, endeavor to respond to the request.
(4) The prefectural governor may, when an agreement is not reached through the consultation at the place of consultation set forth in paragraph (2) or when otherwise specified by an Ordinance of the Ministry of Health, Labour and Welfare, request the applicant to attend a meeting of the Prefectural Council on Medical Service Facilities and explain the reasons, etc.
(5) The applicant shall, when requested by the prefectural governor pursuant to the provision of the preceding paragraph, endeavor to attend the meeting of the Prefectural Council on Medical Service Facilities and explain the reasons, etc.
(6) Notwithstanding the provision of Article 7 (4), the prefectural governor may, if the reasons, etc. are not found to be unavoidable based on the content of the consultation at the place of consultation set forth in paragraph (2) and the content of the explanation set forth in paragraph (4), decide not to grant the permission set forth in paragraph (1) or (2) of the same Article to the applicant (limited to those listed in the items of paragraph (1) of the preceding Article).
(7) The prefectural governor shall, when he/she decides not to grant the permission set forth in paragraph (1) or (2) of Article 7 under the provision of the preceding paragraph, hear the opinions of the Prefectural Council on Medical Service Facilities in advance.
(8) The provisions of the preceding paragraphs shall apply mutatis mutandis to an application for permission to set up new beds in a clinic or permission to increase the number of beds in a clinic. In this case, the term "paragraph (1) or (2) of the same Article" in paragraph (6) shall be deemed to be replaced with "paragraph (3) of the same Article," and the term "paragraph (1) or (2) of Article 7" in the preceding paragraph shall be deemed to be replaced with "paragraph (3) of Article 7."
Article 8 When a clinically trained physician, a clinically trained dentist, or a midwife establishes a clinic or birthing center, he/she shall notify the prefectural governor of the area in which the clinic or birthing center is situated within ten days of its establishment.
Article 8-2 (1) The organizer of a hospital, clinic, or birthing center shall not suspend the operation of said hospital, clinic or birthing center for more than one year without justifiable grounds; provided, however, that this shall not apply to the organizer of a clinic or birthing center of which the prefectural governor was notified and that was established pursuant to the provisions of the preceding Article.
(2) When the organizer of a hospital, clinic, or birthing center suspends the operation of said hospital, clinic, or birthing center, he/she shall notify the prefectural governor within ten days. The same shall apply when a hospital, clinic, or birthing center whose operation was suspended is re-opened.
Article 9 (1) When the organizer of a hospital, clinic, or birthing center discontinues the operation of said hospital, clinic, or birthing center, he/she shall notify the prefectural governor within ten days.
(2) When the organizer of a hospital, clinic, or birthing center has died or has become the subject of an adjudication of disappearance, the person who is obligated to submit a notification of such person's death or disappearance pursuant to the provisions of the Family Registration Act (Act No. 224 of 1947) shall notify the prefectural governor of his/her area of the same within ten days.
Section 2 Management
Article 10 (1) The organizer of a hospital (excluding hospitals specified by an Ordinance of the Ministry of Health, Labour and Welfare set forth in paragraph (3); the same shall apply in the following paragraph) or clinic shall have it managed by a clinically trained physician where a medical practice is operated at said hospital or clinic, or shall have it managed by a clinically trained dentist where a dental practice is operated at said hospital or clinic.
(2) Where both a medical practice and dental practice are operated at a hospital or clinic, the organizer of said hospital or clinic shall have it managed by a clinically trained physician where it is primarily for the operation of a medical practice, or shall have it managed by a clinically trained dentist where it is primarily for the operation of a dental practice.
(3) The organizer of a hospital that provides necessary support for securing medical care in an acute physician shortage area or other hospitals specified by an Ordinance of the Ministry of Health, Labour and Welfare shall, in the case that the hospital is engaged in medical practice or in the case that the hospital is engaged in both medical practice and dental practice and mainly engages in medical practice, have it managed by a clinically trained physician certified under Article 5-2 (1). However, in the case that affects the provision of medical care in the region or in other cases specified by an Ordinance of the Ministry of Health, Labour and Welfare, the hospital may be managed by a clinically trained physician who has not been certified under Article 5-2 (1).
Article 10-2 (1) The organizer of an advanced treatment hospital who intends to have it managed in accordance with the provision of the preceding Article shall, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour and Welfare, appoint as its administrator a person who has the necessary ability and experience to perform the matters listed in each item of Article 16-3 (1) and other tasks related to the management and operation of the advanced treatment hospital.
(2) The appointment of an administrator of an advanced treatment hospital under the provision of the preceding paragraph shall, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour and Welfare, be made based on the results of the examination by a council for selecting a candidate for administrator, which consists of the organizer of the advanced treatment hospital and persons other than those who have a special relationship as specified by an Ordinance of the Ministry of Health, Labour and Welfare.
Article 11 An organizer of a birthing center shall have said birthing center managed by a midwife.
Article 12 (1) The organizer of a hospital, clinic, or birthing center shall manage said hospital, clinic, or birthing center himself/herself where he/she is a person capable of being the administrator of a hospital, clinic, or birthing center; provided, however, that it is permissible for him/her to have another party manage where permitted by the prefectural governor of the area in which the hospital, clinic, or birthing center is situated.
(2) The physician, dentist, or midwife who manages a hospital, clinic, or birthing center shall be a person who does not manage any other hospital, clinic, or birthing center, except where permitted by the prefectural governor of the area in which said hospital, clinic, or birthing center is situated as falling under any of the following items:
(i) When intending to manage a clinic established in an acute physician shortage area.
(ii) When intending to manage a clinic established in a long-term care health facility or other facilities specified by an Ordinance of the Ministry of Health, Labour and Welfare.
(iii) When intending to manage a clinic established in an office or other places of business for employees, etc.
(iv) When intending to manage a clinic established to secure the medical care delivery system prescribed in Article 30-3 (1) on holidays or at night in the region.
(v) Other cases specified by an Ordinance of the Ministry of Health, Labour and Welfare.
Article 12-2 (1) The organizer of a regional medical care support hospital shall submit reports concerning its operation to the prefectural governor pursuant to the provisions of an Ordinance of the Ministry of Health, Labour and Welfare.
(2) The prefectural governor shall make public the details of the reports set forth in the preceding paragraph pursuant to the provisions of an Ordinance of the Ministry of Health, Labour and Welfare.
Article 12-3 (1) The organizer of an advanced treatment hospital shall submit reports concerning its operation to the Minister of Health, Labour and Welfare pursuant to the provisions of an Ordinance of the Ministry of Health, Labour and Welfare.
(2) The Minister of Health, Labour and Welfare shall make public the details of the reports set forth in the preceding paragraph pursuant to the provisions of an Ordinance of the Ministry of Health, Labour and Welfare.
Article 12-4 (1) The organizer of a core hospital for clinical research shall submit a report on its operations to the Minister of Health, Labor and Welfare pursuant to the provisions of an Ordinance of the Ministry of Health, Labor and Welfare.
(2) The Minister of Health, Labor and Welfare shall publicize the content of the report prescribed in the preceding paragraph pursuant to the provisions of an Ordinance of the Ministry of Health, Labor and Welfare.
Article 13 The administrator of a clinic with facilities for the hospitalization of patients shall endeavor to ensure a system for said clinic's physicians to make prompt diagnoses that enable appropriate medical treatment to be provided, even where the symptoms of a hospitalized patient change suddenly, and shall ensure close cooperation with other hospitals or clinics.
Article 14 The administrator of a birthing center shall not allow ten or more pregnant women, women in labor, or women resting after childbirth to be admitted at the same time; provided, however, that this shall not apply to temporary and emergency admissions in the case that there are no other appropriate facilities for hospitalization or admission.
Article 14-2 (1) The administrator of a hospital or clinic shall post the following matters concerning said hospital or clinic in a visible location within said hospital or clinic, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour and Welfare:
(i) The name of the administrator.
(ii) The names of practicing physicians or dentists.
(iii) The days and hours of the physicians' or dentists' practices.
(iv) In addition to those listed in the preceding three items, the matters prescribed by an Ordinance of the Ministry of Health, Labour and Welfare.
(2) The administrator of a birthing center shall post the following matters concerning said birthing center in a visible location within said birthing center, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour and Welfare:
(i) The name of the administrator.
(ii) The names of midwives engaging in services.
(iii) The midwives' working days and hours.
(iv) In addition to what is listed in the preceding three items, the matters prescribed by an Ordinance of the Ministry of Health, Labour and Welfare.
Article 15 (1) The administrator of a hospital or clinic shall supervise the physicians, dentists, pharmacists, and other employees working at said hospital or clinic, and shall take other necessary precautions for the management and operation of said hospital or clinic, so that he/she can fulfill his/her responsibilities prescribed in this Act.
(2) The administrator of a birthing center shall supervise the midwives and other employees working at said birthing center, and shall take other necessary precautions for the management and operation of said birthing center, so that he/she can fulfill his/her responsibilities prescribed in this Act.
(3) The administrator of a hospital or clinic shall notify the prefectural governor of the area in which the hospital or clinic is situated, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour and Welfare, where said hospital or clinic has an x-ray unit for medical treatment, or in other cases prescribed by an Ordinance of the Ministry of Health, Labour and Welfare.
Article 15-2 The administrator of a hospital, clinic or birthing center shall, when performing specimen testing prescribed in Article 2 of the Act on Clinical Laboratory Technicians, etc. (Act No. 76 of 1958) (hereinafter referred to as "specimen testing" in this Article and paragraph (1) of the following Article) in said hospital, clinic or birthing center, ensure that the buildings and equipment of the facilities where specimen testing is performed, management organization, methods for ensuring the accuracy of specimen testing and other matters conform to the standards specified by an Ordinance of the Ministry of Health, Labour and Welfare as necessary for the proper performance of specimen testing.
Article 15-3 (1) When the administrator of a hospital, clinic or birthing center wishes to entrust specimen testing, he/she shall do so to the following persons:
(i) An organizer of a sanitary laboratory registered under Article 20-3 (1) of the Act on Clinical Laboratory Technicians, etc.
(ii) A person who performs specimen testing in a hospital, clinic or other places specified by an Ordinance of the Ministry of Health, Labour and Welfare, and the buildings and equipment of the facilities where he/she performs specimen testing, management organization, methods for ensuring the accuracy of specimen testing and other matters conform to the standards specified by an Ordinance of the Ministry of Health, Labour and Welfare as necessary for the proper performance of specimen testing.
(2) In addition to what is provided for in the preceding paragraph, when the administrator of a hospital, clinic, or birthing center wishes to entrust the operation of the hospital, clinic, or birthing center that are prescribed by Cabinet Order as having a significant influence on physicians' or dentists' diagnoses, on the services of midwives, or on the hospitalization or admission of patients, pregnant women, women in labor, or women resting after childbirth, he/she shall entrust said operations to a party who conforms to the requirements prescribed by an Ordinance of the Ministry of Health, Labour and Welfare as a party with the ability to properly undertake its operation, in accordance with the type of operation undertaken at said hospital, clinic, or birthing center.
Article 16 The administrator of a hospital that carries out a medical practice shall have a physician on night duty in the hospital; provided, however, that this shall not apply to the case where the physicians of said hospital stand by at a place adjacent to said hospital or other cases specified by an Ordinance of the Ministry of Health, Labour and Welfare as those where a system is in place which ensures that the physicians of said hospital promptly provide medical treatment in the event of a sudden change in the medical condition of an inpatient of said hospital.
Article 16-2 (1) The administrator of a regional medical care support hospital shall undertake the following matters, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour and Welfare:
(i) Allowing all or part of the buildings, equipment, instruments, or tools of said hospital to be used by medical care professionals who do not work at said hospital for their practices, research, or training.
(ii) Providing emergency medical care.
(iii) Carrying out training to enhance the quality of community medical care professionals.
(iv) Systematically managing records as listed in Article 22 (ii) and (iii).
(v) When a request to view records listed in Article 22 (ii) or (iii) has been received from a physician who wishes to refer a patient to said regional medical care support hospital or from other persons as prescribed by an Ordinance of the Ministry of Health, Labour and Welfare, making available for inspection the records which are prescribed by an Ordinance of the Ministry of Health, Labour and Welfare as having no risk of harming patient confidentiality, except where there are justifiable grounds for not doing so.
(vi) Providing medical care to patients referred from other hospitals or clinics.
(vii) Other matters as prescribed by an Ordinance of the Ministry of Health, Labour and Welfare.
(2) The administrator of a regional medical care support hospital shall provide necessary support concerning the promotion of in-home medical care provision by medical institutions providing in-home medical care, designated in-home service providers pursuant to the provisions of Article 41 (1) of the Long-Term Care Insurance Act who undertake in-home nursing under Article 8 (4) of the same Act, and other persons providing in-home medical care (hereinafter referred to as "in-home medical care providers, etc." in this paragraph), such as supporting close coordination with in-home medical care providers, etc., and providing information concerning in-home medical care providers, etc. to recipients of medical care or medical institutions in the area.
Article 16-3 (1) The administrator of an advanced treatment hospital shall undertake the following matters pursuant to the provisions of an Ordinance of the Ministry of Health, Labour and Welfare:
(i) Providing advanced medical care.
(ii) Carrying out development and evaluation of advanced medical care techniques.
(iii) Carrying out training in advanced medical care.
(iv) Ensuring a high level of medical safety
(v) Systematically managing the records listed under Article 22-2 (iii) and (iv).
(vi) When a request to view the records listed in Article 22-2 (iii) or (iv) has been received from a physician who wishes to refer a patient to said advanced treatment hospital or from other persons as prescribed by an Ordinance of the Ministry of Health, Labour and Welfare, making available for inspection the records that are prescribed by an Ordinance of the Ministry of Health, Labour and Welfare as having no risk of harming patient confidentiality, except where there are justifiable grounds for not doing so.
(vii) Providing medical care to patients referred from other hospitals or clinics.
(viii) Other matters as prescribed by an Ordinance of the Ministry of Health, Labour and Welfare.
(2) The administrator of an advanced treatment hospital shall, when carrying out matters specified by an Ordinance of the Ministry of Health, Labour and Welfare as important matters concerning the management and operation of the advanced treatment hospital, do so based on a resolution of a council composed of said administrator and physicians, dentists, pharmacists, nurses and other persons working in said advanced treatment hospital, pursuant to an Ordinance of the Ministry of Health, Labour and Welfare.
(3) The administrator of an advanced treatment hospital shall make arrangements so that a medical care coordination system as provided for in Article 30-4 (2)(ii) is properly constructed.
Article 16-4 The administrator of a core hospital for clinical research shall, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour and Welfare, carry out the following matters:
(i) To develop and implement a plan concerning specified clinical research.
(ii) When conducting specified clinical research jointly with other hospitals or clinics, to play a leading role in the implementation of specified clinical research.
(iii) To provide consultation, necessary information, advice and other assistance to other hospitals or clinics concerning the implementation of specified clinical research.
(iv) To provide training on specified clinical research.
(v) To systematically manage the various records listed in items (iii) and (iv) of Article 22-3.
(vi) Other matters specified by an Ordinance of the Ministry of Health, Labour and Welfare.
Article 17 In addition to the provisions of Article 6-10 through Article 6-12 and Article 13 through to the preceding Article, matters that should be observed by the administrator of a hospital, clinic, or birthing center in the management of his/her buildings and equipment, medical supplies, and other articles, and in the hospitalization or admission of patients, pregnant women, women in labor, and women resting after childbirth, shall be as prescribed by an Ordinance of the Ministry of Health, Labour and Welfare.
Article 18 The organizer of a hospital or clinic shall provide an exclusive pharmacist in said hospital or clinic in accordance with the standards specified by an Ordinance of the Ministry of Health, Labour and Welfare and in accordance with ordinances of the prefecture (or, in the case of a clinic situated in a city or special ward with a public health center, said city or special ward with a public health center); provided, however, that this shall not apply where permitted by the prefectural governor of the area in which the hospital or clinic is situated.
Article 19 (1) The organizer of a birthing center shall provide for contract physicians and hospitals or clinics pursuant to the provisions of an Ordinance of the Ministry of Health, Labour and Welfare.
(2) When a midwife who only does home visits commits to provide midwifery services to a pregnant woman, etc., she shall specify the hospital or clinic that responds to the abnormality of said pregnant woman, etc., pursuant to the provisions of an Ordinance of the Ministry of Health, Labour and Welfare.
Article 19-2 The organizer of an advanced treatment hospital shall, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour and Welfare, take the following measures to ensure that the administrator of said advanced treatment hospital properly executes the management and operation of said advanced treatment hospital:
(i) To clarify the authority that said administrator has for the management and operation of said advanced treatment hospital.
(ii) To set up an audit committee for ensuring the safety of medical care.
(iii) To establish a system to ensure that the execution of the duties of said administrator complies with laws and regulations, a system pertaining to the supervision of the business of said advanced treatment hospital by said organizer, and other systems specified by an Ordinance of the Ministry of Health, Labour and Welfare as necessary to ensure the appropriateness of the business of said advanced treatment hospital.
(iv) Other measures specified by an Ordinance of the Ministry of Health, Labour and Welfare as necessary for the proper execution of the management and operation of said advanced treatment hospital by said administrator.
Article 20 A hospital, clinic, or birthing center shall be maintained in a clean state, and its buildings and equipment shall be recognizable as safe in terms of sanitation, fire safety, and security.
Article 21 (1) A hospital shall have the following personnel and facilities and shall prepare the following records, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour and Welfare (in the case of employees listed in item (i) (excluding physicians and dentists) and facilities listed in item (xii), prefectural ordinances):
(i) In addition to physicians, dentists in the numbers prescribed by an Ordinance of the Ministry of Health, Labour and Welfare, nurses, and other employees in the numbers prescribed by prefectural ordinances, in accordance with the classifications of the beds at said hospital.
(ii) A consultation room for each clinical department.
(iii) An operating room.
(iv) Treatment rooms.
(v) A diagnostic laboratory.
(vi) An X-ray unit.
(vii) A dispensary.
(viii) Food service facilities.
(ix) Records concerning medical treatment.
(x) Delivery rooms and neonatal bathing facilities in hospitals that have a gynecology and obstetrics department or an obstetrics department.
(xi) Functional training rooms in hospitals that have long-term care beds.
(xii) Other facilities as prescribed by prefectural ordinances.
(2) A clinic with long-term care beds shall have the following personnel and facilities, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour and Welfare (in the case of employees listed in item (i) (excluding physicians and dentists) and facilities listed in item (iii), prefectural ordinances):
(i) In addition to physicians, dentists in the numbers prescribed by an Ordinance of the Ministry of Health, Labour and Welfare, nurses, and other employees, including those engaged in nursing support, in the numbers prescribed by prefectural ordinances.
(ii) Functional training rooms.
(iii) Other facilities as prescribed by prefectural ordinances.
(3) When formulating the ordinances set forth in the preceding two paragraphs, prefectures shall determine the employees and the number of employees of hospitals and clinics with long-term care beds (limited to those specified by an Ordinance of the Ministry of Health, Labour and Welfare) in accordance with the standards specified by an Ordinance of the Ministry of Health, Labour and Welfare, and other matters with reference to the standards specified by an Ordinance of the Ministry of Health, Labour and Welfare.
Article 22 In addition to the provisions of paragraph (1) of the preceding Article (excluding item (ix)), a regional medical care support hospital shall have the following facilities and shall prepare the following records, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour and Welfare:
(i) An intensive care unit.
(ii) Records concerning medical treatment.
(iii) Records concerning the management and operation of the hospital.
(iv) Chemical, bacteriological, and pathological inspection facilities.
(v) An autopsy room.
(vi) A laboratory.
(vii) A lecture room.
(viii) A library.
(ix) Other facilities as prescribed by an Ordinance of the Ministry of Health, Labour and Welfare.
Article 22-2 In addition to the provisions of Article 21 (1) (excluding items (i) and (ix)), an advanced treatment hospital shall have the following personnel and facilities and shall prepare the following records, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour and Welfare:
(i) Physicians, dentists, pharmacists, nurses, and other employees in the numbers prescribed by an Ordinance of the Ministry of Health, Labour and Welfare.
(ii) An intensive care unit.
(iii) Records concerning medical treatment.
(iv) Records concerning the management and operation of the hospital.
(v) The facilities listed in item (iv) through item (viii) of the preceding Article.
(vi) Other facilities as prescribed by an Ordinance of the Ministry of Health, Labour and Welfare.
Article 22-3 In addition to the provisions of Article 21 (1) (excluding items (i) and (ix)), a core hospital for clinical research shall have the following personnel and facilities and shall prepare the following records, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour and Welfare:
(i) Physicians, dentists, pharmacists, nurses, and other employees involved in clinical research in the numbers prescribed by an Ordinance of the Ministry of Health, Labour and Welfare.
(ii) An intensive care unit.
(iii) Records concerning medical treatment and clinical research.
(iv) Records concerning the management and operation of the hospital.
(v) The facilities listed in item (iv) through item (viii) of Article 22.
(vi) Other facilities as prescribed by an Ordinance of the Ministry of Health, Labour and Welfare.
Article 23 (1) In addition to the provisions of Article 21 through the preceding Article, the necessary standards for ensuring satisfactory ventilation, lighting, illumination, damp proofing, security, emergency evacuation, cleanliness, and other sanitary conditions with regard to the buildings and equipment of a hospital, clinic or birthing center, shall be prescribed by an Ordinance of the Ministry of Health, Labour and Welfare.
(2) Regulations may be established by Cabinet Order to sentence persons who have violated the provisions of the Ordinance of the Ministry of Health, Labour and Welfare as set forth in the provisions of the preceding paragraph to a fine of up to 200,000 yen.
Section 3 Supervision
Article 23-2 When the distribution of personnel in a hospital or in a clinic with long-term care beds is significantly lacking in terms of the standards prescribed by the Ordinance of the Ministry of Health, Labour and Welfare or prefectural ordinances set forth in Article 21 (1) (limited to the parts pertaining to item (i)) or paragraph (2) (limited to the part pertaining to item (i)), and falls under cases prescribed by an Ordinance of the Ministry of Health, Labour and Welfare as cases that cause a significant impediment to the suitable provision of medical care, the prefectural governor may order the organizer to increase the number of personnel by a set deadline, or may suspend all or a part of its operations for a period that he/she prescribes.
Article 24 (1) When a hospital, clinic, or birthing center is lacking in cleanliness, or when its buildings and equipment violate the provisions of Article 21 (1) or (2), or Article 22, or violate the provisions of an Ordinance of the Ministry of Health, Labour and Welfare that is based on the provisions set forth in Article 23 (1), or are found to be a sanitation hazard or safety risk, the prefectural governor may prescribe a period of time and order the organizer to fully or partially limit or prohibit the use thereof, or may order repairs or reconstruction to be carried out by a set deadline.
(2) When the buildings and equipment of an advanced treatment hospital or core hospital for clinical research (hereinafter referred to as "advanced treatment hospital, etc." in this Section) violate the provisions of Article 22-2 or Article 22-3, the Minister of Health, Labour and Welfare may order their repair or reconstruction to be carried out by the organizer of said advanced treatment hospital, etc. by a set deadline.
Article 24-2 (1) When a prefectural governor finds that the business of a hospital, clinic or birthing center violates laws and regulations or dispositions under laws and regulations, or that the operation of a hospital, clinic or birthing center is extremely inappropriate (excluding the cases prescribed in Article 23-2 or paragraph (1) of the preceding Article), he/she may, to the extent necessary for the enforcement of this Act, order the organizer of said hospital, clinic or birthing center to take necessary measures by a set deadline.
(2) In the event that the organizer set forth in the preceding paragraph does not comply with the order as prescribed in the same paragraph, the prefectural governor may order said organizer to suspend all or part of the business of said organizer's hospital, clinic or birthing center for a specified period of time.
Article 25 (1) A prefectural governor, the mayor of a city with a public health center, or the mayor of a special ward of Tokyo may, when he/she finds it necessary, order the organizer or administrator of a hospital, clinic, or birthing center to report as necessary, and may have the relevant officials enter said hospital, clinic, or birthing center and inspect the personnel or the state of cleanliness, its buildings, and equipment, its medical records, birth records, books and documents, and other articles.
(2) A prefectural governor, the mayor of a city with a public health center, or the mayor of a special ward of Tokyo may, when he/she suspects that the operation of a hospital, clinic or birthing center is in violation of laws and regulations or a disposition based on laws and regulations, or suspects that the management thereof is significantly unsuitable, order the organizer or administrator of said hospital, clinic, or birthing center to submit medical records, birth records, books and documents, and other articles, or have the relevant officials enter the office of the organizer of said hospital, clinic or birthing center or other places related to the operation of said hospital, clinic or birthing center and inspect books and documents, and other articles to the extent necessary for the enforcement of this Act.
(3) The Minister of Health, Labour and Welfare may, when he/she finds it necessary, order the organizer or administrator of an advanced treatment hospital, etc. to report as necessary, and may have the relevant officials enter the advanced treatment hospital, etc. and inspect the personnel or the state of cleanliness, its buildings and equipment, medical records, birth records, books and documents, and other articles.
(4) The Minister of Health, Labour and Welfare may, when he/she suspects that the operation of an advanced treatment hospital, etc. is in violation of laws and regulations or a disposition based on laws and regulations, or suspects that the management thereof is significantly unsuitable, order the organizer or administrator of said advanced treatment hospital, etc. to submit medical records, birth records, books and documents, or other articles.
(5) The provisions set forth in Article 6-8 (3) shall apply mutatis mutandis pursuant to entry and inspection as set forth in paragraph (1) through paragraph (3), and the provisions set forth in paragraph (4) of the same Article shall apply mutatis mutandis pursuant to the authority set forth in each of the preceding paragraphs.
Article 25-2 Mayor of cities with public health centers and mayors of special wards of Tokyo shall give notice of the matters as prescribed by an Ordinance of the Ministry of Health, Labour and Welfare concerning clinics and birthing centers, to the prefectural governor, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour and Welfare.
Article 26 (1) The Minister of Health, Labour and Welfare, prefectural governors, mayors of cities with public health centers, and mayors of special wards of Tokyo shall appoint medical care inspectors from among the officials of the Ministry of Health, Labour and Welfare, prefecture, city with the public health center, or special ward of Tokyo, to be entrusted with the authority of the relevant officials provided for in Article 25 (1) and (3).
(2) In addition to the provisions of the preceding paragraph, necessary matters concerning medical care inspectors shall be as prescribed by an Ordinance of the Ministry of Health, Labour and Welfare.
Article 27 A hospital, clinic with in-patient facilities, or birthing center with admission facilities shall not use its buildings and equipment without first undergoing inspection by the prefectural governor with jurisdiction over their location and receiving a license.
Article 27-2 (1) When the organizer or administrator of a hospital or clinic fails to comply with the conditions attached to the permission granted under the provisions of Article 7 (5) without justifiable grounds, the prefectural governor may recommend that said organizer or administrator comply with said conditions by a set deadline, after hearing the opinions of the Prefectural Council on Medical Service Facilities.
(2) When the organizer or administrator of a hospital or clinic who has received a recommendation pursuant to the provision of the preceding paragraph fails to take measures pertaining to said recommendation without justifiable grounds, the prefectural governor may order said organizer or administrator to take measures pertaining to said recommendation by a set deadline, after hearing the opinions of the Prefectural Council on Medical Service Facilities.
(3) In the case where a prefectural governor has issued an order under the preceding paragraph and the organizer or administrator of a hospital or clinic who has received said order fails to comply with it, the prefectural governor may make a public announcement to that effect.
Article 28 The prefectural governor may, when he/she finds the administrator of a hospital, clinic, or birthing center to have committed a criminal act, to have committed an unlawful act related to medical practice, or to be unfit to manage, order the organizer of said hospital, clinic, or birthing center to replace the said administrator by a set deadline.
Article 29 (1) Where any of the following items apply, the prefectural governor may rescind permission for establishment of a hospital, clinic, or birthing center, or may order the organizer to close the hospital, clinic, or birthing center by a period that he/she prescribes:
(i) When operation has not commenced six months or more after permission was received for its establishment, without justifiable grounds.
(ii) When the operation of a hospital, clinic (excluding where notification and establishment have taken place as set forth in Article 8), or a birthing center (excluding where notification and establishment have taken place as set forth in the same Article) has not re-commenced one year or more after it was suspended, without justifiable grounds.
(iii) When the organizer has violated an order or disposition based on the provisions of Article 6-3 (6), Article 24 (1), Article 24-2 (2), or the preceding Article.
(iv) When the organizer has committed a criminal act or an unlawful act related to medical practice.
(2) The prefectural governor may, when operation related to the permission pursuant to the provisions of Article 7 (2) or (3) has not commenced six months or more after said permission was received without justifiable grounds, rescind said permission.
(3) Where any of the following items apply, the prefectural governor may rescind his/her approval for a regional medical care support hospital:
(i) When the regional medical care support hospital has failed to meet the requirements listed in each item of Article 4 (1).
(ii) When the organizer of the regional medical care support hospital has violated provisions of Article 12-2 (1).
(iii) When the organizer of the regional medical care support hospital has violated an order based on the provisions of Article 24 (1) or Article 30-13 (5).
(iv) When the administrator of a regional medical care support hospital has violated the provisions of Article 16-2 (1).
(v) When the organizer or administrator of the regional medical care support hospital has violated an order under the provisions of Article 7-2 (3), Article 27-2 (2), or Article 30-15 (6).
(vi) When the organizer or administrator of the regional medical care support hospital fails to comply with a recommendation under the provisions of Article 30-12 (2) or Article 30-17.
(vii) When the organizer or administrator of the regional medical care support hospital fails to comply with an instruction under the provisions of Article 30-16 (1).
(4) Where any of the following items apply, the Minister of Health, Labour and Welfare may rescind his/her approval for an advanced treatment hospital:
(i) When the advanced treatment hospital has failed to meet the requirements listed in each of the items of Article 4-2 (1).
(ii) When the organizer of the advanced treatment hospital has violated the provisions of Article 10-2, Article 12-3 (1), or Article 19-2.
(iii) When the organizer of the advanced treatment hospital has violated an order based on the provisions of Article 24 (2) or Article 30-13 (5).
(iv) When the administrator of the advanced treatment hospital has violated the provisions of paragraph (1) or (2) of Article 16-3.
(v) When the organizer or administrator of the advanced treatment hospital has violated an order under the provisions of Article 7-2 (3), Article 27-2 (2), or Article 30-15 (6).
(vi) When the organizer or administrator of the advanced treatment hospital fails to comply with a recommendation under the provisions of Article 30-12 (2) or Article 30-17.
(vii) When the organizer or administrator of the advanced treatment hospital fails to comply with an instruction under the provisions of Article 30-16 (1).
(5) In a case falling under any of the following events, the Minister of Health, Labour and Welfare may revoke the approval for core hospital for clinical research:
(i) When the core hospital for clinical research has failed to meet the requirements listed in each of the items of Article 4-3 (1).
(ii) When the organizer of the core hospital for clinical research has violated the provisions of Article 12-4 (1).
(iii) When the organizer of the core hospital for clinical research has violated an order under the provisions of Article 24 (2).
(iv) When the administrator of the core hospital for clinical research has violated the provisions of Article 16-4.
(6) In revoking the approval for a regional medical care support hospital pursuant to the provisions of paragraph (3), the prefectural governor shall hear the opinions of the Prefectural Council on Medical Service Facilities in advance.
(7) In revoking the approval for an advanced treatment hospital, etc. pursuant to the provisions of paragraph (4) or (5), the Minister of Health, Labour and Welfare shall hear the opinions of the Social Security Council in advance.
Article 29-2 The Minister of Health, Labour and Welfare may, when he/she finds there to be an urgent necessity to protect the health of the people, instruct a prefectural governor to render a disposition pursuant to the provisions of Article 28, and paragraph (1) and paragraph (2) of the preceding Article.
Article 30 When a disposition has been rendered pursuant to the provisions of Article 23-2, Article 24 (1), Article 24-2, Article 28, or Article 29 (1) or (3) in advance of an opportunity for explanation being granted or a hearing being undertaken pursuant to Article 13 (2)(i) of the Administrative Procedure Act (Act No. 88 of 1993), the prefectural governor shall grant an opportunity for explanation to parties subject to said disposition within three days of said disposition.
Section 4 Miscellaneous Provisions
Article 30-2 In addition to those provided for in this Chapter, the necessary matters concerning the establishment and management of hospitals, clinics, and birthing centers shall be as specified by Cabinet Order.
Chapter V Ensuring the Medical Care Delivery System
Section 1 Basic Policy
Article 30-3 (1) The Minister of Health, Labour and Welfare shall, in accordance with the comprehensive securing policy prescribed in Article 3 (1) of the Act for Promoting Comprehensive Measures for Securing Regional Medical and Nursing Care (Act No. 64 of 1989), set forth a basic policy (hereinafter referred to as "basic policy") for ensuring the presence of a system that efficiently delivers good quality and appropriate medical care (hereinafter referred to as the "medical care delivery system").
(2) The basic policy shall prescribe the following matters:
(i) Matters that should form the basis of any measures to be undertaken for ensuring the medical care delivery system.
(ii) Basic matters related to investigation and research into ensuring the medical care delivery system.
(iii) Matters related to targets for ensuring the medical care delivery system.
(iv) Basic matters related to the sharing of functions and cooperation between medical institutions, and to promoting the provision of information that concerns medical care functions to recipients of medical care.
(v) Basic matters related to the regional medical care vision prescribed in Article 30-4 (2)(vii).
(vi) Basic matters related to the promotion of the differentiation and coordination of bed functions (meaning the contents of medical care provided in hospital or clinic beds in accordance with the medical conditions of patients; the same shall apply hereinafter) in the region and the provision of information about bed functions to medical care recipients.
(vii) Basic matters related to ensuring the medical care delivery system for outpatient medical care.
(viii) Basic matters related to ensuring the availability of physicians.
(ix) Basic matters related to ensuring the availability of medical care professionals (excluding physicians).
(x) Basic matters related to the preparation of the medical care plans provided for in Article 30-4 (1), and to evaluating the status of implementation of activities under medical care plans.
(xi) Other important matters related to ensuring the medical care delivery system.
(3) When the Minister of Health, Labour and Welfare has set forth or amended the basic policy, he/she shall provide public notice thereof without delay.
Article 30-3-2 When the Minister of Health, Labour and Welfare finds it necessary in order to set down or change the matters listed in item (v) or (vi) of paragraph (2) of the preceding Article, he/she may request the prefectural governor or the organizer or administrator of a hospital, etc. subject to a report on the bed functions prescribed in Article 30-13 (1) to provide the content of the report provided for in the same paragraph and other necessary information, pursuant to an Ordinance of the Ministry of Health, Labour and Welfare.
Section 2 Medical Care Plans
Article 30-4 (1) The prefecture shall, with regard to basic policy, provide a plan (hereinafter referred to as "medical care plan") for ensuring the medical care delivery system in said prefecture, in accordance with the actual conditions in the area.
(2) Medical care plans shall stipulate the following matters:
(i) Matters related to the activities set forth in item (iv) and item (v) and ensuring in-home medical care that should be achieved in the prefecture.
(ii) Matters related to the medical care coordination system (meaning the system to ensure the sharing of functions between medical institutions and the coordination of operations; the same shall apply hereinafter) pertaining to activities as set forth in item (iv) and item (v) and ensuring in-home medical care.
(iii) Matters related to promoting the provision of information on functions of medical institutions under the medical care coordination system.
(iv) Matters related to activities connected with treatment or prevention of illnesses prescribed by an Ordinance of the Ministry of Health, Labour and Welfare as lifestyle diseases or other illnesses that are recognized as specifically requiring the provision of extensive and continuous medical care in order to ensure the health of the people.
(v) Matters related to activities that are necessary for ensuring the following medical care (hereinafter referred to as "activities to ensure emergency medical care") (limited to where it is necessary to ensure this in the case of medical care listed in (c)).
(a) Emergency medical care.
(b) Medical care in times of disaster.
(c) Medical care in remote areas.
(d) Perinatal medical care.
(e) Pediatric medical care (including pediatric emergency medical care).
(f) In addition to what is listed in (a) through (e), matters that are recognized by the prefectural governor as being specifically necessary in the light of outbreaks of illness in said prefecture.
(vi) Matters related to ensuring in-home medical care.
(vii) Matters related to the vision of the future medical care delivery system including the following matters (hereinafter referred to as "regional medical care vision") in the area specified in accordance with the standards set down by an Ordinance of the Ministry of Health, Labour and Welfare as the standards for promoting the differentiation and coordination of bed functions in the region (hereinafter referred to as "vision area"):
(a) The future requirements for the number of beds for each functional classification of beds prescribed in Article 30-13 (1) (hereinafter simply referred to as the "future requirements for the number of beds") in the vision area calculated pursuant to an Ordinance of the Ministry of Health, Labour and Welfare.
(b) In addition to what is listed in (a), matters specified by an Ordinance of the Ministry of Health, Labour and Welfare as necessary for promoting the differentiation and coordination of the bed functions in the vision area.
(viii) Matters related to the promotion of the differentiation and coordination of bed functions to achieve the regional medical care vision.
(ix) Matters related to the promotion of the provision of information on bed functions.
(x) Matters related to ensuring the medical care delivery system for outpatient medical care.
(xi) The following matters related to ensuring the availability of physicians:
(a) Policies for ensuring the availability of physicians in the areas prescribed in items (xiv) and (xv).
(b) The target of the number of physicians to be secured in the area prescribed in item (xiv) to be determined based on the indicator concerning the number of physicians in said area calculated by the method specified by an Ordinance of the Ministry of Health, Labour and Welfare.
(c) The target of the number of physicians to be secured in the area prescribed in item (xv) to be determined based on the indicator concerning the number of physicians in said area calculated by the method specified by an Ordinance of the Ministry of Health, Labour and Welfare.
(d) Measures to dispatch physicians to achieve the targets listed in (b) and (c) and other measures for ensuring the availability of physicians.
(xii) Matters related to ensuring the availability of medical care professionals (excluding physicians).
(xiii) Matters related to ensuring safety in medical care.
(xiv) Matters related to the establishment of an area to be classified as a regional unit for the development of mainly beds in hospitals (excluding beds prescribed in the following item, psychiatric beds, infectious disease beds and tuberculosis beds) and beds in clinics.
(xv) Matters related to the establishment of an area that combines two or more areas prescribed in the preceding item as a regional unit for the development of mainly long-term care beds in hospitals that provide special medical care or general beds used for special medical care as specified by an Ordinance of the Ministry of Health, Labour and Welfare.
(xvi) In the event of the establishment of areas prescribed in paragraphs (6) and (7), matters related to the establishment of said areas.
(xvii) Matters related to the target number of beds for long-term care beds and general beds, the target number of beds for psychiatric beds, the target number of beds for infectious disease beds, and the target number of beds for tuberculosis beds.
(3) In addition to the matters listed in each item of the preceding paragraph, efforts shall be made so that medical care plans stipulate the following matters:
(i) Matters related to targets for the development of regional medical care support hospitals and targets for the development of other medical institutions in consideration of the functions of such institutions.
(ii) In addition to what is listed in the preceding item, matters necessary for securing the medical care delivery system.
(4) The prefecture shall consider the following matters when stipulating matters listed in paragraph (2)(ii):
(i) Specific measures for the establishment of a medical care coordination system shall be specified for each disease prescribed by an Ordinance of the Ministry of Health, Labour and Welfare set forth in item (iv) of paragraph (2) or medical care listed in (a) through (f) of item (v) of the same paragraph or in-home medical care.
(ii) The details of the establishment of the medical care coordination system shall ensure that patients can receive appropriate medical care continuously even after discharge from the hospital.
(iii) The details of the establishment of the medical care coordination system shall include the coordination between health and medical services and welfare services provided in medical institutions and in homes.
(iv) The medical care coordination system shall be established through consultation among medical care professionals, long-term care service providers provided for in the Long-Term Care Insurance Act, citizens, and other related parties in the community.
(5) The prefecture shall, in stipulating matters concerning the reginal medical care vision, take into consideration the contents of reports under Article 30-13 (1), the prospects for changes in the demographic structure and other trends in demand for medical care, the prospects for the arrangement of medical care professionals and medical institutions, and other circumstances.
(6) In stipulating the matters listed in paragraph (2)(xi), the prefecture may, for each type of medical care to be provided that is specified by an Ordinance of the Ministry of Health, Labour and Welfare, establish, in accordance with the standard specified by an Ordinance of the Ministry of Health, Labour and Welfare concerning the indicator prescribed in paragraph (2)(xi)(b), the area prescribed in item (xiv) of the same paragraph where the number of physicians is recognized to be small.
(7) In stipulating the matters listed in paragraph (2)(xi), the prefecture may, for each type of medical care to be provided that is specified by an Ordinance of the Ministry of Health, Labour and Welfare, establish, in accordance with the standard specified by an Ordinance of the Ministry of Health, Labour and Welfare concerning the indicator prescribed in paragraph (2)(xi)(b), the area prescribed in item (xiv) of the same paragraph where the number of physicians is recognized to be large.
(8) Standards related to the establishment of areas provided for in paragraph (2)(xiv) and (xv), and the target number of beds provided for in item (xvii) of the same paragraph (for standards related to the target number of long-term care beds and general beds, standards based on the total number calculated according to each type of bed) shall be as prescribed by an Ordinance of the Ministry of Health, Labour and Welfare.
(9) The prefecture may, where it wishes to stipulate the target number of beds provided for in paragraph (2)(xvii), when a sudden increase in population is expected or when there are other circumstances as provided by a Cabinet Order, disregard the standards set forth in the preceding paragraph with regard to the required number of beds provided for in the same item, pursuant to the provisions of a Cabinet Order.
(10) After providing public notice of the medical care plan for a prefecture pursuant to provisions in paragraph (18), said prefecture may, when a sudden increase in population is expected or when there are other circumstances as provided by a Cabinet Order, regard the target number of beds provided for in paragraph (2)(xvii) as the number calculated pursuant to the provisions of a Cabinet Order, in areas as provided by Cabinet Order, and may engage in activities related to granting permission for applications for permission to establish hospitals and granting permission for other applications as prescribed by Cabinet Order.
(11) After providing public notice of the medical care plan for the prefecture pursuant to the provisions of paragraph (18), said prefecture may, where there has been an application for permission to establish a hospital that includes beds as prescribed by an Ordinance of the Ministry of Health, Labour and Welfare, or where there has been another application as prescribed by a Cabinet Order, regard the target number of beds provided for in paragraph (2)(xvii) as the number calculated pursuant to the provisions of a Cabinet Order, in areas as provided by Cabinet Order, and may engage in activities related to granting permission for said application.
(12) After providing public notice of the medical care plan for the prefecture pursuant to the provisions of paragraph (18), said prefecture may, where an application for permission to establish a hospital or any other application specified by a Cabinet Order has been filed by a participating corporation (meaning a participating corporation prescribed in Article 70 (1)) of a regional medical coordination promotion corporation and where it is found that said application is necessary for promoting the achievement of the regional medical care vision specified in said medical care plan and other requirements specified by an Ordinance of the Ministry of Health, Labour and Welfare are met, regard the number obtained by adding the number calculated pursuant to the provisions of a Cabinet Order to the target number of beds provided for in paragraph (2)(xvii) in said medical care plan pertaining to said application as said target number of beds, and may engage in activities related to granting permission for said application.
(13) In preparing medical care plans, prefectures shall ensure consistency with the prefectural plans prescribed in Article 4 (1) of the Act for Promoting Comprehensive Measures for Securing Regional Medical and Nursing Care and the prefectural long-term care insurance business support plans prescribed in Article 118 (1) of the Long-Term Care Insurance Act.
(14) In preparing medical care plans, prefectures shall endeavor to ensure that harmony is maintained with plans prepared pursuant to the provisions of other laws and regulations and with matters that concern ensuring medical care, and shall endeavor to seek coordination among public health, pharmacy, social welfare, and other measures which are closely related to medical care.
(15) In preparing medical care plans, prefectures shall undertake liaison and coordination with related prefectures, when it is considered necessary in the light of the supply and demand of medical care in areas near the boundaries of said prefectures.
(16) The prefecture shall hear the opinions of groups of persons with the relevant knowledge and experience in diagnoses or prescriptions, in order to prepare a draft medical care plan based on expert scientific opinions on medical care.
(17) The prefecture shall hear the opinions of the Prefectural Council on Medical Service Facilities, municipalities (including a part of the administrative associations and cross-regional federations set forth in Article 284 (1) of the Local Autonomy Act (Act No. 67 of 1947) that handle first aid services), and the Council of Insurers set forth in Article 157-2 (1) of the Act on Assurance of Medical Care for Elderly People (Act No. 80 of 1982) in advance, when stipulating the medical care plan or revising the medical care plan pursuant to the provisions of Article 30-6.
(18) When a prefecture has established a medical care plan or revised a medical care plan pursuant to the provisions of Article 30-6, it shall submit said plan to the Minister of Health, Labour and Welfare without delay and provide public notice of the details thereof.
Article 30-5 A prefecture may, if it finds it necessary for the preparation of the medical care plan or for the execution of activities based on the medical care plan, request the delivery of any necessary information from the municipalities and their public agencies, medical insurers provided for in Article 7 (7) of the Long-Term Care Insurance Act (referred to as "medical insurers" in Article 30-14 (1) and Article 30-18-2 (1)), or organizers or administrators of medical institutions, including information concerning the functions of medical institutions within the boundaries of said prefecture.
Article 30-6 (1) The prefecture shall, every three years, inspect, analyze and evaluate the matters listed in Article 30-4 (2)(vi) and (xi), the matters listed in Article 30-4 (2)(vi) and (xi) out of the matters listed in the following items, and other matters specified by an Ordinance of the Ministry of Health, Labour and Welfare (referred to as "specified matters" in the following paragraph) and shall revise the medical care plan of said prefecture when it finds it necessary:
(i) Matters listed in each item of Article 30-4 (2) (excluding items (vi) and (xi)).
(ii) In the case where the medical care plan stipulates the matters listed in each item of Article 30-4 (3), matters listed in said items.
(2) The prefecture shall, every six years, inspect, analyze and evaluate the matters listed in each item of the preceding paragraph (excluding specified matters), and shall revise the medical care plan of said prefecture when it finds it necessary.
Article 30-7 (1) Organizers and administrators of medical institutions shall endeavor to cooperate as necessary in the construction of the medical care coordination system, in order to contribute to the implementation of the medical care plan.
(2) Organizers and administrators of medical institutions listed in the following items shall, when providing the necessary cooperation set forth in the preceding paragraph, endeavor to fulfill the roles prescribed in the respective items, while coordinating their operations with those of other medical institutions, in order to efficiently provide high-quality and appropriate medical care:
(i) Hospitals: To secure necessary medical care in the community by cooperating in the promotion of differentiation and coordination of the bed functions in the community, according to the bed functions.
(ii) Clinics with beds: To provide the following medical care and ensure other necessary medical care in the community so that patients can lead their daily lives in their familiar communities, according to the content of the medical care they provide:
(a) To provide medical care necessary for patients discharged from hospitals to make a smooth transition to in-home medical treatment.
(b) To provide necessary in-home medical care.
(c) To hospitalize patients and provide them with necessary medical care when their condition suddenly changes or otherwise when hospitalization is necessary.
(3) Organizers and administrators of hospitals shall provide in-home medical care, and shall seek cooperation with welfare services and endeavor to give the necessary support for the provision of in-home medical care, in order to contribute to the implementation of the medical care plan.
(4) Organizers and administrators of hospitals shall endeavor to allow the use of all or parts of the hospital's buildings, equipment, instruments, and tools by physicians, dentists, or pharmacists who do not work at said hospital in their practice, research, or training, provided there is no hindrance to the medical care services of said hospital, in order to contribute to the implementation of the medical care plan.
Article 30-8 The Minister of Health, Labour and Welfare may provide the necessary advice to the prefectures regarding the method of preparing medical care plans and other key practical matters regarding the preparation of medical care plans.
Article 30-9 The national government may provide subsidies to prefectures for part of the costs required for activities based on medical care plans, within the extent of the budget, in order to promote the fulfillment of medical care plans.
Article 30-10 (1) National government and local governments shall endeavor to undertake any necessary measures, including improving hospitals or clinics in areas with insufficient hospitals or clinics, promoting the differentiation and coordination of the bed functions in the community and ensuring the availability of physicians, in order to promote the fulfillment of medical care plans.
(2) In addition to what is set forth in the preceding paragraph, the national government shall endeavor to improve the system for providing medical care as necessary on a cross-regional level which extends beyond prefectural boundaries.
Article 30-11 The prefectural governor may, where it is specifically necessary in order to promote the fulfillment of the medical care plan, hear the opinions of the Prefectural Council on Medical Service Facilities, and recommend that a person who wishes to establish a hospital or clinic, or an organizer or administrator of a hospital or clinic, establish a hospital, increase a hospital's number of beds, or change its bed classifications, or recommend that such a person establish beds in a clinic or increase the number of beds in a clinic.
Article 30-12 (1) The provisions of Article 7-2 (3) through (5) shall apply mutatis mutandis to hospitals established by persons other than those listed in each item of paragraph (1) of the same Article (limited to those having long-term care beds or general beds) or clinics (limited to those setting up beds with permission under Article 7 (3)), when it is especially necessary for promoting the achievement of the medical care plan. In this case, the term "order" in Article 7-2 (3) shall be deemed to be replaced with "request," the term "preceding three paragraphs" in paragraph (4) of the same Article shall be deemed to be replaced with "preceding paragraph," the term "the number of beds, and the number of beds to which the relevant application relates" shall be deemed to be replaced with "the number of beds," the terms "refuse permission as set forth in paragraph (1) through (3) of the preceding Article pursuant to the provisions of paragraph (1) or (2), or paragraph (3)" in paragraph (5) of the same Article shall be deemed to be replaced with "paragraph (3)," and the term "wishes to issue an order" shall be deemed to be replaced with "wishes to issue a request."
(2) When a prefectural governor finds that the organizer or administrator of a hospital or clinic that has received a request under Article 7-2 (3) as applied mutatis mutandis by replacing the terms in accordance with the preceding paragraph has not taken measures pertaining to said request without justifiable grounds, the prefectural governor may recommend that said organizer or administrator of the hospital or clinic should take said measures, after hearing the opinions of the Prefectural Council on Medical Service Facilities.
(3) In the case where a prefectural governor has made a recommendation under the preceding paragraph, he/she may, if the organizer or administrator of a hospital or clinic that has received said recommendation fails to comply with it, make a public announcement to that effect.
Section 3 Promotion of differentiation and coordination of the bed functions in the community
Article 30-13 (1) In order to promote the differentiation and coordination of the bed functions in the community, the administrator of a hospital or clinic with general beds or long-term care beds (hereinafter referred to as a "hospital, etc. subject to a report on the bed functions") shall, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour and Welfare, report the following matters in accordance with the classification specified by an Ordinance of the Ministry of Health, Labour and Welfare according to the bed functions (hereinafter referred to as "functional classification of beds") of said hospital, etc. subject to a report on the bed functions to the governor of the prefecture where said hospital, etc. subject to a report on the bed functions is situated:
(i) The bed functions on the date specified by an Ordinance of the Ministry of Health, Labour and Welfare (referred to as the "reference date" in the following item) (hereinafter referred to as the "reference date bed functions").
(ii) The bed functions expected on the day when the period specified by an Ordinance of the Ministry of Health, Labour and Welfare from the reference date has elapsed (hereinafter referred to as the "bed functions after the reference date").
(iii) Details of medical care to be provided to patients hospitalized in said hospital, etc. subject to a report on the bed functions.
(iv) Other matters specified by an Ordinance of the Ministry of Health, Labour and Welfare.
(2) The administrator of a hospital, etc. subject to a report on the bed functions shall, when the bed functions after the reference date reported under the provision of the preceding paragraph are deemed to have changed, as specified by an Ordinance of the Ministry of Health, Labour and Welfare, immediately report to the governor of the prefecture where said hospital, etc. subject to a report on the bed functions is situated, pursuant to an Ordinance of the Ministry of Health, Labour and Welfare.
(3) The prefectural governor may, when he/she finds it necessary in order to confirm the contents of the report prescribed in the preceding two paragraphs, request municipalities and other public offices to provide necessary information concerning hospitals, etc. subject to a report on the bed functions located within the area of said prefecture.
(4) The prefectural governor shall, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour and Welfare, publicize the matters reported in accordance with the provisions of paragraphs (1) and (2).
(5) When the administrator of a hospital, etc. subject to a report on the bed functions has failed to make a report pursuant to the provisions of paragraph (1) or (2) or has made a false report, the prefectural governor may order the organizer of said hospital, etc. subject to a report on the bed functions to have said administrator make a report or correct the contents of the report, by setting a period of time.
(6) In the case where the prefectural governor has issued an order pursuant to the provision of the preceding paragraph, if the organizer of a hospital, etc. subject to a report on the bed functions who has received said order fails to comply with it, the prefectural governor may make a public announcement to that effect.
Article 30-14 (1) The prefecture shall establish a place of consultation (hereinafter referred to as the "place of consultation" except for Article 30-18-2 (1) and (2) and Article 30-23 (1)) for consultation with organizations of academic experts on medical treatment, other medical experts, medical insurers, and other related parties (hereinafter referred to as "related parties" in this Article) in each of the vision areas and other areas that the governor of said prefecture deems appropriate (referred to as the "vision area, etc." in Article 30-16 (1) and Article 30-18-2 (3)), and shall, in cooperation with related parties, hold consultations on measures to achieve the future requirements for the number of beds specified in the medical care plan and other matters necessary to promote the achievement of the regional medical care vision.
(2) When related parties are requested by the prefecture to participate in a consultation conducted by the prefecture pursuant to the provision of the preceding paragraph, they shall endeavor to cooperate by participating in it, and shall also endeavor to cooperate in the implementation of matters which related parties have agreed upon at the place of such consultation.
(3) In order to promote the achievement of the regional medical care vision specified in the medical care plan, a person who has filed an application prescribed in Article 7 (5) shall endeavor to respond to a request made by the prefectural governor to participate in a consultation at the place of consultation, with regard to the establishment of a hospital or an increase in the number of beds or a change in the type of beds in a hospital, or the establishment of beds in a clinic or an increase in the number of beds or a change in the type of beds in a clinic pertaining to said application.
Article 30-15 (1) In the case where the reference date bed functions and the bed functions after the reference date pertaining to a report under the provision of Article 30-13 (1) are different, or in other cases specified by an Ordinance of the Ministry of Health, Labour and Welfare, the prefectural governor may, if the number of beds according to the functional classification of beds pertaining to the bed functions after the reference date pertaining to said report of beds at a hospital subject to a report on the bed functions in the vision area including the location of a hospital, etc. subject to a report on the bed functions having filed said report (hereinafter referred to as a "reporting hospital, etc." in this Article and the following Article) has already reached the future requirements for the number of beds according to the functional classification of beds pertaining to the bed functions after the reference date pertaining to said report in said vision area as specified in the medical care plan, request the organizer or administrator of a reporting hospital, etc. to submit a document stating the reasons why the reference date bed functions and the bed functions after the reference date pertaining to said report are different, and other matters specified by an Ordinance of the Ministry of Health, Labour and Welfare (hereinafter referred to as "reasons, etc." in this Article).
(2) When the prefectural governor finds that the reasons, etc. stated in the document set forth in the preceding paragraph are not sufficient, he/she may request the organizer or administrator of said reporting hospital, etc. to participate in the consultation at the place of consultation.
(3) The organizer or administrator of a reporting hospital, etc. shall, when requested by the prefectural governor under the preceding paragraph, endeavor to respond to the request.
(4) When no agreement is reached through the consultation at the place of consultation set forth in paragraph (2), or when otherwise specified by an Ordinance of the Ministry of Health, Labour and Welfare, the prefectural governor may request the organizer or administrator of said reporting hospital, etc. to attend a meeting of the Prefectural Council on Medical Service Facilities and explain said reasons, etc.
(5) The organizer or administrator of a reporting hospital, etc. shall, when requested by the prefectural governor under the preceding paragraph, endeavor to attend a meeting of the Prefectural Council on Medical Service Facilities and explain said reasons, etc.
(6) If said reasons, etc. are not found to be unavoidable based on the content of the consultation at the place of consultation set forth in paragraph (2) and the content of the explanation set forth in paragraph (4), the prefectural governor may order the organizer or administrator of the reporting hospital, etc. (limited to those established by the persons listed in the items of Article 7-2 (1)) not to change the reference date bed functions pertaining to a report under the provision of Article 30-13 (1) to the bed functions after the reference date pertaining to said report and to take other necessary measures, after hearing the opinions of the Prefectural Council on Medical Service Facilities.
(7) The provision of the preceding paragraph shall apply mutatis mutandis to a reporting hospital, etc. established by a person other than those listed in the items of Article 7-2 (1), when it is especially necessary for promoting the achievement of the regional medical care vision specified in the medical care plan. In this case, the term "order" in the preceding paragraph shall be deemed to be replaced with "request."
Article 30-16 (1) The prefectural governor may, when no agreement is reached through consultation at the place of consultation on matters necessary to promote the achievement of the regional medical care vision specified in the medical care plan, or when otherwise specified by an Ordinance of the Ministry of Health, Labour and Welfare, instruct the organizer or administrator of a hospital, etc. subject to a report on the bed functions (limited to those established by the persons listed in the items of Article 7-2 (1)) in the vision area, etc. to provide medical care pertaining to the case where, out of the functional classification of beds, the number of existing beds according to the functional classification of beds in the vision area pertaining to said vision area, etc. has not reached the future requirements for the number of beds in said vision area specified in the medical care plan and take other necessary measures, after hearing the opinions of the Prefectural Council on Medical Service Facilities.
(2) The provisions of the preceding paragraph shall apply mutatis mutandis to a hospital, etc. subject to a report on the bed functions established by a person other than those listed in the items of Article 7-2 (1), when it is especially necessary for promoting the achievement of the regional medical care vision specified in the medical care plan. In this case, the term "instruct" in the preceding paragraph shall be deemed to be replaced with "request."
Article 30-17 The prefectural governor may, when he/she finds that the organizer or administrator of a hospital, etc. subject to a report on the bed functions who has received a request under Article 30-15 (6) as applied mutatis mutandis by replacing the terms in accordance with paragraph (7) of the same Article, or under paragraph (1) of the preceding Article as applied mutatis mutandis by replacing the terms in accordance with paragraph (2) of the same Article has not taken measures pertaining to said request without justifiable grounds, recommend that said organizer or administrator of a hospital, etc. subject to a report on the bed functions should take said measures, after hearing the opinions of the Prefectural Council on Medical Service Facilities.
Article 30-18 In the event that a prefectural governor has issued an order under the provision of Article 30-15 (6), an instruction under the provision of Article 30-16 (1), or a recommendation under the provision of the preceding Article, and the organizer or administrator of a hospital, etc. subject to a report on the bed functions who has received said order, instruction or recommendation fails to comply with it, the prefectural governor may make a public announcement to that effect.
Section 4 Securing the Medical Care Delivery System for Outpatient Medical Care in the Region
Article 30-18-2 (1) The prefecture shall establish a place of consultation for consultation with organizations of academic experts on medical treatment, other medical experts, medical insurers, and other related parties (hereinafter referred to as "related parties" in this paragraph and the following paragraph) in each of the areas set forth in Article 30-4 (2)(xiv) and other areas that the governor of said prefecture deems appropriate (referred to as the "target area" in paragraph (3)), and shall, in cooperation with related parties, hold consultations on the following matters (with regard to the matters listed in items (ii) through (iv), limited to those related to securing the medical care delivery system for outpatient medical care; the same shall apply in paragraph (3)), and summarize and publicize the results thereof.
(i) Matters concerning the status of the medical care delivery system for outpatient medical care, based on the information on the number of physicians indicated by the indicator prescribed in Article 30-4 (2)(xi)(b).
(ii) Matters concerning the promotion of functional differentiation and coordination of hospitals and clinics.
(iii) Matters concerning the promotion of medical treatment provided by multiple physicians in cooperation.
(iv) Matters concerning the efficient utilization of all or part of buildings, equipment, instruments and appliances of medical institutions.
(v) Other matters necessary for securing the medical care delivery system for outpatient medical care.
(2) When related parties are requested by the prefecture to participate in a consultation conducted by the prefecture pursuant to the provision of the preceding paragraph, they shall endeavor to cooperate by participating in it, and shall also endeavor to cooperate in the implementation of matters which related parties have agreed upon at the place of such consultation.
(3) When the target area coincides with the vision area, etc., the prefecture may, in lieu of the consultation set forth in paragraph (1) in said target area, hold consultations on the matters listed in the items of the same paragraph at the place of consultation in said vision area, etc.
(4) In the case prescribed in the preceding paragraph, related parties as prescribed in Article 30-14 (1) shall, when requested by the prefecture to participate in a consultation conducted by the prefecture pursuant to the provision of the preceding paragraph, endeavor to cooperate by participating in it, and shall also endeavor to cooperate in the implementation of matters which related parties have agreed upon at the place of such consultation.
Section 5 Measures to Ensure the Availability of Medical Care Professionals, etc.
Article 30-19 The administrator of a hospital or clinic shall endeavor to take measures to improve the working environment of medical care professionals working in said hospital or clinic and other measures that contribute to ensuring the availability of medical care professionals.
Article 30-20 The Minister of Health, Labour and Welfare shall establish and publicize matters that should serve as guidelines for the appropriate and effective implementation of measures to be taken by administrators of hospitals and clinics in accordance with the provisions of the preceding Article.
Article 30-21 (1) The prefecture shall endeavor to implement the following affairs in order to promote the improvement of the working environment of medical care professionals:
(i) To provide consultation, necessary information, advice and other assistance concerning the improvement of the working environment of medical care professionals working in hospitals or clinics.
(ii) To conduct surveys and awareness-raising activities concerning the improvement of the working environment of medical care professionals working in hospitals or clinics.
(iii) In addition to what is listed in the preceding two items, to provide support necessary for improving the working environment of medical care professionals.
(2) The prefecture may entrust all or part of the affairs listed in the items of the preceding paragraph to a person specified by an Ordinance of the Ministry of Health, Labour and Welfare.
(3) A person entrusted pursuant to the provisions of the preceding paragraph shall, when implementing the affairs listed in each item of paragraph (1) or the affairs pertaining to said entrustment, pay special attention to the following matters:
(i) Importance of improving the working environment in a hospital or clinic in an acute physician shortage area where physicians will be dispatched.
(ii) Importance of securing the function as a center to promote the improvement of the working environment of medical care professionals.
(4) The prefecture or a person entrusted pursuant to the provisions of paragraph (2) shall, when implementing the affairs listed in each item of paragraph (1) or the affairs pertaining to said entrustment, mutually cooperate with a person who implements the affairs to support regional medical care prescribed in Article 30-25 (3) or the affairs pertaining to the entrustment set forth in the same paragraph.
(5) A person entrusted pursuant to the provisions of paragraph (2), or an officer or employee thereof, or a person who used to be such a person shall not divulge any secret that has come to his/her knowledge concerning the affairs pertaining to said entrustment without justifiable grounds.
Article 30-22 In order to contribute to appropriate implementation of the affairs listed in each item of paragraph (1) of the preceding Article, the national government shall provide necessary information and other forms of cooperation to prefectures.
Article 30-23 (1) The prefecture shall establish a place of consultation with the administrators of the following entities and other related parties (referred to as the "Council for Regional Medical Care Measures" in the following paragraph), shall hold consultations with the cooperation of these persons on matters necessary for the implementation of the matters listed in each item of the same paragraph concerning ensuring the availability of physicians specified in the medical care plans, and shall make public announcement of the matters agreed upon through said consultations:
(i) Advanced treatment hospitals.
(ii) Regional medical care support hospitals.
(iii) Public medical institutions provided for in Article 31 (referred to as "public medical institutions" in item (v)).
(iv) Hospitals designated by prefectural governors and provided for in Article 16-2 (1) of the Medical Practitioners Act.
(v) Hospitals other than public medical institutions (excluding those specified by an Ordinance of the Ministry of Health, Labour and Welfare as being equivalent to public medical institutions).
(vi) Groups of persons with the relevant knowledge and experience in medical practice.
(vii) Universities prescribed in Article 1 of the School Education Act (Act No. 26 of 1947) (hereinafter simply referred to as "universities") and other organizations related to the training of medical care professionals.
(viii) Social medical corporations provided for in Article 42-2 (1) authorized by the relevant prefectural governor.
(ix) Other parties as prescribed by an Ordinance of the Ministry of Health, Labour and Welfare.
(2) The matters to be discussed at the Council for Regional Medical Care Measures pursuant to the provisions of the preceding paragraph shall be the following matters:
(i) Matters concerning plans specified by an Ordinance of the Ministry of Health, Labour and Welfare as those aimed at contributing to ensuring the availability of physicians in acute physician shortage areas and at developing and improving the abilities of physicians to be dispatched to acute physician shortage areas.
(ii) Matters concerning dispatch of physicians.
(iii) Matters concerning continuous assistance for the development and improvement of the abilities of the physicians dispatched to acute physician shortage areas in accordance with the plans prescribed in item (i).
(iv) Matters concerning measures to alleviate the burden on physicians dispatched to acute physician shortage areas.
(v) Matters concerning measures to be taken in cooperation between universities and prefectures for ensuring the availability of physicians in acute physician shortage areas that are specified by an Ordinance of the Ministry of Education, Culture, Sports, Science and Technology and an Ordinance of the Ministry of Health, Labour and Welfare.
(vi) Matters that fall under the authority as set forth in the Medical Practitioners Act.
(vii) Other matters concerning ensuring the availability of physicians specified in the medical care plan.
(3) The prefectural governor shall, when holding consultations on the matters listed in item (ii) of the preceding paragraph, take into account the information on the number of physicians indicated by the indicator prescribed in Article 30-4 (2)(xi)(b) and give consideration to other matters specified by an Ordinance of the Ministry of Health, Labour and Welfare, so that the dispatch of physicians will contribute to ensuring the availability of physicians in acute physician shortage areas.
(4) Administrators of the entities listed in the items of paragraph (1) and other related parties shall endeavor to cooperate, if requested by the prefecture, by participating in consultations carried out by the prefecture as set forth in the provisions of the same paragraph.
Article 30-24 The prefectural governor may, when he/she finds it especially necessary based on the matters agreed upon through the consultation prescribed in paragraph (1) of the preceding Article (referred to as "matters agreed upon" in paragraph (1) of the following Article, Article 30-27 and Article 31), request the organizers and administrators of entities listed in the items of paragraph (1) of the preceding Article and other related parties to provide necessary cooperation for ensuring the availability of physicians in hospitals or clinics in acute physician shortage areas, such as dispatching physicians and developing training systems.
Article 30-25 (1) The prefecture shall, based on the matters agreed upon, endeavor to implement the following affairs in order to secure the medical care required in the region:
(i) To conduct surveys and analyses concerning: trends in ensuring the availability of physicians in hospitals and clinics located in the areas prescribed in Article 30-4 (6); factors contributing to ensuring the availability of physicians in hospitals and clinics located in the areas prescribed in Article 30-4 (7); and other matters concerning the securing of medical care required in the region.
(ii) To provide consultation, necessary information, advice and other assistance concerning ensuring the availability of physicians to organizers and administrators of hospitals and clinics and other related parties.
(iii) To provide consultation, necessary information, advice and other assistance concerning employment to physicians who wish to work, students majoring in medicine at universities and other related parties.
(iv) To provide physicians with consultation, necessary information, advice and other assistance concerning training on the latest knowledge and skills related to medical care and other programs for the development and improvement of their abilities.
(v) To formulate the plans prescribed in Article 30-23 (2)(i).
(vi) To make the necessary coordination with regard to the implementation of the matters listed in items (ii) through (iv) of Article 30-23 (2).
(vii) In addition to what is listed in each of the preceding items, to provide necessary support for ensuring the availability of physicians in hospitals and clinics.
(2) In addition to the affairs listed in the items of the preceding paragraph, the prefecture may carry out free employment placement services for physicians pursuant to the provisions of Article 29 (1) of the Employment Security Act (Act No. 141 of 1947) or carry out worker dispatching services for medical practitioners by obtaining the license provided for in Article 5 (1) of the Act for Securing the Proper Operation of Worker Dispatching Businesses and Protecting Dispatched Workers (Act No. 88 of 1985).
(3) The prefecture may entrust all or part of the affairs listed in the items of paragraph (1) and the affairs provided for in the preceding paragraph (hereinafter referred to as "affairs to support regional medical care" in this Article and the following Article) to a person specified by an Ordinance of the Ministry of Health, Labour and Welfare.
(4) The prefecture or a person who has been entrusted under the provision of the preceding paragraph shall, when implementing the affairs to support regional medical care or the affairs pertaining to said entrustment, endeavor to secure the functions as a center for securing the medical care required in the region.
(5) The prefecture or a person who has been entrusted under the provision of paragraph (3) shall, when implementing the affairs to support regional medical care or the affairs pertaining to said entrustment, cooperate with a person who implements affairs listed in each item of Article 30-21 (1) or affairs pertaining to the entrustment under Article 30-21 (2).
(6) A person who has been entrusted under the provision of paragraph (3) or an officer or employee thereof, or a person who used to be such a person shall not divulge any secret that has come to his/her knowledge with regard to the affairs pertaining to said entrustment without justifiable grounds.
Article 30-26 In order to contribute to the appropriate implementation of affairs to support regional medical care, the national government shall provide necessary information and other forms of cooperation to prefectures.
Article 30-27 The persons listed in the items of Article 30-23 (1) (excluding item (iii)) and medical care professionals shall endeavor to cooperate in the implementation of matters agreed upon and other matters concerning the securing of medical care required in relevant prefectures. They shall also, when cooperation is requested in accordance with the provisions of Article 30-24, respond to said request and endeavor to cooperate in ensuring the availability of physicians.
Section 6 Public Medical Institutions
Article 31 Public medical institutions (hospitals or clinics established by a prefecture, municipality or other party as prescribed by the Minister of Health, Labour and Welfare; the same shall apply hereinafter in this Section) shall endeavor to cooperate in the implementation of matters agreed upon and other matters concerning the securing of medical care required in relevant prefectures. They shall also, when cooperation is requested in accordance with the provisions of Article 30-24, respond to said request and cooperate in ensuring the availability of physicians.
Articles 32 and 33 Deleted
Article 34 (1) The Minister of Health, Labour and Welfare may, if he/she finds it specifically necessary for the dissemination of medical care, order the parties provided for in Article 31 to establish a public medical institution.
(2) In the case referred to in the preceding paragraph, the national treasury shall subsidize part of the costs required for said establishment, within the extent determined by the budget.
Article 35 (1) The Minister of Health, Labour and Welfare or a prefectural governor may order the organizer or administrator of a public medical institution to undertake the following matters:
(i) Allow the use of all or parts of the buildings, equipment, instruments, and tools for the practice and research of physicians and dentists who do not work at said public medical institution, provided that this is not a hindrance to the medical care services of said hospital or clinic.
(ii) Provide the necessary conditions for practical training pursuant to Article 11 (ii) of the Medical Practitioners Act or Article 11 (ii) of the Dentists Act, or for clinical training pursuant to Article 16-2 (1) of the Medical Practitioners Act or Article 16-2 (1) of the Dentists Act.
(iii) Undertake necessary measures to ensure medical care in relation to activities to ensure emergency medical care as prescribed by the medical care plan of the prefecture in which said public medical institution is situated.
(2) The Minister of Health, Labour and Welfare or a prefectural governor may instruct the organizer of a public medical institution as necessary on matters concerning the operation thereof other than those listed in each item of the preceding paragraph.
Articles 36 to 38 Deleted
Chapter VI Medical Corporations
Section 1 General Rules
Article 39 (1) An association or foundation that wishes to establish a hospital, a clinic where a physician or dentist will work full-time, a long-term care health facility, or an integrated facility for medical and long-term care may incorporate said facility pursuant to the provisions of this Act.
(2) A corporation pursuant to the provisions of the previous paragraph shall include in its name the term "medical corporation."
Article 40 An entity that is not a medical corporation shall not use the term "medical corporation" in its name.
Article 40-2 A medical corporation shall, as well as seeking to independently strengthen its operational foundations, seek to improve the quality of the medical care it provides and ensure transparency in its operation, and shall endeavor to actively fulfill its role as a major medical care actor in the community.
Article 41 (1) A medical corporation shall possess the assets necessary for it to operate.
(2) Necessary matters concerning the assets set forth in the preceding paragraph shall be as prescribed by an Ordinance of the Ministry of Health, Labour and Welfare, in accordance with the scale, etc. of medical care functions established by the medical corporation.
Article 42 A medical corporation may carry out all or some of the following operations, provided there is no hindrance to the operation of the hospital, clinic, long-term care health facility, or integrated facility for medical and long-term care it has established (including a hospital, clinic, long-term care health facility, or integrated facility for medical and long-term care publically established by said medical corporation and managed by a designated administrator provided for in Article 244-2 (3) of the Local Autonomy Act (hereinafter referred to as "hospital, etc. managed by a designated administrator")), pursuant to the provisions of its articles of incorporation or its act of endowment:
(i) The training or re-training of medical personnel.
(ii) The establishment of a research center for medicine or dentistry.
(iii) The establishment of clinics other than clinics provided for in Article 39 (1).
(iv) The establishment of facilities that allow people to engage in aerobic exercise for the prevention of illness (meaning physical exercise undertaken in order to maintain or rehabilitate physiological functions related to whole-body stamina, through the continuous intake of oxygen; the same shall apply in the following item) that are affiliated with a clinic and whose personnel, equipment, and operation comply with standards prescribed by the Minister of Health, Labour and Welfare.
(v) The establishment of facilities that allow the use of a hot spring for the prevention of illness that has a space for aerobic exercise and whose personnel, equipment, and operation comply with standards prescribed by the Minister of Health, Labour and Welfare.
(vi) In addition to what is listed in each of the preceding items, operations related to health and hygiene.
(vii) The establishment of the activities prescribed by the Minister of Health, Labour and Welfare, among those listed in Article 2 (2) and (3) of the Social Welfare Act (Act No. 45 of 1951).
(viii) The establishment of the fee-based home care for the elderly provided for in Article 29 (1) of the Act on Social Welfare Services for the Elderly (Act No. 133 of 1963).
Article 42-2 (1) A medical corporation that has received authorization from the prefectural governor as falling under the following requirements, pursuant to the provisions of a Cabinet Order (hereinafter referred to as "social medical corporations") may undertake operations as prescribed by the Minister of Health, Labour and Welfare (hereinafter referred to as "profit-making activities"), for the purpose of allocating its proceeds to the administration of a hospital, clinic, long-term care health facility, or integrated facility for medical and long-term care established by said social medical corporation, pursuant to the provisions of its articles of incorporation or act of endowment, provided that this does not hinder the operation of the hospital, clinic, long-term care health facility, or integrated facility for medical and long-term care said medical corporation has established (including hospitals, etc. managed by a designated administrator):
(i) No more than one-third of the medical corporation's total number of officers is composed of any officer himself/herself, the spouse thereof, relatives thereof within the third degree of kinship, and any other party specially related thereto as prescribed by an Ordinance of the Ministry of Health, Labour and Welfare.
(ii) No more than one-third of the total number of members of an associated medical corporation is composed of any member himself/herself, the spouse thereof, relatives thereof within the third degree of kinship, and any other party specially related thereto as prescribed by an Ordinance of the Ministry of Health, Labour and Welfare.
(iii) No more than one-third of the total number of councilors of an associated medical corporation is composed of any councilor himself/herself, the spouse thereof, relatives thereof within the third degree of kinship, and any other party specially related thereto as prescribed by an Ordinance of the Ministry of Health, Labour and Welfare.
(iv) It carries out operations related to activities to ensure emergency medical care (limited to those listed in the medical care plan prepared by the prefecture of the hospital or clinic established by said medical corporation; the same shall apply in the following Article) in the prefecture (in the case of a medical corporation listed in (a) or (b) below, the prefecture specified in (a) or (b) respectively) in which said hospital or clinic is situated.
(a) A medical corporation that establishes hospitals or clinics in two or more prefectures (excluding those listed in (b)): All prefectures where said hospitals or clinics are located.
(b) A medical corporation that establishes hospitals in one prefecture and clinics in the area prescribed in Article 30-4 (2)(xiv) specified in the medical care plan of the prefecture other than the prefecture where said hospitals are located, which is adjacent to the area prescribed in the same item specified in the medical care plan of the prefecture where said hospitals are located, and medical care in said hospitals and said clinics is provided in an integrated manner in conformity with the standards specified by an Ordinance of the Ministry of Health, Labour and Welfare: The prefecture where said hospitals are located.
(v) The operations set forth in the preceding item comply with the standards prescribed by the Minister of Health, Labour and Welfare with regard to the following matters:
(a) The buildings and equipment of the hospitals or clinics engaged in said operations.
(b) The system by which said operations are undertaken.
(c) The outcome of said operations.
(vi) In addition to what is listed in each of the preceding items, matters that comply with the requirements set out by an Ordinance of the Ministry of Health, Labour and Welfare with regard to public operations.
(vii) It is stipulated in the articles of incorporation or the act of endowment that any residual assets at the time of dissolution will belong to the national government, local government, or another social medical corporation.
(2) In granting the authorization set forth in the preceding paragraph, the prefectural governor shall hear the opinions of the Prefectural Council on Medical Service Facilities in advance.
(3) Accounting for profit-making activities shall be kept separately from accounting for the operation of a hospital, clinic, long-term care health facility, or integrated facility for medical and long-term care established by said social medical corporation (including a hospital, etc. managed by a designated administrator), and from operations listed in each item of the preceding Article, and shall be accounted for in a special account.
Article 42-3 (1) Out of medical corporations that have received authorization set forth in paragraph (1) of the preceding Article (hereinafter referred to as "authorization as a social medical corporation" in this paragraph and Article 64-2 (1)), those that have fallen under Article 64-2 (1)(i) due to the fact that they no longer meet the requirements listed in paragraph (1)(v)(c) of the preceding Article (limited to the case where said failure to meet the requirements is due to reasons specified by an Ordinance of the Ministry of Health, Labour and Welfare as reasons not attributable to said medical corporations) and have their authorization as a social medical corporation rescinded pursuant to the provision of Article 64-2 (1) (limited to those that fall under the requirements listed in each item (excluding item (v)(c)) of paragraph (1) of the preceding Article) may prepare a plan for the continuous implementation of activities to ensure emergency medical care (hereinafter referred to as the "implementation plan" in this Article) and submit it to the prefectural governor to receive approval to the effect that the implementation plan is appropriate.
(2) A medical corporation that has received the approval set forth in the preceding paragraph may conduct profit-making operations in accordance with the provisions of paragraphs (1) and (3) of the preceding Article.
(3) The provisions of paragraph (2) of the preceding Article shall apply mutatis mutandis to the case of granting the approval set forth in paragraph (1).
(4) In addition to what is provided for in the preceding three paragraphs, matters necessary for the approval of an implementation plan and its revocation shall be specified by a Cabinet Order.
Article 43 (1) A medical corporation shall complete its registration pursuant to the provisions of a Cabinet Order, in the case of its establishment, the establishment of secondary offices, a relocation of its offices, a change in other registered matters, dissolution, merger, split, the appointment or change of a liquidator, and the completion of liquidation.
(2) Matters which are to be registered pursuant to the provisions of the preceding paragraph may not be duly asserted against a third party after registration.
Section 2 Establishment
Article 44 (1) A medical corporation may not be established without the authorization of the prefectural governor of the location of its principal office (hereinafter referred to simply as "prefectural governor" in this Chapter (excluding paragraph (3) and Article 66-3)).
(2) A person who wishes to establish a medical corporation shall stipulate at least the following matters in its articles of incorporation or act of endowment:
(i) Its purpose.
(ii) Its name.
(iii) The name and established location of the hospital, clinic, long-term care health facility, or integrated facility for medical and long-term care (including a publically established hospital, clinic, long-term care health facility, or integrated facility for medical and long-term care that is to be managed by a designated administrator as provided in Article 244-2 (3) of the Local Autonomy Act) to be established.
(iv) The location of its offices.
(v) Provisions on assets and accounting.
(vi) Provisions on officers.
(vii) Provisions on the board of directors.
(viii) For an association of medical corporations, provisions on general meetings and the acquisition or loss of member status.
(ix) For medical corporation foundations, provisions on the board of councilors and councilors.
(x) Provisions on dissolution.
(xi) Provisions on changes to the articles of incorporation or act of endowment.
(xii) The method of public notice.
(3) If a person who wishes to establish a medical corporation foundation dies without stipulating the name, location of its offices, or method of appointment and dismissal of directors, the prefectural governor shall determine such matters ex officio or at the request of an interested party.
(4) The initial officers at the time of the establishment of a medical corporation shall be stipulated in the articles of incorporation or act of endowment.
(5) Where, among the matters listed in paragraph (2)(x), provisions on persons with vested rights to residual assets have been established, such persons shall be selected from among the national government or local governments, or medical corporations or other persons who deliver medical care, as prescribed by an Ordinance of the Ministry of Health, Labour and Welfare.
(6) In addition to the provisions of this Section, any necessary matters related to applications for authorization to establish a medical corporation shall be as prescribed by an Ordinance of the Ministry of Health, Labour and Welfare.
Article 45 (1) Where there has been an application for authorization pursuant to the provisions of paragraph (1) of the preceding Article, the prefectural governor shall reach a decision on such authorization based on an examination of whether the assets of the medical corporation to which said application relates comply with the requirements set forth in Article 41, and whether the articles of incorporation or act of endowment are not in violation of laws and regulations.
(2) In granting or refusing authorization pursuant to the provisions of paragraph (1) of the preceding Article, the prefectural governor shall hear the opinions of Prefectural Council on Medical Service Facilities in advance.
Article 46 (1) A medical corporation shall be incorporated through the registration of its establishment at the location of the principal office thereof, pursuant to the provisions of a Cabinet Order.
(2) A medical corporation shall prepare an inventory of assets at the time of incorporation, and keep it in its principal office at all times.
Section 3 Organizations
Subsection 1 Establishment of Organizations
Article 46-2 (1) A medical corporation as an association shall have a general meeting of members, directors, a board of directors, and auditors.
(2) A medical corporation as a foundation shall have councilors, a board of councilors, directors, a board of directors, and auditors.
Subsection 2 General Meeting of Members
Article 46-3 (1) A general meeting of members may adopt resolutions on matters provided for in this Act and matters provided for in the articles of incorporation.
(2) Provisions in the articles of incorporation to the effect that the directors, the board of directors, or other organizations other than the general meeting of members may decide on matters requiring a resolution of the general meeting of members under the provisions of this Act shall have no effect.
Article 46-3-2 (1) A medical corporation as an association shall keep a list of its members and make necessary changes whenever there is a change in the members.
(2) The president of a medical corporation as an association shall hold an ordinary general meeting of members at least once a year.
(3) The president may, whenever he/she finds it necessary, convene an extraordinary general meeting of members.
(4) When one fifth or more of the total number of members request the convening of an extraordinary general meeting of members by indicating the matters that are the purpose of the general meeting of members, the president shall convene an extraordinary general meeting of members within 20 days from the date of the request; provided, however, that the articles of incorporation may provide for a ratio of less than one fifth of the total number of members.
(5) A notice of convocation of a general meeting of members shall be given at least five days prior to the date of such general meeting of members, indicating the matters to be discussed at such general meeting of members and in accordance with the method prescribed in the articles of incorporation.
(6) At a general meeting of members, resolutions may be adopted only with respect to matters for which advance notice has been given pursuant to the provision of the preceding paragraph, except as otherwise provided in the articles of incorporation.
Article 46-3-3 (1) Each member shall have one voting right.
(2) Except as otherwise provided in the articles of incorporation, no general meeting of members may be held and no resolution may be adopted unless a majority of all members are present.
(3) Except as otherwise provided in this Act or the articles of incorporation, the agenda of a general meeting of members shall be decided by a majority of the voting rights of those present, and in case of a tie vote, the chairperson shall decide.
(4) In the case of the preceding paragraph, the chairperson may not participate in the voting as a member.
(5) Any member who is not present at the general meeting of members may vote in writing or by proxy, unless otherwise provided for in the articles of incorporation.
(6) Any member who has a special interest in the resolutions of the general meeting of members may not participate in the voting.
Article 46-3-4 In the event that the directors and auditors are requested by members to explain specific matters at a general meeting of members, they shall provide necessary explanations regarding such matters. However, this shall not apply to cases where such matters do not relate to the matters that are the purpose of the general meeting of members or other cases specified by Ordinance of the Ministry of Health, Labour and Welfare as cases where there are justifiable grounds.
Article 46-3-5 (1) The chairperson of a general meeting of members shall be elected at the general meeting of members.
(2) The chairperson of a general meeting of members shall maintain order and organize the proceedings of said general meeting of members.
(3) The chairperson of a general meeting of members may dismiss any person who does not obey his/her orders or who otherwise disturbs the order of said general meeting of members.
Article 46-3-6 The provisions of Article 57 of the Act on General Incorporated Associations and General Incorporated Foundations (Act No. 48 of 2006) shall apply mutatis mutandis to the general meeting of members of a medical corporation. In this case, the term "Ordinance of the Ministry of Justice" in paragraphs (1), (3) and (4)(ii) of the same Article shall be deemed to be replaced with "Ordinance of the Ministry of Health, Labour and Welfare."
Subsection 3 Councilors and Board of Councilors
Article 46-4 (1) The persons who serve as councilors shall be as follows:
(i) Persons elected as provided for in the act of endowment from among medical care professionals.
(ii) Persons elected as provided for in the act of endowment from among persons who have knowledge and experience in the management of a hospital, clinic, long-term care health facility, or integrated facility for medical and long-term care.
(iii) Persons elected as provided for in the act of endowment from among medical care recipients.
(iv) In addition to those listed in the preceding three items, persons elected as provided for in the act of endowment.
(2) Any person who falls under any of the following items may not serve as a councilor of a medical corporation:
(i) The juridical person.
(ii) A person specified by an Ordinance of the Ministry of Health, Labour and Welfare as a person who is unable to execute his/her duties properly due to mental or physical disorder.
(iii) A person sentenced to a fine or severer punishment pursuant to the provisions of this Act, the Medical Practitioners Act, the Dental Practitioners Act or any other laws concerning medical affairs specified by a Cabinet Order, and for whom two years have not yet elapsed from the day on which the execution of the sentence was completed or the sentence became no longer applicable.
(iv) Except for those who fall under the preceding item, a person who has been sentenced to prison or severer punishment and has completed the execution of the sentence or is no longer subject to the execution of the sentence.
(3) A councilor shall not concurrently serve as an officer or employee of the relevant medical corporation as a foundation.
(4) The relationship between a medical corporation as a foundation and its councilors shall be governed by the provisions concerning delegation.
Article 46-4-2 (1) The board of councilors shall consist of a number of councilors that exceeds the fixed number of directors (in the case of a medical corporation approved under the proviso of Article 46-5 (1), three or more councilors).
(2) In addition to expressing the opinions set forth in Article 46-4-5 (1), the board of councilors may adopt resolutions only on the matters provided for in this Act and the matters provided for in the act of endowment.
(3) Provisions in the act of endowment to the effect that the directors, the board of directors, or other organizations other than the board of councilors may decide on matters requiring a resolution of the board of councilors under the provisions of this Act shall have no effect.
Article 46-4-3 (1) The president of a medical corporation as a foundation shall hold an ordinary meeting of the board of councilors at least once a year.
(2) The president may convene an extraordinary meeting of the board of councilors whenever he/she finds it necessary.
(3) The meeting of the board of councilors shall have a chairperson.
(4) When one fifth or more of the total number of councilors request the convening of a meeting of the board of councilors by indicating the matters that are the purpose of the meeting, the president shall convene a meeting of the board of councilors within 20 days from the date of the request; provided, however, that the act of endowment may provide for a ratio of less than one fifth of the total number of councilors.
(5) Notice of a meeting of the board of councilors shall be given at least five days prior to the date of the meeting, indicating the matters that are the purpose of the meeting and in accordance with the method prescribed in the act of endowment.
(6) At a meeting of the board of councilors, resolutions may be adopted only with respect to matters for which prior notice has been given pursuant to the preceding paragraph, except as otherwise provided in the act of endowment.
Article 46-4-4 (1) No meeting of the board of councilors may be held and no resolution may be adopted unless a majority of all councilors are present.
(2) Except as otherwise provided in this Act, the agenda of a meeting of the board of councilors shall be decided by a majority of the voting rights of those present, and in case of a tie vote, the chairperson shall decide.
(3) In the case of the preceding paragraph, the chairperson may not participate in the voting as a councilor.
(4) Any councilor who has a special interest in the resolutions of the meeting of the board of councilors may not participate in the voting.
Article 46-4-5 (1) The president shall hear the opinion of the board of councilors before the medical corporation takes any of the following actions:
(i) Determining or changing the budget.
(ii) Borrowings (excluding temporary borrowings to be redeemed with the income of the relevant fiscal year).
(iii) Disposal of important assets.
(iv) Determining or changing the business plan.
(v) Merger and split.
(vi) Dissolution due to any of the reasons listed in Article 55 (1)(ii) out of those listed in Article 55 (3)(ii).
(vii) Other important matters concerning the business of the medical corporation as specified in the act of endowment.
(2) With regard to the matters listed in each item of the preceding paragraph, it may be provided for in the act of endowment that a resolution of the board of councilors shall be required.
Article 46-4-6 The board of councilors may express its opinions to the officers, respond to their inquiries, or collect reports from them concerning the status of the business or the status of the property of the medical corporation or the status of the execution of business by the officers.
Article 46-4-7 The provisions of Article 193 of the Act on General Incorporated Associations and General Incorporated Foundations shall apply mutatis mutandis to the meeting of the board of councilors of a medical corporation. In this case, the term "Ordinance of the Ministry of Justice" in paragraph (1), (3) and (4)(ii) of the same Article shall be deemed to be replaced with "Ordinance of the Ministry of Health, Labour and Welfare."
Subsection 4 Election and Dismissal of Officers
Article 46-5 (1) A medical corporation shall have three or more directors and one or more auditors as its officers. However, in cases where the approval of the prefectural governor has been obtained, it shall be sufficient to have one or two directors.
(2) Officers of a medical corporation as an association shall be elected by a resolution of a general meeting of members.
(3) Officers of a medical corporation as a foundation shall be elected by a resolution of the board of councilors.
(4) The relationship between a medical corporation and its officers shall be governed by the provisions concerning delegation.
(5) The provision of Article 46-4 (2) shall apply mutatis mutandis to officers of a medical corporation.
(6) A medical corporation shall include as directors the administrators of all hospitals, clinics, long-term care health facilities or integrated facilities for medical and long-term care it has established (including hospitals, etc. it manages as a designated administrator). However, in the case where a medical corporation has established two or more hospitals, clinics, long-term care health facilities or integrated facilities for medical and long-term care and approval is obtained from the prefectural governor, it is not obliged to include as directors some of the administrators (excluding the administrators of hospitals, etc. it manages as a designated administrator).
(7) The directors set forth in the main clause of the preceding paragraph shall lose their positions as directors when they resign from their positions as administrators.
(8) Auditors shall not concurrently serve as directors or employees of the medical corporation.
(9) The term of office of an officer shall not exceed two years. However, this shall not preclude reappointment.
Article 46-5-2 (1) An officer of a medical corporation as an association may be dismissed at any time by a resolution of the general meeting of members.
(2) An officer who has been dismissed pursuant to the provision of the preceding paragraph may claim compensation for damages caused by the dismissal from the medical corporation as an association unless there are justifiable grounds for such dismissal.
(3) A medical corporation as an association may not adopt a resolution at a general meeting of members set forth in paragraph (1) (limited to the case of dismissal of auditors) unless two-thirds or more of those present (or, if a higher ratio is specified in the articles of incorporation, that ratio) approve the resolution.
(4) When an officer of a medical corporation as a foundation falls under any of the following, the officer may be dismissed by a resolution of the board of councilors:
(i) When the officer has violated or neglected his/her duties.
(ii) When the officer is unable to properly perform his/her duties due to a mental or physical disorder.
(5) A medical corporation as a foundation may not adopt a resolution at a meeting of the board of councilors set forth in the preceding paragraph (limited to the case of dismissal of auditors) unless two-thirds or more of those present (or, if a higher ratio is specified in the act of endowment, that ratio) approve the resolution.
Article 46-5-3 (1) In the event a situation arises in which the number of officers is less than the number prescribed in this Act or the articles of incorporation or act of endowment, an officer who has retired due to expiration of the term of office or resignation shall continue to have the rights and obligations as an officer until a newly elected officer (including a person who is to perform the duties of a temporary officer set forth in the following paragraph) assumes office.
(2) In the case prescribed in the preceding paragraph, if there is a risk of damage due to delay in the business of the medical corporation, the prefectural governor shall appoint a person to perform the duties of a temporary officer at the request of an interested party or by his/her authority.
(3) If more than one-fifth of positions of directors or auditors are vacant, the vacancy shall be filled within one month.
Article 46-5-4 The provisions of Article 72 and Article 74 (excluding paragraph (4)) of the Act on General Incorporated Associations and General Incorporated Foundations shall apply mutatis mutandis to the election and dismissal of officers of a medical corporation as an association and a medical corporation as a foundation. In this case, the term "and the matters listed in Article 38 (1)(i)" in paragraph (3) of the same Article as applied mutatis mutandis to the election and dismissal of officers of a medical corporation as an association shall be deemed to be replaced with "and the date, time and place of said general meeting of members," the term "general meeting of members" in Article 72 and Article 74 (1) through (3) of the same Act as applied mutatis mutandis to the election and dismissal of officers of a medical corporation as a foundation shall be deemed to be replaced with "meeting of the board of councilors," and the term "and the matters listed in Article 38 (1)(i)" in the same paragraphs shall be deemed to be replaced with "and the date, time and place of said meeting of the board of councilors."
Subsection 5 Directors
Article 46-6 (1) One of the directors of a medical corporation (excluding a medical corporation prescribed in the following paragraph) shall be the president, who shall be elected from among the directors who are physicians or dentists. However, in the case where approval has been obtained from the prefectural governor, the president may be elected from among the directors who are neither physicians nor dentists.
(2) In the case of a medical corporation that has one director with approval under the proviso of Article 46-5 (1), said director shall be deemed to be the president with regard to the application of the provisions of this Chapter (excluding paragraph (3) of the following Article).
Article 46-6-2 (1) The president shall have the authority to represent the medical corporation and to perform any and all judicial or extrajudicial acts concerning the business of the medical corporation.
(2) The restrictions placed on the authority set forth in the preceding paragraph shall not be asserted against a bona fide third party.
(3) The provisions of Article 46-5-3 (1) and (2) shall apply mutatis mutandis to the case where the position of the president is vacant.
Article 46-6-3 A director who discovers that there is a fact that is likely to cause significant damage to the medical corporation shall immediately report said fact to the auditor.
Article 46-6-4 The provisions of Article 78, Article 80, Articles 82 through 84, Article 88 (excluding paragraph (2)) and Article 89 of the Act on General Incorporated Associations and General Incorporated Foundations shall apply mutatis mutandis to the directors of a medical corporation as an association and a medical corporation as a foundation. In this case, the term "general meeting of members" in Article 84 (1) of the same Act as applied mutatis mutandis to said directors shall be deemed to be replaced with "board of directors," the term "significant" in Article 88 (1) of the same Act shall be deemed to be replaced with "irrecoverable," the term "articles of incorporation" in Article 83 of the same Act as applied mutatis mutandis to the directors of a medical corporation as a foundation shall be deemed to be replaced with "act of endowment," the term "general meeting of members" shall be deemed to be replaced with "meeting of the board of councilors," the term "members" in the heading of Article 88 of the same Act and paragraph (1) of the same Article shall be deemed to be replaced with "councilors," the term "articles of incorporation" in the same paragraph and Article 89 of the same Act shall be deemed to be replaced with "act of endowment," the term "general meeting of members" in the same Article shall be deemed to be replaced with "meeting of the board of councilors," and any other necessary technical replacement of terms shall be prescribed by a Cabinet Order.
Subsection 6 Board of Directors
Article 46-7 (1) The board of directors shall be composed of all directors.
(2) The board of directors shall perform the following duties:
(i) Decision on the execution of business of the medical corporation.
(ii) Supervision of the execution of the duties by the directors.
(iii) Election and dismissal of the president.
(3) The board of directors may not delegate the following matters and other important decisions on the execution of business to the directors:
(i) Disposal and acceptance of important assets.
(ii) Borrowing a large amount of money.
(iii) Selection and dismissal of employees with important roles.
(iv) Establishment, change and abolition of secondary offices and other important organizations.
(v) In the case of a medical corporation as an association, exemption from liability under Article 47 (1) based on the provisions of the articles of incorporation pursuant to the provision of Article 114 (1) of the Act on General Incorporated Associations and General Incorporated Foundations as applied mutatis mutandis pursuant to Article 47-2 (1).
(vi) In the case of a medical corporation as a foundation, exemption from liability under Article 47 (1) as applied mutatis mutandis pursuant to Article 47 (4) based on the provisions of the act of endowment pursuant to the provision of Article 114 (1) of the Act on General Incorporated Associations and General Incorporated Foundations as applied mutatis mutandis pursuant to Article 47-2 (1).
Article 46-7-2 (1) The provisions of Articles 91 through 98 (excluding the items of Article 91 (1) and Article 92 (1)) of the Act on General Incorporated Associations and General Incorporated Foundations shall apply mutatis mutandis to the board of directors of a medical corporation as an association and a medical corporation as a foundation. In this case, the terms "the following directors" in Article 91 (1) of the same Act as applied mutatis mutandis to said board of directors and "the directors listed in the items of the preceding paragraph" in paragraph (2) of the same Article shall be deemed to be replaced with "the president," and the term "Ordinance of the Ministry of Justice" in Article 95 (3) and (4) and Article 97 (2)(ii) of the same Act shall be deemed to be replaced with "Ordinance of the Ministry of Health, Labour and Welfare," while the term "articles of incorporation" in Article 91 (2), Article 93 (1), Article 94 (1), Article 95 (1) and (3), and Article 96 of the same Act as applied mutatis mutandis to the board of directors of a medical corporation as a foundation shall be deemed to be replaced with "act of endowment," the term "members, when necessary to exercise their rights, with the permission of the court" in Article 97 (2) of the same Act shall be deemed to be replaced with "councilors, at any time during the business hours of the medical corporation as a foundation," and any other necessary technical replacement of terms shall be prescribed by a Cabinet Order.
(2) With regard to the permission set forth in Article 97 (2) and (3) of the Act on General Incorporated Associations and General Incorporated Foundations as applied mutatis mutandis by replacing the terms under the preceding paragraph, the provisions of Article 287 (1), Article 288, Article 289 (limited to the part pertaining to item (i)), the main clause of Article 290, Article 291 (limited to the part pertaining to item (ii)), the main clause of Article 292, Article 294 and Article 295 of the same Act shall apply mutatis mutandis.
Subsection 7 Auditors
Article 46-8 The duties of the auditors shall be as follows:
(i) To audit the business of the medical corporation.
(ii) To audit the status of the property of the medical corporation.
(iii) To prepare an audit report on the status of the business or property of the medical corporation for each fiscal year and submit it to the general meeting of members or the board of councilors and the board of directors within three months after the end of said fiscal year.
(iv) To report to the prefectural governor, the general meeting of members or the board of councilors, or the board of directors, if, as a result of the audit prescribed in item (i) or (ii), it is found that there is any wrongful act concerning the business or property of the medical corporation or any material fact in violation of laws and regulations, or the articles of incorporation or act of endowment.
(v) In the case of an auditor of a medical corporation as an association, to convene a general meeting of members when it is necessary to make a report under the provision of the preceding item.
(vi) In the case of an auditor of a medical corporation as a foundation, to request the president to convene a meeting of the board of councilors when it is necessary to make a report under the provision of item (iv).
(vii) In the case of an auditor of a medical corporation as an association, to investigate proposals, documents and other items specified by an Ordinance of the Ministry of Health, Labour and Welfare (referred to as "proposals, etc." in the following item) that the directors intend to submit to the general meeting of members. In this case, if it is found that there is a violation of laws and regulations or the articles of incorporation, or that there are extremely unjust matters, to report the results of the investigation to the general meeting of members.
(viii) In the case of an auditor of a medical corporation as a foundation, to investigate proposals, etc. that the directors intend to submit to the board of councilors. In this case, if it is found that there is a violation of laws and regulations or the act of endowment, or that there are extremely unjust matters, to report the results of the investigation to the board of councilors.
Article 46-8-2 (1) The auditor shall attend the meeting of the board of directors and state his/her opinion when he/she finds it necessary.
(2) In the case prescribed in item (iv) of the preceding Article, the auditor may, when he/she finds it necessary, request the directors (in the case prescribed in the proviso of Article 93 (1) of the Act on General Incorporated Associations and General Incorporated Foundations as applied mutatis mutandis under Article 46-7-2 (1), the person with the authority to convene the meeting as prescribed in paragraph (2) of the same Article) to convene a meeting of the board of directors.
(3) If a notice of convocation of a meeting of the board of directors is not issued within five days from the date of the request under the preceding paragraph setting the date of the meeting within two weeks from the date of the request, the auditor who made the request may convene a meeting of the board of directors.
Article 46-8-3 The provisions of Articles 103 through 106 of the Act on General Incorporated Associations and General Incorporated Foundations shall apply mutatis mutandis to the auditors of a medical corporation as an association and a medical corporation as a foundation. In this case, the term "articles of incorporation" in Article 103 (1) of the same Act as applied mutatis mutandis to the auditors of a medical corporation as a foundation shall be deemed to be replaced with "act of endowment," the terms "articles of incorporation" and "general meeting of members" in Article 105 (1) and (2) of the same Act shall be deemed to be replaced with "act of endowment" and "meeting of the board of councilors," respectively, and the term "general meeting of members" in paragraph (3) of the same Article shall be deemed to be replaced with "meeting of the board of councilors."
Subsection 8 Liability for Damages of Officers, etc.
Article 47 (1) A director or auditor of a medical corporation as an association shall, if he/she has neglected his/her duties, be liable to compensate said medical corporation for damages caused thereby.
(2) When a director of a medical corporation as an association has conducted a transaction set forth in item (i) of Article 84 (1) of the Act on General Incorporated Associations and General Incorporated Foundations in violation of the same paragraph as applied mutatis mutandis by replacing the terms pursuant to Article 46-6-4, the amount of profit obtained by the director or a third party from said transaction shall be presumed to be the amount of damage set forth in the preceding paragraph.
(3) When a medical corporation as an association has suffered damage due to a transaction set forth in Article 84 (1)(ii) or (iii) of the Act on General Incorporated Associations and General Incorporated Foundations as applied mutatis mutandis by replacing the terms pursuant to Article 46-6-4, any of the directors listed below shall be presumed to have neglected his/her duties:
(i) A director set forth in Article 84 (1) of the Act on General Incorporated Associations and General Incorporated Foundations as applied mutatis mutandis by replacing the terms pursuant to Article 46-6-4.
(ii) A director who has decided that the medical corporation as an association shall conduct said transaction.
(iii) A director who voted in favor of the resolution for approval of said transaction by the board of directors.
(4) The provisions of the preceding three paragraphs shall apply mutatis mutandis to councilors or directors, or auditors of a medical corporation as a foundation.
Article 47-2 (1) The provisions of Articles 112 through 116 of the Act on General Incorporated Associations and General Incorporated Foundations shall apply mutatis mutandis to the liability of directors or auditors of a medical corporation as an association set forth in paragraph (1) of the preceding Article and the liability of councilors or directors or auditors of a medical corporation as a foundation set forth in paragraph (1) of the same Article as applied mutatis mutandis pursuant to paragraph (4) of the same Article. In this case, the term "Ordinance of the Ministry of Justice" in Article 113 (1)(ii) and (4) of the same Act as applied mutatis mutandis to the liability of these persons shall be deemed to be replaced with "Ordinance of the Ministry of Health, Labour and Welfare," the term "all members" in Article 112 of the same Act as applied mutatis mutandis to the liability of councilors or directors or auditors of a medical corporation as a foundation shall be deemed to be replaced with "all councilors," the term "general meeting of members" in Article 113 of the same Act shall be deemed to be replaced with "meeting of the board of councilors," the term "articles of incorporation" in the heading of Article 114 of the same Act and paragraphs (1) and (2) of the same Article shall be deemed to be replaced with "act of endowment," the term "general meeting of members" in the same paragraph shall be deemed to be replaced with "meeting of the board of councilors," the term "articles of incorporation" in paragraph (3) of the same Article shall be deemed to be replaced with "act of endowment," the term "members" shall be deemed to be replaced with "councilors," the terms "all members," "articles of incorporation" and "members" in paragraph (4) of the same Article shall be deemed to be replaced with "all councilors," "act of endowment" and "councilors," respectively, the term "articles of incorporation" in paragraph (5) of the same Article and paragraphs (1) and (3) of Article 115 of the same Act shall be deemed to be replaced with "act of endowment," the term "general meeting of members" in the same paragraph and paragraph (4) of the same Article shall be deemed to be replaced with "meeting of the board of councilors," and any other necessary technical replacement of terms shall be prescribed by a Cabinet Order.
(2) A medical corporation as an association may not adopt a resolution at a general meeting of members set forth in Article 113 (1) of the Act on General Incorporated Associations and General Incorporated Foundations as applied mutatis mutandis by replacing the terms under the preceding paragraph, unless two-thirds or more (in the case where a higher ratio is specified in the articles of incorporation, that ratio) of those present approve the resolution.
(3) A medical corporation as a foundation may not adopt a resolution at a meeting of the board of councilors set forth in Article 113 (1) of the Act on General Incorporated Associations and General Incorporated Foundations as applied mutatis mutandis by replacing the terms under paragraph (1), unless two-thirds or more (in the case where a higher ratio is specified in the act of endowment, that ratio) of those present approve the resolution.
Article 48 (1) When a councilor, director or auditor (hereinafter referred to as "officer, etc." in this paragraph, the following Article and Article 49-3) of a medical corporation acted in bad faith or were grossly negligent in performing his/her duties, said officer, etc. shall be liable to compensate for any damage caused to a third party thereby.
(2) The provisions of the preceding paragraph shall apply when a person listed in each of the following items commits an act specified in the respective items; provided, however, that this shall not apply in the case where the person proves that he/she has exercised due care in committing said act:
(i) Director: Any of the following acts:
(a) False statement of material matters to be stated in the documents to be prepared pursuant to the provision of Article 51 (1).
(b) False registration.
(c) False public notice.
(ii) Auditor: False statement of material matters to be stated in an audit report.
Article 49 In the case where an officer, etc. is liable to compensate for damage caused to the medical corporation or a third party, if other officers, etc. are also liable to compensate for said damage, they shall be jointly and severally liable.
Article 49-2 The provisions of Chapter VI, Section 2, Subsection 2 of the Act on General Incorporated Associations and General Incorporated Foundations shall apply mutatis mutandis to a medical corporation as an association. In this case, the term "Ordinance of the Ministry of Justice" in Article 278 (1) of the same Act shall be deemed to be replaced with "Ordinance of the Ministry of Health, Labour and Welfare," and the term "members at the time of incorporation, directors at the time of incorporation, officers, etc. (meaning officers, etc. prescribed in Article 111 (1); the same shall apply in paragraph (3)) or liquidators" shall be deemed to be replaced with "directors or auditors," the terms "members at the time of incorporation, directors at the time of incorporation, officers, etc. or liquidators" and "Ordinance of the Ministry of Justice" in paragraph (3) of the same Article shall be deemed to be replaced with "directors or auditors" and "Ordinance of the Ministry of Health, Labour and Welfare," respectively, and the term "liquidators and these persons" in Article 280 (2) of the same Act shall be deemed to be replaced with "directors."
Article 49-3 The provisions of Chapter VI, Section 2, Subsection 3 of the Act on General Incorporated Associations and General Incorporated Foundations shall apply mutatis mutandis to an action for dismissal of an officer, etc. of a medical corporation. In this case, the term "articles of incorporation" in Article 284 of the same Act shall be deemed to be replaced with "articles of incorporation or act of endowment," and any other necessary technical replacement of terms shall be specified by a Cabinet Order.
Section 4 Accounting
Article 50 The accounting of a medical corporation shall be in accordance with accounting practices that are generally accepted as fair and appropriate, in addition to the provisions of this Act and an Ordinance of the Ministry of Health, Labour and Welfare under this Act.
Article 50-2 (1) A medical corporation shall prepare accurate accounting books in a timely manner pursuant to the provisions of an Ordinance of the Ministry of Health, Labour and Welfare.
(2) A medical corporation shall preserve its accounting books and important materials concerning its business for ten years from the time of closure of the accounting books.
Article 51 (1) A medical corporation shall, within two months after the end of each fiscal year, prepare a business report, an inventory of property, a balance sheet, a profit and loss statement, a report on the status of transactions with related business operators (meaning a person who has a special relationship with the medical corporation or its officers specified by an Ordinance of the Ministry of Health, Labour and Welfare, such as the spouse of the president being its representative), and other documents specified by an Ordinance of the Ministry of Health, Labour and Welfare (hereinafter referred to as "business report, etc.").
(2) A medical corporation (limited to those that meet the standards specified by an Ordinance of the Ministry of Health, Labour and Welfare in consideration of the scale of their business activities and other circumstances) shall prepare the balance sheet and profit and loss statement set forth in the preceding paragraph pursuant to an Ordinance of the Ministry of Health, Labour and Welfare.
(3) A medical corporation shall preserve the balance sheet and profit and loss statement for ten years from the time of preparation of said balance sheet and profit and loss statement.
(4) A medical corporation shall have its business report, etc. audited by an auditor pursuant to an Ordinance of the Ministry of Health, Labour and Welfare.
(5) A medical corporation set forth in paragraph (2) shall have its inventory of property, balance sheet and profit and loss statement audited by a certified public accountant or an audit corporation, pursuant to an Ordinance of the Ministry of Health, Labour and Welfare.
(6) A medical corporation shall obtain the approval of the board of directors for the business report, etc. audited by the auditor or certified public accountant or audit corporation set forth in the preceding two paragraphs.
Article 51-2 (1) The directors of a medical corporation as an association shall submit the business report, etc. approved under paragraph (6) of the preceding Article to the general meeting of members.
(2) Upon the notice of convocation of the general meeting of members set forth in the preceding paragraph, the directors shall provide the members with the business report, etc. approved under paragraph (6) of the preceding Article pursuant to the provisions of an Ordinance of the Ministry of Health, Labour and Welfare.
(3) The business report, etc. (limited to the balance sheet and profit and loss statement) submitted pursuant to the provision of paragraph (1) shall be approved by the general meeting of members.
(4) The directors shall report the contents of the business report, etc. (excluding the balance sheet and profit and loss statement) submitted pursuant to the provisions of paragraph (1) to the general meeting of members.
(5) The provisions of the preceding paragraphs shall apply mutatis mutandis to a medical corporation as a foundation. In this case, the term "general meeting of members" in the preceding paragraphs shall be deemed to be replaced with "meeting of the board of councilors," and the term "members" in paragraph (2) shall be deemed to be replaced with "councilors."
Article 51-3 A medical corporation (limited to those that meet the standards specified by an Ordinance of the Ministry of Health, Labour and Welfare in consideration of the scale of their business activities and other circumstances) shall, pursuant to an Ordinance of the Ministry of Health, Labour and Welfare, publicize the business report, etc. (limited to the balance sheet and profit and loss statement) approved under paragraph (3) of the preceding Article (including cases where it is applied mutatis mutandis by replacing the terms pursuant to paragraph (5) of the same Article).
Article 51-4 (1) A medical corporation (excluding those prescribed in the following paragraph) shall keep the following documents at its principal office and make them available for inspection upon request from its members, councilors or creditors, except in cases where there are justifiable grounds, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour and Welfare:
(i) The business report, etc.
(ii) The audit report set forth in Article 46-8 (iii) (hereinafter referred to as "auditor's audit report").
(iii) The articles of incorporation or act of endowment.
(2) A social medical corporation and a medical corporation set forth in Article 51 (2) (excluding social medical corporations) shall keep the following documents (in the case of documents listed in item (ii), limited to medical corporations set forth in Article 51 (2)) at its principal office and make them available for inspection upon request, except in cases where there are justifiable grounds, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour and Welfare:
(i) Documents listed in each item of the preceding paragraph.
(ii) Audit reports of certified public accountants or audit corporations (hereinafter referred to as "audit report of a certified public accountant, etc.").
(3) A medical corporation shall keep the business report, etc., the auditor's audit report and the audit report of a certified public accountant, etc. at its principal office for five years from one week prior to the date of the general meeting of members set forth in Article 51-2 (1) (in the case of a medical corporation as a foundation, the date of the meeting of the board of councilors set forth in paragraph (1) of the same Article as applied mutatis mutandis by replacing the terms pursuant to paragraph (5) of the same Article).
(4) The provisions of the preceding three paragraphs shall apply mutatis mutandis to the keeping and inspection of documents at the secondary office of a medical corporation. In this case, the term "documents" in paragraph (1) shall be deemed to be replaced with "copies of documents," and the term "documents (limited to" in paragraph (2) shall be deemed to be replaced with "copies of documents (limited to," the term "five years" in the preceding paragraph shall be deemed to be replaced with "three years," the term "business report, etc." shall be deemed to be replaced with "copies of business report, etc.," and the term "audit report" shall be deemed to be replaced with "copies of audit report."
Article 52 (1) A medical corporation shall, pursuant to an Ordinance of the Ministry of Health, Labour and Welfare, submit the following documents to the prefectural governor within three months after the end of each fiscal year:
(i) The business report, etc.
(ii) The auditor's audit report.
(iii) In the case of a medical corporation set forth in Article 51 (2), the audit report of a certified public accountant, etc.
(2) The prefectural governor shall, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour and Welfare, make the articles of incorporation, act of endowment, or documents submitted under the preceding paragraph available for inspection upon request.
Article 53 The fiscal year of a medical corporation shall begin on April 1 and end on March 31 of the following year; provided, however, that this shall not apply when it is otherwise specified in the articles of incorporation or act of endowment.
Article 54 A medical corporation shall not distribute dividends of surplus.
Section 5 Social Medical Corporation Bonds
Article 54-2 (1) A social medical corporation may issue social medical corporation bonds (monetary claims against a social medical corporation that arise as a result of allotments carried out pursuant to the provisions of the Companies Act (Act No. 86 of 2005) as applied mutatis mutandis pursuant to Article 54-7, and which are redeemed in accordance with the provisions on the matters listed in each item of paragraph (1) of the following Article; the same shall apply hereinafter) in an amount not exceeding the limit decided at a general meeting or by the board of councilors pursuant to the provisions of the act of endowment, in order to contribute to the implementation of activities to ensure emergency medical care.
(2) When a social medical corporation has issued social medical corporation bonds pursuant to the preceding paragraph, it shall not transfer funds equivalent to the proceeds from the issuance of said social medical corporation bonds to a special account as provided for in Article 42-2 (3).
Article 54-3 (1) A social medical corporation shall, whenever it wishes to solicit subscribers for social medical corporation bonds it is issuing, specify the following matters regarding its social medical corporation bonds for subscription (meaning social medical corporation bonds that will be allocated to the persons who subscribe for said social medical corporation bonds in response to said solicitation; the same shall apply hereinafter):
(i) The use of funds provided by the issuance of social medical corporation bonds for subscription.
(ii) The total amount of social medical corporation bonds for subscription.
(iii) The amount of each social medical corporation bond for subscription.
(iv) The coupon rate for the social medical corporation bonds for subscription.
(v) The method and due date for the redemption of social medical corporation bonds for subscription.
(vi) The method and due date for payment of interest.
(vii) When social medical corporation bond certificates (meaning securities that represent the social medical corporation bonds; the same shall apply hereinafter) will be issued, a statement to that effect.
(viii) When it will be arranged that the bondholder of a social medical corporation bond (hereinafter referred to as a "social medical corporation bondholder") may not make a claim, in whole or in part, pursuant to the provisions of Article 698 of the Companies Act as applied mutatis mutandis pursuant to Article 54-7, a statement to that effect.
(ix) When it will be arranged that a social medical corporation bond administrator may carry out the act listed in Article 706 (1)(ii) of the Companies Act as applied mutatis mutandis pursuant to Article 54-7, in the absence of a social medical corporation bondholders meeting resolution, a statement to that effect.
(x) The amount to be paid in for each social medical corporation bond for subscription (meaning the amount of monies to be paid in, in exchange for each social medical corporation bond for subscription), or the minimum amount thereof, or the method for calculating such amounts.
(xi) The due date for payment of the monies in exchange for the social medical corporation bonds for subscription.
(xii) When it will be arranged that the issuance of social medical corporation bonds for subscription will not be carried out in its entirety where the persons to whom the social medical corporation bonds for subscription will be allotted have not been established for the total amount of the social medical corporation bonds by a certain day, a statement to that effect and that certain day.
(xiii) In addition to what is listed in each of the preceding items, the matters prescribed by an Ordinance of the Ministry of Health, Labour and Welfare.
(2) The matters listed in item (ii) of the preceding paragraph and other matters prescribed by an Ordinance of the Ministry of Health, Labour and Welfare as important matters that concern the solicitation of subscribers for social medical corporation bonds shall be decided by a majority of the directors.
Article 54-4 A social medical corporation shall prepare its social medical corporation bond registry and enter or record the following matters in that registry, without delay after the date social medical corporation bonds are issued:
(i) The matters listed in paragraph (1)(iv) through (ix) of the preceding Article, and other matters prescribed by an Ordinance of the Ministry of Health, Labour and Welfare as matters that specify the features of social medical corporation bonds (hereinafter referred to as a "class").
(ii) The total amount of social medical corporation bonds and the amount of each social medical corporation bond for each class.
(iii) The amount of monies paid in, in exchange for each social medical corporation bond and the date of payment.
(iv) The name and address of social medical corporation bondholders (excluding social medical corporation bondholders of social medical corporation bearer bonds (social medical corporation bonds for which social medical corporation bond certificates are issued in bearer form)).
(v) The dates when the social medical corporation bondholders set forth in the preceding item acquired each social medical corporation bond.
(vi) When social medical corporation bond certificates have been issued, the serial numbers of the social medical corporation bond certificates, the dates of their issuance, whether the social medical corporation bond certificates are registered or in bearer form, and the number of social medical corporation bearer bond certificates.
(vii) In addition to what is listed in each of the preceding items, the matters prescribed by an Ordinance of the Ministry of Health, Labour and Welfare.
Article 54-5 A social medical corporation shall, where it issues social medical corporation bonds, appoint a social medical corporation bond administrator, and entrust the receipt of payments, the preservation of rights of claim on behalf of the social medical corporation bondholders, and other administration of the social medical corporation bonds to that administrator; provided, however, that this shall not apply where the amount of each social medical corporation bond is 100,000,000 yen or more, and in other cases prescribed by an Ordinance of the Ministry of Health, Labour and Welfare as cases where it is unlikely that the protection of social medical corporation bondholders will be compromised.
Article 54-6 (1) Social medical corporation bondholders shall be the framework for social medical corporation bondholders meetings for each class of social medical corporation bonds.
(2) A social medical corporation bondholders meeting may adopt resolutions on matters provided for in this Act or the Companies Act as applied mutatis mutandis pursuant to the following Article, and matters related to the interests of the social medical corporation bondholders.
Article 54-7 Where a social medical corporation issues social medical corporation bonds, the provisions set forth in Article 677 through Article 680, Article 682, Article 683, Article 684 (excluding paragraph (4) and paragraph (5)), Article 685 through Article 701, Article 703 through Article 714, Article 717 through Article 742, Part VII, Chapter II, Section 7, Article 868 (4), Article 869, Article 870 (1) (limited to the parts pertaining to item (ii) and item (xii) through item (ix)), Article 871 (limited to the parts pertaining to item (ii)), Article 872 (limited to the parts pertaining to item (iv)), Article 873, Article 874 (limited to the parts pertaining to item (i) and item (iv)), Article 875, and Article 876 of the Companies Act shall apply mutatis mutandis to social medical corporation bonds, social medical corporation bonds for subscription, social medical corporation bond certificates, social medical corporation bondholders, social medical corporation bond administrators, social medical corporation bondholders meetings, and social medical corporation bond registers. Where this is the case, any necessary replacement of terms shall be prescribed by Cabinet Order.
Article 54-8 A social medical corporation bond shall be deemed to be a bond in regard to the application of the Secured Bonds Trust Act (Act No. 52 of 1905) and other laws and regulations as prescribed by Cabinet Order, pursuant to the provisions of a Cabinet Order.
Section 6 Changes to Articles of Incorporation and Act of Endowment
Article 54-9 (1) In order for a medical corporation as an association to change its articles of incorporation, a resolution of the general meeting of members shall be adopted.
(2) In order for a medical corporation as a foundation to change its act of endowment, it shall hear the opinion of the board of councilors in advance.
(3) Changes to the articles of incorporation or act of endowment (excluding those pertaining to matters specified by an Ordinance of the Ministry of Health, Labour and Welfare) shall not take effect unless approved by the prefectural governor.
(4) In the case where an application for approval has been filed pursuant to the provision of the preceding paragraph, the prefectural governor shall decide on the approval after examining the matters prescribed in Article 45 (1) and whether the procedures for the change of the articles of incorporation or act of endowment are not in violation of laws and regulations or the articles of incorporation or act of endowment.
(5) When a medical corporation has changed its articles of incorporation or act of endowment pertaining to the matters specified by an Ordinance of the Ministry of Health, Labour and Welfare as set forth in paragraph (3), it shall immediately notify the prefectural governor of the changed articles of incorporation or act of endowment.
(6) The provisions of Article 44 (5) shall apply mutatis mutandis to the case where provisions concerning the person to whom the residual property shall belong are established or changed as a result of changing the articles of incorporation or act of endowment.
Section 7 Dissolution and Liquidation
Article 55 (1) An association of medical corporations shall be dissolved on the following grounds:
(i) Occurrence of grounds for dissolution that are specified by the articles of incorporation.
(ii) The inability to successfully carry out the operations that are its purpose.
(iii) A general meeting resolution.
(iv) Merger with another medical corporation (limited to the case where said medical corporation ceases to exist as a result of the merger; the same shall apply in paragraph (1) of the following Article and Article 56-3).
(v) A lack of members.
(vi) A decision to commence bankruptcy proceedings.
(vii) Rescission of authorization for establishment.
(2) An association of medical corporations may not adopt a general meeting resolution as set forth in item (iii) of the preceding paragraph without the support of a three-quarters majority of all members; provided, however, that this shall not apply when it is otherwise specified in the articles of incorporation.
(3) A medical corporation foundation shall be dissolved on the following grounds:
(i) Occurrence of grounds for dissolution that are specified by the act of endowment.
(ii) Grounds listed in paragraph (1)(ii), (iv), (vi), or (vii).
(4) Where a medical corporation can no longer perform on its obligations by means of its assets, a court shall, in response to a petition from the directors or obligees or ex officio, issue a decision for the commencement of bankruptcy procedures.
(5) In the case prescribed in the preceding paragraph, the directors shall immediately file a petition for the commencement of bankruptcy procedures.
(6) Dissolution resulting from the grounds listed in paragraph (1)(ii) or (iii) shall not be effective without the authorization of the prefectural governor.
(7) In granting or refusing the authorization set forth in the preceding paragraph, a prefectural governor shall hear the opinions of the Prefectural Council on Medical Service Facilities in advance.
(8) A liquidator shall, where a medical corporation has been dissolved based on the grounds listed in paragraph (1)(i) or (v), or paragraph (3)(i), notify the prefectural governor to that effect.
Article 56 (1) The residual assets of a dissolved medical corporation shall belong to persons to whom they should belong pursuant to the provisions of the articles of incorporation or act of endowment, except in the case of dissolution due to a decision to merge or to commence bankruptcy proceedings.
(2) Assets not disposed of pursuant to the provisions of the preceding paragraph shall belong to the national treasury.
Article 56-2 A dissolved medical corporation shall be deemed to remain in existence until the liquidation is completed, to the extent of the purpose of liquidation.
Article 56-3 When a medical corporation has been dissolved, a director shall become its liquidator, except in the case of dissolution due to a decision to merge or to commence bankruptcy proceedings; provided, however, that this shall not apply when it is otherwise specified in the articles of incorporation or act of endowment, or when a person other than a director is appointed at a general meeting.
Article 56-4 In the absence of a liquidator pursuant to the provisions of the preceding Article or when damages are likely to be incurred due to the absence of a liquidator, a court may appoint the liquidator in response to a petition by an interested party or the public prosecutor, or ex officio.
Article 56-5 When there are material grounds for doing so, a court may dismiss a liquidator in response to a petition by an interested party or the public prosecutor, or ex officio.
Article 56-6 A liquidator appointed during liquidation shall notify the prefectural governor of his/her name and address.
Article 56-7 (1) A liquidator shall perform the following duties:
(i) The conclusion of current business.
(ii) The collection of debts and the performance of obligations.
(iii) The delivery of residual assets.
(2) A liquidator may engage in any and all acts that are necessary to the performance of the duties listed in each of the items of the preceding paragraph.
Article 56-8 (1) A liquidator shall provide public notice on at least three occasions, requiring obligees to submit their claims within a stated period, within two months of the date that said liquidator takes office. In this case, the period for filing claims shall not be less than two months.
(2) The public notice set forth in the preceding paragraph shall note that if an obligee fails to submit his/her claim within the stated period, his/her claim will be excluded from the liquidation proceedings; provided, however, that the liquidator may not exclude any known obligee.
(3) The liquidator shall notify each known obligee separately of the requirement for him/her to submit his/her claim.
(4) The public notice set forth in paragraph (1) shall be carried out via publication in the Official Gazette.
Article 56-9 A obligee who submits his/her claim after the expiry of the period set forth in paragraph (1) of the preceding Article may claim only the assets which, after all debts of the medical corporation have been fully paid, have not yet been delivered to persons with vested rights.
Article 56-10 (1) When it has become clear that the assets of a medical corporation in liquidation are insufficient to perform on its obligations, the liquidator shall immediately file to commence bankruptcy proceedings and provide public notice to that effect.
(2) Where a medical corporation in liquidation is subject to a ruling for the commencement of bankruptcy proceedings, the liquidator shall be deemed to have completed his/her duties when the administration of the relevant proceedings has been transferred to the bankruptcy trustee.
(3) In the case provided for in the preceding paragraph, when a medical corporation in liquidation has already made payment to an obligee or delivered assets to persons with vested interests, the bankruptcy trustee may retrieve such monies or assets.
(4) Public notice pursuant to the provisions of paragraph (1) shall be carried out via publication in the Official Gazette.
Article 56-11 When liquidation proceedings are completed, the liquidator shall notify the prefectural governor to that effect.
Article 56-12 (1) The dissolution and liquidation of a medical corporation shall be subject to court supervision.
(2) A court may conduct the necessary investigations for the supervision set forth in the preceding paragraph at any time, ex officio.
(3) A court supervising the dissolution and liquidation of a medical corporation may seek the opinion of the prefectural governor, or may commission an investigation thereby.
(4) The prefectural governor provided for in the preceding paragraph may state his/her opinion to the court provided for in the same paragraph.
Article 56-13 Cases related to the supervision of the dissolution and liquidation of a medical corporation or to the liquidator shall be subject to the jurisdiction of the district court with jurisdiction over the location of the principal office thereof.
Article 56-14 No appeal may be entered against a judicial decision on the appointment of the liquidators.
Article 56-15 A court may, where a liquidator has been appointed pursuant to the provisions of Article 56-4, specify the amount in fees to be paid to said liquidator by the medical corporation. In this case, the court shall hear the statements of said liquidator and the auditor.
Article 56-16 (1) A court may appoint an inspector so as to have him/her carry out the necessary investigations for the supervision of the dissolution and liquidation of a medical corporation.
(2) The provisions of the preceding two Articles shall apply mutatis mutandis to where the court has appointed an inspector as prescribed in the preceding paragraph. In this case, the term "liquidator and the auditor" in the preceding Article shall be deemed to be replaced with "medical corporation and the inspector."
Section 8 Merger and Split
Subsection 1 Merger
Division 1 General Rules
Article 57 A medical corporation may merge with another medical corporation. In this case, the medical corporation to be merged shall conclude a merger agreement.
Division 2 Absorption-Type Merger
Article 58 When a medical corporation conducts an absorption-type merger (meaning a merger by a medical corporation with another medical corporation whereby all of the rights and obligations of the medical corporation to be dissolved as a result of the merger are to be succeeded to by the medical corporation to survive the merger; hereinafter the same shall apply in this Division), the absorption-type merger agreement shall stipulate the names and locations of the principal offices of the medical corporation that will survive the absorption-type merger (hereinafter referred to as the "surviving medical corporation in the absorption-type merger" in this Division) and the medical corporation that will dissolve as a result of the absorption-type merger (hereinafter referred to as the "dissolving medical corporation in the absorption-type merger" in this Division), and other matters specified by an Ordinance of the Ministry of Health, Labour and Welfare.
Article 58-2 (1) A medical corporation as an association shall obtain the consent of all members of said medical corporation for an absorption-type merger agreement.
(2) A medical corporation as a foundation may conduct an absorption-type merger only when its act of endowment provides that it may do so.
(3) A medical corporation as a foundation shall obtain the consent of two-thirds or more of its directors for an absorption-type merger agreement, unless otherwise provided for in its act of endowment.
(4) An absorption-type merger shall not take effect unless approved by the prefectural governor (meaning the prefectural governor of the location of the principal office of the surviving medical corporation in the absorption-type merger).
(5) The provision of Article 55 (7) shall apply mutatis mutandis to the approval set forth in the preceding paragraph.
Article 58-3 (1) When a medical corporation has obtained the approval set forth in paragraph (4) of the preceding Article, it shall prepare an inventory of property and a balance sheet within two weeks from the date of the notice of the approval.
(2) Until the merger pertaining to an absorption-type merger approved under paragraph (4) of the preceding Article is registered, a medical corporation shall keep the inventory of property and balance sheet prepared pursuant to the provision of the preceding paragraph at its principal office and make them available for inspection upon request from its creditors, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour and Welfare.
Article 58-4 (1) A medical corporation shall, within the period set forth in paragraph (1) of the preceding Article, make a public notice to its creditors to the effect that any objection, if any, should be stated within a certain period of time, and shall notify each known creditor separately. However, such period shall not be less than two months.
(2) If creditors do not object to the absorption-type merger within the period set forth in the preceding paragraph, it shall be deemed that they have approved the absorption-type merger.
(3) When a creditor has made an objection, the medical corporation shall pay or provide reasonable security to the creditor or place reasonable property with a trust company, etc. (meaning a trust company and a financial institution (meaning a financial institution authorized under Article 1 (1) of the Act on Engagement in Trust Business by Financial Institutions (Act No. 43 of 1943) engaged in trust business; the same shall apply hereinafter) for the purpose of having the creditor receive payment; provided, however, that this shall not apply when the absorption-type merger is unlikely to harm the creditor.
Article 58-5 The surviving medical corporation in the absorption-type merger shall succeed to the rights and obligations of the dissolving medical corporation in the absorption-type merger (including the rights and obligations that said medical corporation has based on the permission or other disposition of the administrative agency with respect to the business it conducts).
Article 58-6 An absorption-type merger shall become effective when the surviving medical corporation in the absorption-type merger registers the merger at the location of its principal office pursuant to the provisions of a Cabinet Order.
Division 3 Consolidation-Type Merger
Article 59 When two or more medical corporations conduct a consolidation-type merger (meaning a merger between two or more medical corporations in which all of the rights and obligations of the medical corporation to be dissolved as a result of the merger shall be succeeded to by the medical corporation to be established as a result of the merger; hereinafter the same shall apply in this Division), the following matters shall be stipulated in the consolidation-type merger agreement:
(i) The name and location of the principal office of the medical corporation to be dissolved as a result of the consolidation-type merger (hereinafter referred to as the "medical corporation dissolved in the consolidation-type merger" in this Division).
(ii) The purpose, name and location of the principal office of the medical corporation to be established as a result of the consolidation-type merger (hereinafter referred to as the "medical corporation established in the consolidation-type merger" in this Division).
(iii) Matters specified in the articles of incorporation or act of endowment of the medical corporation established in the consolidation-type merger.
(iv) In addition to the matters listed in the preceding three items, matters specified by an Ordinance of the Ministry of Health, Labour and Welfare.
Article 59-2 The provisions of Article 58-2 through Article 58-4 shall apply mutatis mutandis to the case where a medical corporation conducts a consolidation-type merger. In this case, the term "absorption-type merger agreement" in Article 58-2 (1) and (3) shall be deemed to be replaced with "consolidation-type merger agreement," and the term "surviving medical corporation in the absorption-type merger" in paragraph (4) of the same Article shall be deemed to be replaced with "medical corporation established in the consolidation-type merger."
Article 59-3 A medical corporation established in the consolidation-type merger shall succeed to the rights and obligations of the medical corporation dissolved in the consolidation-type merger (including the rights and obligations that said medical corporation has based on the permission or other disposition of the administrative agency with respect to the business it conducts).
Article 59-4 A consolidation-type merger shall become effective when the medical corporation established in the consolidation-type merger registers the merger at the location of its principal office pursuant to the provisions of a Cabinet Order.
Article 59-5 The provisions of Section 2 (excluding Article 44 (2), (4) and (5) and Article 46 (2)) shall not apply to the establishment of a medical corporation established in the consolidation-type merger.
Subsection 2 Split
Division 1 Absorption-Type Split
Article 60 A medical corporation (excluding social medical corporations and those specified by an Ordinance of the Ministry of Health, Labour and Welfare; hereinafter the same shall apply in this Subsection) may conduct an absorption-type split (meaning that all or part of the rights and obligations which a medical corporation has with respect to its business are succeeded to by another medical corporation after the split; hereinafter the same shall apply in this Division). In this case, an absorption-type split agreement shall be concluded with the medical corporation that succeeds to all or part of the rights and obligations (hereinafter referred to as the "succeeding medical corporation in the absorption-type split" in this Division) held by said medical corporation with respect to its business.
Article 60-2 When a medical corporation conducts an absorption-type split, the following matters shall be stipulated in the absorption-type split agreement:
(i) The names and locations of the principal offices of the medical corporation that conducts the absorption-type split (hereinafter referred to as the "medical corporation conducting the absorption-type split" in this Division) and the succeeding medical corporation in the absorption-type split.
(ii) Assets, liabilities, employment contracts and other matters concerning rights and obligations to be succeeded to by the succeeding medical corporation in the absorption-type split from the medical corporation conducting the absorption-type split as a result of the absorption-type split.
(iii) In addition to the matters listed in the preceding two items, matters specified by an Ordinance of the Ministry of Health, Labour and Welfare.
Article 60-3 (1) A medical corporation as an association shall obtain the consent of all members of said medical corporation for an absorption-type split agreement.
(2) A medical corporation as a foundation may conduct an absorption-type split only when its act of endowment provides that it may do so.
(3) A medical corporation as a foundation shall obtain the consent of two-thirds or more of its directors for an absorption-type split agreement, unless otherwise provided for in its act of endowment.
(4) An absorption-type split shall not take effect unless approved by the prefectural governor (in the case where the principal offices of the medical corporation conducting the absorption-type split and the succeeding medical corporation in the absorption-type split are located within the area of two or more prefectures, the governors of all the prefectures where the principal offices of said medical corporation conducting the absorption-type split and said succeeding medical corporation in the absorption-type split are located).
(5) The provision of Article 55 (7) shall apply mutatis mutandis to the approval set forth in the preceding paragraph.
Article 60-4 (1) When a medical corporation has obtained the approval set forth in paragraph (4) of the preceding Article, it shall prepare an inventory of property and a balance sheet within two weeks from the date of the notice of the approval.
(2) Until the split pertaining to an absorption-type split approved under paragraph (4) of the preceding Article is registered, a medical corporation shall keep the inventory of property and balance sheet prepared pursuant to the provision of the preceding paragraph at its principal office and make them available for inspection upon request from its creditors, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour and Welfare.
Article 60-5 (1) A medical corporation shall, within the period set forth in paragraph (1) of the preceding Article, make a public notice to its creditors to the effect that any objection, if any, should be stated within a certain period of time, and shall notify each known creditor separately. However, such period shall not be less than two months.
(2) If creditors do not object to the absorption-type split within the period set forth in the preceding paragraph, it shall be deemed that they have approved the absorption-type split.
(3) When a creditor has made an objection, the medical corporation shall pay or provide reasonable security to the creditor or place reasonable property with a trust company, etc. for the purpose of having the creditor receive payment; provided, however, that this shall not apply when the absorption-type split is unlikely to harm the creditor.
Article 60-6 (1) The succeeding medical corporation in the absorption-type split shall, in accordance with the provisions of the absorption-type split agreement, succeed to the rights and obligations of the medical corporation conducting the absorption-type split (including the rights and obligations said medical corporation holds with respect to the facilities used for its business under the permission and other dispositions prescribed in this Act).
(2) Notwithstanding the provisions of the preceding paragraph, any creditor of the medical corporation conducting the absorption-type split who has not received the separate notification set forth in paragraph (1) of the preceding Article may demand performance of the obligation from the medical corporation conducting the absorption-type split within the limit of the value of the property that the medical corporation conducting the absorption-type split possessed on the date of registration of the split set forth in the following Article, even if the absorption-type split agreement stipulates that the creditor may not demand performance of said obligation from the medical corporation conducting the absorption-type split after the absorption-type split.
(3) Notwithstanding the provisions of paragraph (1), any creditor of the medical corporation conducting the absorption-type split who has not received the separate notification set forth in paragraph (1) of the preceding Article may demand performance of the obligation from the succeeding medical corporation in the absorption-type split within the limit of the value of the property that it has succeeded to, even if the absorption-type split agreement stipulates that the creditor may not demand performance of said obligation from the succeeding medical corporation in the absorption-type split after the absorption-type split.
Article 60-7 An absorption-type split shall become effective when the succeeding medical corporation in the absorption-type split registers the split at the location of its principal office pursuant to the provisions of a Cabinet Order.
Division 2 Incorporation-Type Split
Article 61 (1) One or two or more medical corporations may conduct an incorporation-type split (meaning that all or part of the rights and obligations which one or two or more medical corporations have with respect to their business are succeeded to by a medical corporation to be established through a split; the same shall apply hereinafter in this Division). In this case, an incorporation-type split plan shall be prepared.
(2) In the case where two or more medical corporations jointly conduct an incorporation-type split, said two or more medical corporations shall jointly prepare an incorporation-type split plan.
Article 61-2 When one or two or more medical corporations conduct an incorporation-type split, the following matters shall be specified in the incorporation-type split plan:
(i) The purpose, name and location of the principal office of the medical corporation to be established as a result of the incorporation-type split (hereinafter referred to as the "medical corporation established in the incorporation-type split" in this Division).
(ii) Matters specified in the articles of incorporation or act of endowment of the medical corporation established in the incorporation-type split.
(iii) Assets, liabilities, employment contracts and other matters concerning rights and obligations to be succeeded to by the medical corporation established in the incorporation-type split from the medical corporation that conducts the incorporation-type split (hereinafter referred to as the "medical corporation conducting the incorporation-type split" in this Division) as a result of the incorporation-type split.
(iv) In addition to the matters listed in the preceding three items, matters specified by an Ordinance of the Ministry of Health, Labour and Welfare.
Article 61-3 The provisions of Article 60-3 through Article 60-5 shall apply mutatis mutandis to the case where a medical corporation conducts an incorporation-type split. In this case, the term "absorption-type split agreement" in Article 60-3 (1) and (3) shall be deemed to be replaced with "incorporation-type split plan," the term "medical corporation conducting the absorption-type split" in paragraph (4) of the same Article shall be deemed to be replaced with "medical corporation conducting the incorporation-type split," and the term "succeeding medical corporation in the absorption-type split" shall be deemed to be replaced with "medical corporation established in the incorporation-type split."
Article 61-4 (1) The medical corporation established in the incorporation-type split shall, in accordance with the provisions of the incorporation-type split plan, succeed to the rights and obligations of the medical corporation conducting the incorporation-type split (including the rights and obligations said medical corporation holds with respect to the facilities used for its business under the permission and other dispositions prescribed in this Act).
(2) Notwithstanding the provisions of the preceding paragraph, any creditor of the medical corporation conducting the incorporation-type split who has not received the separate notification set forth in Article 60-5 (1) as applied mutatis mutandis pursuant to the preceding Article may demand performance of the obligation from the medical corporation conducting the incorporation-type split within the limit of the value of the property that the medical corporation conducting the incorporation-type split possessed on the date of registration of the split set forth in the following Article, even if the incorporation-type split plan stipulates that the creditor may not demand performance of said obligation from the medical corporation conducting the incorporation-type split after the incorporation-type split.
(3) Notwithstanding the provisions of paragraph (1), any creditor of the medical corporation conducting the incorporation-type split who has not received the separate notification set forth in Article 60-5 (1) as applied mutatis mutandis pursuant to the preceding Article may demand performance of the obligation from the medical corporation established in the incorporation-type split within the limit of the value of the property that it has succeeded to, even if the incorporation-type split plan stipulates that the creditor may not demand performance of said obligation from the medical corporation established in the incorporation-type split after the incorporation-type split.
Article 61-5 An incorporation-type split shall become effective when the medical corporation established in the incorporation-type split registers the split at the location of its principal office pursuant to the provisions of a Cabinet Order.
Article 61-6 The provisions of Section 2 (excluding Article 44 (2), (4) and (5) and Article 46 (2)) shall not apply to the establishment of a medical corporation established in the incorporation-type split.
Division 3 Miscellaneous Provisions
Article 62 The provisions of Article 2 through Article 8 (excluding the items of Article 2 (3) and the items of Article 4 (3)) of the Act on the Succession to Labor Contracts upon Company Split (Act No. 103 of 2000) and Article 5 (1) of the Supplementary Provisions of the Act for Partial Revision of the Commercial Code, etc. (Act No. 90 of 2000) shall apply mutatis mutandis to the case where a medical corporation conducts a split pursuant to the provisions of this Subsection. In this case, the term "succeeding company, etc." in Article 2 (1) and (2) of the Act on the Succession to Labor Contracts upon Company Split shall be deemed to be replaced with "succeeding medical corporation, etc.," the term "split company" in the same paragraph shall be deemed to be replaced with "split medical corporation," the term "according to the cases listed in the following items, specified in the relevant items" in paragraph (3) of the same Article shall be deemed to be replaced with "two weeks from the day on which a notice of approval under Article 60-3 (4) of the Medical Care Act (Act No. 205 of 1948) or a notice of approval under Article 60-3 (4) of the same Act as applied mutatis mutandis by replacing the terms pursuant to Article 61-3 of the same Act is given," the term "split company" in Article 3 through Article 8 (excluding Article 4 (3)) of the same Act shall be deemed to be replaced with "split medical corporation," the term "succeeding company, etc." shall be deemed to be replaced with "succeeding medical corporation, etc.," the term "according to the cases listed in the following items, in the relevant items" in Article 4 (3) of the same Act shall be deemed to be replaced with "the split medical corporation, on the day until the day before the day of registration of the split pertaining to an absorption-type split approved under Article 60-3 (4) of the Medical Care Act or an incorporation-type split approved under Article 60-3 (4) of the same Act as applied mutatis mutandis by replacing the terms pursuant to Article 61-3 of the same Act," and the necessary technical replacement of terms shall be specified by a Cabinet Order.
Article 62-2 The provisions of Article 398-9 (3) through (5) and Article 398-10 (1) and (2) of the Civil Code (Act No. 89 of 1896) shall apply mutatis mutandis to the case where a medical corporation conducts a split pursuant to the provisions of this Subsection. In this case, the term "the preceding two paragraphs" in Article 398-9 (3) of the same Act shall be deemed to be replaced with "paragraph (1) or (2) of the following Article as applied mutatis mutandis pursuant to Article 62-2 of the Medical Care Act (Act No. 205 of 1948)," and the term "the preceding paragraph" shall be deemed to be replaced with "the same paragraph."
Subsection 3 Miscellaneous Provisions
Article 62-3 In addition to what is specifically provided for in this Section, necessary matters concerning mergers and splits of medical corporations shall be specified by a Cabinet Order.
Section 9 Supervision
Article 63 (1) When a prefectural governor suspects the operations or accounting of a medical corporation to be in violation of laws and regulations, a disposition by the prefectural governor based on laws and regulations, the articles of incorporation, or the act of endowment, or suspects its administration to be significantly inappropriate, he/she may request said medical corporation to report on the status of its operations or accounting, or may have the relevant officials enter its offices and inspect the status of its operations or accounting.
(2) The provisions set forth in Article 6-8 (3) and (4) shall apply mutatis mutandis to any entry and inspection pursuant to the provisions of the preceding paragraph.
Article 64 (1) When a prefectural governor finds the operations or accounting of a medical corporation to be in violation of laws and regulations, a disposition of the prefectural governor based on laws and regulations, the articles of incorporation, or the act of endowment, or finds its administration to be significantly inappropriate, he/she may order said medical corporation to take any necessary measures by a set deadline.
(2) When a medical corporation fails to abide by an order as set forth in the preceding paragraph, the prefectural governor may order said medical corporation to suspend all or a part of its operations for a period that he/she prescribes, or may recommend the dismissal of its officers.
(3) In ordering the suspension of operations or recommending the dismissal of officers pursuant to the provisions of the preceding paragraph, the prefectural governor shall hear the opinions of the Prefectural Council on Medical Service Facilities in advance.
Article 64-2 (1) A prefectural governor may, where a social medical corporation falls under any of the following items, rescind the social medical corporation's authorization, or order all or a part of the profit-making activities to be suspended for a period that he/she prescribes:
(i) When the requirements listed in each item of Article 42-2 (1) are no longer being met.
(ii) When operations other than those stipulated in the articles of incorporation or act of endowment have been carried out.
(iii) When profits from the profit-making activities are not set aside for the administration of a hospital, clinic, long-term care health facility, or integrated facility for medical and long-term care established by said social medical corporation.
(iv) When the continuation of profit-making activities is found to be a hindrance to the operation of a hospital, clinic, long-term care health facility, or integrated facility for medical and long-term care established by a social medical corporation (including a hospital, etc. managed by a designated administrator).
(v) When authorization as set forth in Article 42-2 (1) has been received by unlawful means.
(vi) When the social medical corporation has violated this Act, any order based on this Act, or any disposition based on these.
(2) In rescinding authorization pursuant to the provisions of the preceding paragraph, the prefectural governor shall hear the opinions of the Prefectural Council on Medical Service Facilities in advance.
Article 65 A prefectural governor may, when a medical corporation fails to establish or re-open a hospital, clinic, long-term care health facility, or integrated facility for medical and long-term care without justifiable grounds, within one year of the establishment of said medical corporation or within one year of the suspension or abolition of all of its hospitals, clinics, long-term care health facilities, and integrated facilities for medical and long-term care, rescind its authorization for establishment.
Article 66 (1) A prefectural governor may, where a medical corporation has violated the provisions of laws and regulations or an order by the prefectural governor based on the provisions of laws and regulations, rescind its authorization for establishment, provided that the purpose of supervision cannot be achieved by any other means.
(2) In rescinding authorization for establishment pursuant to the provisions of the preceding paragraph, the prefectural governor shall hear the opinions of the Prefectural Council on Medical Service Facilities in advance.
Article 66-2 The Minister of Health, Labour and Welfare may, when he/she finds there to be a risk of significant harm to the public interest due to a failure to undertake disposition pursuant to the provisions of Article 64 (1) and (2), Article 64-2 (1), Article 65, or paragraph (1) of the preceding Article, instruct the prefectural governor to undertake disposition pursuant to said provisions.
Article 66-3 The prefectural governor concerned (meaning the prefectural governor of the location of a hospital, clinic, long-term care health facility or integrated facility for medical and long-term care established by a medical corporation, who is not the prefectural governor of the location of the principal office of said medical corporation) may, when he/she finds it necessary, express the opinion to the prefectural governor of the location of the principal office of said medical corporation that appropriate measures should be taken against said medical corporation.
Article 67 (1) In issuing a disposition refusing authorization pursuant to the provisions of Article 44 (1), Article 55 (6), Article 58-2 (4) (including the cases where it is applied mutatis mutandis by replacing the terms pursuant to Article 59-2), or Article 60-3 (4) (including the cases where it is applied mutatis mutandis by replacing the terms pursuant to Article 61-3) or recommending the dismissal of an officer pursuant to the provisions of Article 64 (2), the prefectural governor shall grant the person named in said disposition or the party under said recommendation the opportunity to give an explanation to a designated official or to another party. In this case, the prefectural governor shall give written notice in advance to the person named in said ruling or the party under said recommendation of the date and time and location of the explanation and the grounds for said disposition or said recommendation.
(2) A person who receives a notice as set forth in the preceding paragraph may have a representative appear, and may submit his/her own supporting evidence.
(3) A person who has given a hearing to an explanation pursuant to the provisions of paragraph (1) shall create and retain a hearing record, prepare a written report, and state his/her opinion to the prefectural governor concerning whether the relevant disposition or recommendation is necessary.
Article 68 The provisions set forth in Article 4, Article 158, and Article 164 of the Act on General Incorporated Associations and General Incorporated Foundations, and Article 662, Article 664, Article 868 (1), Article 871, Article 874 (limited to parts pertaining to item (i)), Article 875, and Article 876 of the Companies Act shall apply mutatis mutandis to medical corporations. In this case, the term "distribute its assets to its partners" in Article 664 of the Companies Act shall be deemed to be replaced with "assign its assets to persons with vested interests in residual assets or to the national treasury," and the term "head office" in Article 868 (1) of the same Act shall be deemed to be replaced with "principal office."
Article 69 In addition to what is specifically provided for in this Chapter, matters necessary for the supervision of medical corporations shall be specified by a Cabinet Order.
Chapter VII Regional Medical Coordination Promotion Corporation
Section 1 Approval
Article 70 (1) The following corporations (excluding profit-oriented corporations; hereinafter referred to as "participating corporations" in this Chapter), and general incorporated associations that have members specified by an Ordinance of the Ministry of Health, Labour and Welfare as persons necessary for efficiently providing high-quality and appropriate medical care in the region and have policies in place for promoting coordination of operations (hereinafter referred to as the "medical coordination promotion policy" in this Chapter) pertaining to a hospital, clinic, long-term care health facility, or integrated facility for medical and long-term care (hereinafter referred to as "hospital, etc." in this Chapter) with the purpose of performing medical coordination promotion operations may obtain approval from the governor of the prefecture to which the area to promote said coordination specified in the articles of incorporation belongs (hereinafter referred to as "medical coordination promotion area") (in the case where said medical coordination promotion area extends over two or more prefectures, any one of these prefectures):
(i) A corporation that establishes a hospital, etc. in the medical coordination promotion area.
(ii) A corporation that establishes or manages in the medical coordination promotion area a facility or office related to nursing care business (meaning business that provides welfare services or health and medical services to persons with physical or mental disabilities that hinder them from performing daily activities, including care for bathing, excretion, meals, etc., functional training, nursing care and medical treatment management, and other services, to enable them to lead self-reliant daily lives according to their abilities) and other businesses that contribute to the establishment of a community-based integrated care system (referring to the community-based integrated care system prescribed in Article 2 (1) of the Act on Promotion of Comprehensive Securing of Medical Care and Nursing Care in the Region; the same shall apply in Article 70-7) (hereinafter referred to as "nursing care business, etc." in this Chapter).
(2) The medical coordination promotion operations set forth in the preceding paragraph shall mean the following operations and other operations performed for the purpose of promoting coordination of operations pertaining to a hospital, etc. in accordance with the medical coordination promotion policy:
(i) Training to improve the qualities of medical care professionals.
(ii) Supply of medicines, medical equipment and other supplies necessary for operations pertaining to a hospital, etc.
(iii) Loans of funds and other support specified by an Ordinance of the Ministry of Health, Labour and Welfare as support for raising funds necessary for a participating corporation to perform operations pertaining to a hospital, etc.
Article 70-2 (1) A general incorporated association that intends to obtain the approval set forth in paragraph (1) of the preceding Article (hereinafter referred to as "approval for medical coordination promotion" in this Chapter) shall, pursuant to the provision of a Cabinet Order, apply to the prefectural governor with a medical coordination promotion policy.
(2) The medical coordination promotion policy shall contain the following matters:
(i) The medical coordination promotion area.
(ii) Matters concerning the sharing of functions and the coordination of operations among hospitals, etc. established by the participating corporations (referred to as "participating hospitals, etc." in paragraph (4) and Article 70-11) in the medical coordination promotion area.
(iii) Matters concerning the targets of the matters listed in the preceding item.
(iv) Other matters specified by an Ordinance of the Ministry of Health, Labour and Welfare.
(3) A medical coordination promotion area shall be established by taking into consideration the vision area specified in the medical care plan of the prefecture to which said medical coordination promotion area belongs.
(4) In addition to the matters listed in each item of paragraph (2), the medical coordination promotion policy may contain matters concerning the coordination of operations among participating hospitals, etc. and participating nursing care facilities, etc. (referring to facilities or offices pertaining to nursing care business, etc. established or managed by a participating corporation in a medical coordination promotion area; the same shall apply in Article 70-11).
(5) When the medical coordination promotion area pertaining to an application for approval for medical coordination promotion extends over two or more prefectures, the prefectural governor who shall conduct the affairs concerning the approval for medical coordination promotion shall be determined through consultation among the governors of the prefectures to which said medical coordination promotion area belongs. In this case, the prefectural governor who has received the application for approval for medical coordination promotion shall notify the general incorporated association that has applied for approval for medical coordination promotion of the prefectural governor who shall conduct the affairs concerning the approval for medical coordination promotion.
Article 70-3 (1) The prefectural governor may, when he/she finds that a general incorporated association that has applied for approval for medical coordination promotion conforms to the following standards, grant approval for medical coordination promotion to said general incorporated association:
(i) The main purpose of the general incorporated association is to perform medical coordination promotion operations (which means the medical coordination promotion operations prescribed in Article 70 (2); the same shall apply hereinafter in this Chapter).
(ii) The general incorporated association has the financial basis and technical capability necessary to perform medical coordination promotion operations.
(iii) In the performance of medical coordination promotion operations, the general incorporated association does not provide any special benefits to its members, directors, auditors, employees or any other related parties specified by a Cabinet Order.
(iv) In the case where the general incorporated association conducts any operations other than medical coordination promotion operations, there is no risk that the implementation of medical coordination promotion operations will be hindered by conducting any operations other than medical coordination promotion operations.
(v) The medical coordination promotion policy does not violate the provisions of paragraphs (2) and (3) of the preceding Article.
(vi) The medical coordination promotion area is specified in the articles of incorporation.
(vii) The articles of incorporation stipulate that the members should be limited to participating corporations and persons specified by an Ordinance of the Ministry of Health, Labour and Welfare as necessary for efficiently providing high-quality and appropriate medical care in the medical coordination promotion area.
(viii) The number of participating corporations establishing a hospital, etc. is two or more and other requirements for the composition of the participating corporations specified by an Ordinance of the Ministry of Health, Labour and Welfare as appropriate in light of the purpose prescribed in Article 70 (1) (referred to as the "purpose of medical coordination promotion" in the following item and item (x)(a)) are met.
(ix) No unfairly discriminatory conditions or other unreasonable conditions are attached to the member's acquisition or loss of qualification in light of the purpose of medical coordination promotion.
(x) Each member has one voting right. However, this shall not apply if provisions of the articles of incorporation concerning voting rights of members, such as the number of voting rights that may be exercised at a general meeting of members, matters on which voting rights may be exercised, conditions for exercising voting rights, fall under all of the following:
(a) The voting rights of members are not treated in an unfairly discriminatory manner in light of the purpose of medical coordination promotion.
(b) The voting rights of members are not treated differently according to the value of money or other property that the members have provided to the general incorporated association.
(xi) The total number of voting rights held by the participating corporations accounts for a majority of the voting rights of all members.
(xii) The articles of incorporation stipulate that persons specified by an Ordinance of the Ministry of Health, Labour and Welfare as those who are likely to have an undue influence on the resolution of a general meeting of members due to their interest in a profit-oriented organization or its officers or other circumstances should not be designated as members, directors or auditors (referred to as "officers" in the following item).
(xiii) The general incorporated association falls under all of the following with regard to its officers:
(a) The general incorporated association has three or more directors and one or more auditors as its officers.
(b) No more than one-third of the total number of officers consist of an officer, his/her spouse, his/her relatives within the third degree of kinship, or other persons who have a special relationship with him/her as specified by an Ordinance of the Ministry of Health, Labour and Welfare.
(c) At least one of the directors is a representative of an organization of academic experts on medical treatment or other persons specified by an Ordinance of the Ministry of Health, Labour and Welfare as necessary for the effective implementation of medical coordination promotion operations.
(xiv) The general incorporated association has one representative director.
(xv) The general incorporated association has a board of directors.
(xvi) The articles of incorporation stipulate that the general incorporated association should have a council that meets the following requirements (referred to as the "council for regional medical coordination promotion" in Article 70-13 (2)):
(a) The council consists of recipients of medical care or nursing care, organizations of academic experts on medical treatment and other related organizations, persons with academic background, and other related persons.
(b) The council is able to provide necessary opinions to the general incorporated association when said general incorporated association expresses the opinions prescribed in the following item.
(c) The council is able to evaluate the status of the implementation of the operations of the general incorporated association in light of the targets set forth in paragraph (2)(iii) of the preceding Article, and to state its opinions at a general meeting of members and board of directors meeting when it finds it necessary.
(xvii) The articles of incorporation stipulate that the participating corporations should, prior to making decisions on the following matters and other important matters, seek the opinions of the general incorporated association:
(a) Decision or change of the budget.
(b) Borrowings (excluding temporary borrowings to be redeemed with income within the fiscal year).
(c) Disposal of important assets.
(d) Decision or change of the business plan.
(e) Change of the articles of incorporation or act of endowment.
(f) Merger or split.
(g) Dissolution due to inability to succeed in the intended business or other reasons specified by an Ordinance of the Ministry of Health, Labour and Welfare.
(xviii) The articles of incorporation stipulate that in the event that a disposition of rescission of the approval for medical coordination promotion is made pursuant to the provisions of Article 70-21 (1) or (2), when there is a residual amount of property acquired for the purpose of medical coordination promotion set forth in Article 30 (2) of the Act on Authorization of Public Interest Incorporated Associations and Public Interest Incorporated Foundations (Act No. 49 of 2006) as applied mutatis mutandis by replacing the terms under Article 70-22, the equivalent amount of property should be donated to the national government, local governments, medical corporations or other medical care providers specified by an Ordinance of the Ministry of Health, Labour and Welfare (referred to as "the state, etc." in the following item) within one month from the day of said disposition of rescission of the approval for medical coordination promotion.
(xix) The articles of incorporation stipulate that in the case of liquidation, the residual property shall be attributed to the state, etc.
(xx) In addition to what is listed in each of the preceding items, the general incorporated association meets the requirements specified by an Ordinance of the Ministry of Health, Labour and Welfare as necessary for the appropriate performance of medical coordination promotion operations.
(2) In granting approval for medical coordination promotion, the prefectural governor shall give consideration to consistency with the regional medical care vision specified in the medical care plan of the prefecture and hear the opinions of the Prefectural Council on Medical Service Facilities in advance.
Article 70-4 A general incorporated association that falls under any of the following shall not be eligible to receive approval for medical coordination promotion:
(i) Any of its directors and auditors falls under any of the following:
(a) In the case where a regional medical coordination promotion corporation (which means a regional medical coordination promotion corporation prescribed in paragraph (1) of the following Article) has had its approval for medical coordination promotion rescinded pursuant to the provision of Article 70-21 (1) or (2), a person who was a director engaged in the operations of said regional medical coordination promotion corporation within one year prior to the day on which the fact that caused the rescission occurred and for whom five years have not yet elapsed from the day of the rescission.
(b) A person sentenced to a fine or severer punishment pursuant to the provisions of this Act or other laws concerning healthcare or social welfare that are specified by a Cabinet Order for whom five years have not passed from the day on which the execution of the sentence was completed or the sentence became no longer applicable.
(c) A person sentenced to prison or severer punishment for whom five years have not passed from the day on which the execution of the sentence was completed or the sentence became no longer applicable.
(d) A person who is a member of an organized crime group prescribed in item (vi) of Article 2 of the Act on Prevention of Unjust Acts by Organized Crime Group Members (Act No. 77 of 1991) (hereinafter referred to as an "organized crime group member" in this item) or a person for whom five years have not passed from the day on which he/she ceased to be an organized crime group member (referred to as an "organized crime group member, etc." in item (iii)).
(ii) A general incorporated association which has had its approval for medical coordination promotion rescinded pursuant to the provision of Article 70-21 (1) or (2) and for which five years have not passed from the date of such rescission.
(iii) A general incorporated association whose business activities are controlled by an organized crime group member, etc.
Article 70-5 (1) A general incorporated association that has obtained approval for medical coordination promotion (hereinafter referred to as a "regional medical coordination promotion corporation") shall use the words "regional medical coordination promotion corporation" in its name.
(2) A regional medical coordination promotion corporation shall be deemed to have amended its articles of incorporation to change the words "general incorporated association" in its name to "regional medical coordination promotion corporation."
(3) A written application for registration of the change of name pursuant to the provision of the preceding paragraph shall be accompanied by a document certifying that the corporation has obtained approval for medical coordination promotion.
(4) A person who is not a regional medical coordination promotion corporation shall not use the words in its name or trade name that may be misunderstood as a regional medical coordination promotion corporation.
(5) A regional medical coordination promotion corporation shall not use a name or trade name that may be misunderstood as another regional medical coordination promotion corporation for wrongful purposes.
Article 70-6 When a prefectural governor has granted approval for medical coordination promotion, he/she shall make a public announcement to that effect pursuant to the provisions of an Ordinance of the Ministry of Health, Labour and Welfare.
Section 2 Business, etc.
Article 70-7 A regional medical coordination promotion corporation shall voluntarily strengthen its operational base, promote coordination of operations of participating corporations that establish hospitals, etc. or establish or manage facilities or offices pertaining to nursing care business, etc. in the medical coordination promotion area, and ensure transparency of the management thereof, thereby endeavoring to play an active role that contributes to the achievement of the regional medical care vision and the establishment of the community-based integrated care system.
Article 70-8 (1) A regional medical coordination promotion corporation may, only when the matters prescribed in Article 70-2 (4) are stated in the medical coordination promotion policy, conduct, in accordance with the medical coordination promotion policy, business aimed at promoting coordination of operations of hospitals, etc. established by participating corporations and those of facilities or offices established or managed by participating corporations and engaged in nursing care business, etc.
(2) A regional medical coordination promotion corporation may make an investment only when the following requirements are met:
(i) The business operator receiving the investment is engaged in a business related to the medical coordination promotion operations in the medical coordination promotion area.
(ii) The investment profit is to be used in the medical coordination promotion operations.
(iii) Other requirements specified by an Ordinance of the Ministry of Health, Labour and Welfare as unlikely to hinder the implementation of the medical coordination promotion operations are met.
(3) A regional medical coordination promotion corporation shall, when intending to establish a hospital, etc. (including management of a public hospital, etc. conducted as a designated administrator as set forth in Article 244-2 (3) of the Local Autonomy Act), or establish or manage a facility or office specified by an Ordinance of the Ministry of Health, Labour and Welfare and engaged in nursing care business, etc., receive prior confirmation from the prefectural governor who has granted approval for medical coordination promotion (hereinafter referred to as the "prefectural governor having granted approval" in this Chapter) that it will pose no obstacle to the implementation of the medical coordination promotion operations.
(4) A regional medical coordination promotion corporation may not apply for permission to establish a hospital, permission under Article 62 (2) of the Social Welfare Act (limited to that pertaining to the establishment of facilities specified by an Ordinance of the Ministry of Health, Labour and Welfare), or any other permission specified by an Ordinance of the Ministry of Health, Labour and Welfare without receiving the confirmation set forth in the preceding paragraph.
(5) The prefectural governor having granted approval shall, when making a confirmation or a disposition not to confirm under paragraph (3), hear the opinions of the Prefectural Council on Medical Service Facilities in advance.
Article 70-9 The provisions of Article 18 of the Act on Authorization of Public Interest Incorporated Associations and Public Interest Incorporated Foundations shall apply mutatis mutandis to a regional medical coordination promotion corporation. In this case, the term "business property for public interest purposes" in the same Article shall be deemed to be replaced with "business property for the purpose of medical coordination promotion," the term "business for public interest purposes" shall be deemed to be replaced with "medical coordination promotion operations set forth in Article 70 (2) of the Medical Care Act (Act No. 205 of 1948) (hereinafter referred to as "medical coordination promotion operations" in this Article)," the term "Cabinet Office Ordinance" shall be deemed to be replaced with "Ordinance of the Ministry of Health, Labour and Welfare," the term "approval for public interest" in item (i) of the same Article shall be deemed to be replaced with "approval for medical coordination promotion set forth in Article 70-2 (1) of the Medical Care Act (hereinafter referred to as "approval for medical coordination promotion" in this Article)," the term "business for public interest purposes" shall be deemed to be replaced with "medical coordination promotion operations," the term "approval for public interest" in items (ii) and (iii) of the same Article shall be deemed to be replaced with "approval for medical coordination promotion," the term "business for public interest purposes" shall be deemed to be replaced with "medical coordination promotion operations," the term "approval for public interest" in item (iv) of the same Article shall be deemed to be replaced with "approval for medical coordination promotion," the term "profit-making businesses, etc." shall be deemed to be replaced with "businesses other than medical coordination promotion operations," the term "Cabinet Office Ordinance" shall be deemed to be replaced with "Ordinance of the Ministry of Health, Labour and Welfare," the term "approval for public interest" in item (vii) of the same Article shall be deemed to be replaced with "approval for medical coordination promotion," the term "Cabinet Office Ordinance" shall be deemed to be replaced with "Ordinance of the Ministry of Health, Labour and Welfare," the term "business for public interest purposes" shall be deemed to be replaced with "medical coordination promotion operations," the term "business for public interest purposes" in item (viii) of the same Article shall be deemed to be replaced with "medical coordination promotion operations," and the term "Cabinet Office Ordinance" shall be deemed to be replaced with "Ordinance of the Ministry of Health, Labour and Welfare."
Article 70-10 The provision of Article 41 shall apply mutatis mutandis to a regional medical coordination promotion corporation. In this case, the term "scale, etc. of the medical institutions established by the medical corporation" in paragraph (2) of the same Article shall be deemed to be replaced with "medical coordination promotion operations prescribed in Article 70 (2) conducted by a regional medical coordination promotion corporation prescribed in Article 70-5 (1)."
Article 70-11 A participating corporation shall post a mark at participating hospitals, etc. and participating nursing care facilities, etc. it establishes to indicate that the coordination of operations of said participating hospitals, etc. and participating nursing care facilities, etc. is being promoted in accordance with the medical coordination promotion policy.
Article 70-12 (1) The provision of Article 46-5-3 (3) shall apply mutatis mutandis to the directors of a regional medical coordination promotion corporation, and the provisions of Article 46-5 (9) and Article 46-5-3 (3) shall apply mutatis mutandis to the auditors of a regional medical coordination promotion corporation.
(2) When applying the provision of Article 100 of the Act on General Incorporated Associations and General Incorporated Foundations to the auditors of a regional medical coordination promotion corporation, the term "directors (in the case of a general incorporated association with a board of directors, the board of directors)" in the same Article shall be deemed to be replaced with "prefectural governor having granted approval (referred to the prefectural governor having granted approval prescribed in Article 70-8 (3) of the Medical Care Act (Act No. 205 of 1948)), the general meeting of members, or the board of directors."
Article 70-13 (1) A regional medical coordination promotion corporation shall publicize the results of the evaluation set forth in Article 70-3 (1)(xvi)(c).
(2) A regional medical coordination promotion corporation shall respect the opinions of the council for regional medical coordination promotion set forth in Article 70-3 (1)(xvi)(c).
Article 70-14 The provisions of Section 4 of the preceding Chapter (excluding Article 50, Article 50-2, Article 51-2 (5) and Article 51-4 (1)) shall apply mutatis mutandis to the accounting of a regional medical coordination promotion corporation. In this case, the term "report on the status of transactions with related business operators" in Article 51 (1) shall be deemed to be replaced with "report on the status of transactions with related business operators, a report on the status of support set forth in Article 70 (2)(iii), and a report on the status of investment set forth in Article 70-8 (2)," the terms "medical corporation (limited to those that meet the standards specified by an Ordinance of the Ministry of Health, Labour and Welfare in consideration of the scale of their business activities and other circumstances)" in paragraph (2) of the same Article, "medical corporation set forth in paragraph (2)" in paragraph (5) of the same Article, and "medical corporation (limited to those that meet the standards specified by an Ordinance of the Ministry of Health, Labour and Welfare in consideration of the scale of their business activities and other circumstances)" in Article 51-3 shall be deemed to be replaced with "regional medical coordination promotion corporation," the term "paragraph (3) of the preceding Article (including cases where it is applied mutatis mutandis by replacing the terms pursuant to paragraph (5) of the same Article)" in the same Article shall be deemed to be replaced with "paragraph (3) of the preceding Article," the term "social medical corporation and a medical corporation set forth in Article 51 (2) (excluding a social medical corporation)" in Article 51-4 (2) shall be deemed to be replaced with "regional medical coordination promotion corporation," the term "documents (limited to medical corporations set forth in Article 51 (2) in the case of documents listed in item (ii))" shall be deemed to be replaced with "documents," the term "documents listed in each item of the preceding paragraph" in item (i) of the same paragraph shall be deemed to be replaced with "business report, etc., audit report set forth in Article 46-8 (iii) and the articles of incorporation," the term "auditor's audit report" in paragraph (3) of the same Article shall be deemed to be replaced with "audit report set forth in Article 46-8 (iii)," the term "preceding three paragraphs" in paragraph (4) of the same Article shall be deemed to be replaced with "preceding two paragraphs," the term "auditor's audit report" in Article 52 (1)(ii) shall be deemed to be replaced with "audit report set forth in Article 46-8 (iii)," and the term "in the case of a medical corporation set forth in Article 51 (2), the audit report of a certified public accountant, etc." in item (iii) of the same paragraph shall be deemed to be replaced with "the audit report of a certified public accountant, etc."
Article 70-15 The provisions of Section 7 of the preceding Chapter (excluding Article 55 (1) (limited to the part pertaining to items (iv) and (vii)) and Article 55 (3)) shall apply mutatis mutandis to the dissolution and liquidation of a regional medical coordination promotion corporation. In this case, the term "prefectural governor" in paragraph (6) of the same Article shall be deemed to be replaced with "prefectural governor having granted approval (meaning the prefectural governor having granted approval prescribed in Article 70-8 (3); hereinafter the same shall apply in this Section)," the term "prefectural governor" in paragraphs (7) and (8) of the same Article shall be deemed to be replaced with "prefectural governor having granted approval," the term "or (v), or paragraph (3)(i)" in paragraph (8) of the same Article shall be deemed to be replaced with "or (v)," the term "decision to merge or to commence bankruptcy proceedings" in Article 56 (1) and Article 56-3 shall be deemed to be replaced with "decision to commence bankruptcy proceedings," the term "prefectural governor" in Article 56-6 and Article 56-11 shall be deemed to be replaced with "prefectural governor having granted approval," the term "liquidation" in Article 56-12 (1) shall be deemed to be replaced with "liquidation (limited to the part pertaining to dissolution and liquidation prescribed in this Section (excluding Article 55 (1) (limited to the part pertaining to items (iv) and (vii)) and Article 55 (3)) as applied mutatis mutandis by replacing the terms pursuant to Article 70-15)," and the term "prefectural governor" in paragraphs (3) and (4) of the same Article shall be deemed to be replaced with "prefectural governor having granted approval."
Article 70-16 The provisions of Article 5 (1), Article 49 (2) (limited to the part pertaining to item (vi) (limited to the part pertaining to the general meeting of members set forth in item (iii) of Article 148)), Article 67 (1) and (3), and Chapter V of the Act on General Incorporated Associations and General Incorporated Foundations shall not apply to a regional medical coordination promotion corporation.
Section 3 Supervision
Article 70-17 In addition to the matters listed in each item of Article 11 (1) of the Act on General Incorporated Associations and General Incorporated Foundations and the provisions of the articles of incorporation prescribed in Article 70-3 (1)(vi), (vii), (xii) and (xvi) through (xix), a regional medical coordination promotion corporation shall provide for the following matters in its articles of incorporation:
(i) Provisions concerning assets and accounting.
(ii) Provisions concerning officers.
(iii) Provisions concerning the board of directors.
(iv) Provisions concerning dissolution.
(v) Provisions concerning change of the articles of incorporation.
(vi) Names and locations of hospitals, etc. it has established (including hospitals, etc. it manages as a designated administrator) or facilities or offices engaged in nursing care business, etc. it has established or manages, which are specified by an Ordinance of the Ministry of Health, Labour and Welfare, if any.
Article 70-18 (1) The provisions of Article 54-9 (excluding paragraphs (1) and (2)) shall apply mutatis mutandis to the change of the articles of incorporation of a regional medical coordination promotion corporation. In this case, the term "prefectural governor" in paragraph (3) of the same Article shall be deemed to be replaced with "prefectural governor having granted approval (meaning the prefectural governor having granted approval prescribed in Article 70-8 (3); the same shall apply in the following paragraph and paragraph (5))," the term "prefectural governor" in paragraph (4) of the same Article shall be deemed to be replaced with "prefectural governor having granted approval," the term "matters prescribed in Article 45 (1) and" shall be deemed to be replaced with "whether the assets of the regional medical coordination promotion corporation (meaning the regional medical coordination promotion corporation prescribed in Article 70-5 (1)) pertaining to said application meet the requirements set forth in Article 41 as applied mutatis mutandis by replacing the terms pursuant to Article 70-10, whether the content of the articles of incorporation after change does not violate the provisions of laws and regulations, and," and the term "prefectural governor" in paragraph (5) of the same Article shall be deemed to be replaced with "prefectural governor having granted approval."
(2) A prefectural governor having granted approval shall, when giving the approval set forth in Article 54-9 (3) (limited to the approval pertaining to the matters listed in item (vi) of the preceding Article and other important matters specified by an Ordinance of the Ministry of Health, Labour and Welfare; hereinafter the same shall apply in this paragraph) as applied mutatis mutandis by replacing the terms in accordance with the preceding paragraph or making a disposition not to give the approval, hear the opinions of the Prefectural Council on Medical Service Facilities in advance.
Article 70-19 (1) The selection and dismissal of a representative director shall not be effective unless approved by the prefectural governor having granted approval.
(2) A prefectural governor having granted approval shall, when giving the approval or making a disposition not to give the approval set forth in the preceding paragraph, hear the opinions of the Prefectural Council on Medical Service Facilities in advance.
Article 70-20 The provisions of Article 6-8 (3) and (4), Article 63 (1) and Article 64 shall apply mutatis mutandis to a regional medical coordination promotion corporation. In this case, the term "paragraph (1)" in Article 6-8 (3) and (4) shall be deemed to be replaced with "Article 63 (1) as applied mutatis mutandis by replacing the terms pursuant to Article 70-20," the term "prefectural governor" in Article 63 (1) shall be deemed to be replaced with "prefectural governor having granted approval (meaning the prefectural governor having granted approval prescribed in Article 70-8 (3); hereinafter the same shall apply in this paragraph and the following Article)," the term "by the prefectural governor" shall be deemed to be replaced with "by the prefectural governor having granted approval," and the term "prefectural governor" in Article 64 shall be deemed to be replaced with "prefectural governor having granted approval."
Article 70-21 (1) In the case where a regional medical coordination promotion corporation falls under any of the following items, the prefectural governor having granted approval shall rescind the approval for medical coordination promotion:
(i) When the regional medical coordination promotion corporation has come to fall under Article 70-4 (i) or (iii).
(ii) When the regional medical coordination promotion corporation has received the approval for medical coordination promotion by deception or other wrongful means.
(2) In the case where a regional medical coordination promotion corporation falls under any of the following items, the prefectural governor having granted approval may rescind the approval for medical coordination promotion:
(i) When the regional medical coordination promotion corporation no longer conforms to any of the standards listed in each item of Article 70-3 (1).
(ii) When the regional medical coordination promotion corporation has filed an application for revocation of the approval for medical coordination promotion.
(iii) When the regional medical coordination promotion corporation has violated this Act or any order under this Act or any disposition thereunder.
(3) A prefectural governor having granted approval shall, when rescinding the approval for medical coordination promotion pursuant to the provisions of the preceding two paragraphs, hear the opinions of the Prefectural Council on Medical Service Facilities in advance.
(4) A prefectural governor having granted approval who rescinded the approval for medical coordination promotion pursuant to the provisions of paragraph (1) or (2) shall make a public announcement to that effect in accordance with an Ordinance of the Ministry of Health, Labour and Welfare.
(5) A reginal medical coordination promotion corporation that has received a disposition of rescission of the approval for medical coordination promotion pursuant to the provisions of paragraph (1) or paragraph (2) shall be deemed to have amended its articles of incorporation to change the words "regional medical coordination promotion corporation" in its name to "general incorporated association."
(6) A prefectural governor having granted approval who rescinded the approval for medical coordination promotion pursuant to the provisions of paragraph (1) or (2) shall immediately commission the registration of the change of the name of said regional medical coordination promotion corporation to the registration office having jurisdiction over the location of the principal office or secondary office of said regional medical coordination promotion corporation.
(7) The written commission for registration of the change of the name pursuant to the provision of the preceding paragraph shall be accompanied by a document certifying that the disposition pertaining to the cause of said registration has been made.
Article 70-22 The provisions of Article 30 of the Act on Authorization of Public Interest Incorporated Associations and Public Interest Incorporated Foundations shall apply mutatis mutandis to the case where a prefectural governor having granted approval rescinds the approval for medical coordination promotion pursuant to the provisions of paragraph (1) or (2) of the preceding Article. In this case, the term "the remaining amount of the public interest purposes acquired property" in Article 30 of the same Act shall be deemed to be replaced with "the remaining amount of the acquired property for the purpose of medical coordination promotion," the term "in the event that, or a public interest corporation ceases to exist as a result of a merger (excluding a case in which a juridical person that succeeds its rights and obligations is a public interest corporation)" in paragraph (1) of the same Article shall be deemed to be replaced with "in the event that," the term "item (xvii) of Article 5" shall be deemed to be replaced with "Article 70-3 (1)(xviii) of the Medical Care Act (Act No. 205 of 1948)," the term "after the day of, or such merger" shall be deemed to be replaced with "after the day of," the term "the national government, in case the Prime Minister is the administrative agency, or the prefecture, in case the prefectural governor is the administrative agency" shall be deemed to be replaced with "the prefecture governed by the prefectural governor having granted approval (meaning the prefectural governor having granted approval prescribed in Article 70-8 (3) of the same Act; the same shall apply in paragraph (4))," the term "the juridical person, or the juridical person that succeeds the rights and obligations of the public interest corporation that ceases to exist as a result of the merger" shall be deemed to be replaced with "the juridical person," the term "Authorization Cancelled Juridical Person, etc." shall be deemed to be replaced with "Authorization Cancelled Juridical Person," the term "Property for Business for Public Interest Purposes (excluding those acquired before the day on which Public Interest Corporation Authorization was granted, in case of the property listed in item (vi) of Article 18)" in paragraph (2)(i) of the same Article shall be deemed to be replaced with "property for business for the purpose of medical coordination promotion (which means property for business for the purpose of medical coordination promotion prescribed in Article 18 as applied mutatis mutandis by replacing the terms pursuant to Article 70-9 of the Medical Care Act; the same shall apply in the following item and item (iii))," the term "business for public interest purposes" in items (ii) and (iii) of the same paragraph shall be deemed to be replaced with "medical coordination promotion operations," the term "Property for Business for Public Interest Purposes" shall be deemed to be replaced with "property for business for the purpose of medical coordination promotion," the term "Cabinet Office Ordinance" in the same item and paragraph (3) of the same Article shall be deemed to be replaced with "Ordinance of the Ministry of Health, Labour and Welfare," the term "Authorization Cancelled Juridical Person, etc." in paragraph (4) of the same Article shall be deemed to be replaced with "Authorization Cancelled Juridical Person," the term "the national government or the prefecture" shall be deemed to be replaced with "the prefecture governed by the prefectural governor having granted approval," and the term "item (xvii) of Article 5" in paragraph (5) of the same Article shall be deemed to be replaced with "Article 70-3 (1)(xviii) of the Medical Care Act."
Article 70-23 The provisions of Article 66-2 and Article 67 shall apply mutatis mutandis to a regional medical coordination promotion corporation. In this case, the term "Article 64 (1) and (2), Article 64-2 (1), Article 65, and paragraph (1) of the preceding Article" in Article 66-2 shall be deemed to be replaced with "Article 64 (1) and (2) as applied mutatis mutandis by replacing the terms pursuant to Article 70-20 and Article 70-21 (1) and (2)," and the term "prefectural governor" shall be deemed to be replaced with "prefectural governor having granted approval (meaning the prefectural governor having granted approval prescribed in Article 70-8 (3); the same shall apply in Article 67 (1) and (3))," the term "prefectural governor" in Article 67 (1) shall be deemed to be replaced with "prefectural governor having granted approval," the term "Article 44 (1), Article 55 (6), Article 58-2 (4) (including the cases where it is applied mutatis mutandis by replacing the terms pursuant to Article 59-2), or Article 60-3 (4) (including the cases where it is applied mutatis mutandis by replacing the terms pursuant to Article 61-3)" shall be deemed to be replaced with "disposition of not granting approval for medical coordination promotion or Article 55 (6) as applied mutatis mutandis by replacing the terms pursuant to Article 70-15," the term "Article 64 (2)" shall be deemed to be replaced with "Article 64 (2) as applied mutatis mutandis by replacing the terms pursuant to Article 70-20," and the term "prefectural governor" in paragraph (3) of the same Article shall be deemed to be replaced with "prefectural governor having granted approval."
Section 4 Miscellaneous Provisions
Article 71 In addition to what is specifically provided for in this Chapter, approval for medical coordination promotion and supervision of a regional medical coordination promotion corporation in the case where the medical coordination promotion area extends over two or more prefectures, and other necessary matters concerning the approval for medical coordination promotion and supervision of a regional medical coordination promotion corporation shall be specified by a Cabinet Order, and other necessary matters concerning the enforcement of the provisions of this Chapter shall be specified by an Ordinance of the Ministry of Health, Labour and Welfare.
Chapter VIII Miscellaneous Provisions
Article 72 (1) A Prefectural Council on Medical Service Facilities shall be established in the prefectures in order to carry out investigations and deliberations on matters placed under their jurisdiction by this Act, and in order to carry out investigations and deliberations on significant matters related to ensuring the system for providing medical care in said prefecture in response to consultations with the prefectural governor.
(2) Any necessary matters concerning the organization and operation of a Prefectural Council on Medical Service Facilities shall be stipulated by Cabinet Order.
Article 73 Designated cities set forth in Article 252-19 (1) of the Local Autonomy Act (hereinafter referred to as "designated cities" in this Article) shall, pursuant to the provisions of a Cabinet Order, handle affairs specified by a Cabinet Order to be handled by prefectures in this Act. In this case, provisions set forth in this Act concerning prefectures shall apply mutatis mutandis to designated cities as provisions concerning designated cities.
Article 74 (1) Affairs placed under the jurisdiction of a prefectural governor, mayor of a city with a public health center, or mayor of a special ward of Tokyo pursuant to the provisions of Article 5 (2), Article 23-2, Article 24 (1), Article 24-2, and Article 25 (1) and (2), shall, where the Minister of Health, Labour and Welfare finds there to be an urgent necessity therefor in order to protect the health of the people, be undertaken by the Minister of Health, Labour and Welfare, prefectural governor, mayor of a city with a public health center, or mayor of a special ward of Tokyo. In this case, provisions set forth in this Act concerning a prefectural governor, mayor of a city with a public health center, or mayor of a special ward of Tokyo (limited to those pertaining to said affairs) shall apply mutatis mutandis to the Minister of Health, Labour and Welfare as provisions concerning the Minister of Health, Labour and Welfare.
(2) In the case set forth in the preceding paragraph, when the relevant affairs are undertaken by the Minister of Health, Labour and Welfare, a prefectural governor, mayor of a city with a public health center, or mayor of a special ward of Tokyo, they shall be undertaken under close mutual cooperation.
Article 75 (1) The authority of the Minister of Health, Labour and Welfare pursuant to the provisions of this Act may be delegated to the Director-General of a Regional Bureau of Health and Welfare, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour and Welfare.
(2) The authority delegated to the Director-General of a Regional Bureau of Health and Welfare pursuant to the provisions of the preceding paragraph may be delegated to the Director-General of a Regional Branch Bureau of Health and Welfare pursuant to the provisions of an Ordinance of the Ministry of Health, Labour and Welfare.
Article 76 Where an order has been established, revised, or abolished based on the provisions of this Act, said order may specify any necessary transitional measures (including transitional measures related to penal provisions) within the scope reasonably necessary in accordance with said establishment, revision, or abolition.
Chapter IX Penal Provisions
Article 77 When an officer of a social medical corporation has acted in a manner that is contrary to his/her duties for the purpose of promoting his/her own interest or the interest of a third party, or with the object of inflicting damage on the social medical corporation, and has inflicted financial damage on said social medical corporation, said officer shall be punished by imprisonment with work for up to seven years, a fine of up to five million yen, or both.
Article 78 When a social medical corporation's representative bondholder (meaning a social medical corporation's representative bondholder appointed pursuant to the provisions of Article 736 (1) of the Companies Act as applied mutatis mutandis pursuant to Article 54-7; the same shall apply in Article 81 (1) and Article 91) or resolution administrator (meaning a resolution administrator pursuant to the provisions of Article 737 (2) of the same Act as applied mutatis mutandis pursuant to Article 54-7; the same shall apply in Article 81 (1) and Article 91) has acted in a manner that is contrary to his/her duties for the purpose of promoting his/her own interest or the interest of a third party, or with the object of inflicting damage on the social medical corporation bondholders, and has inflicted financial damage on said social medical corporation bondholders, said person shall be punished by imprisonment with work for up to five years, a fine of up to five million yen, or both.
Article 79 Any attempt to commit the crimes set forth in the preceding two Articles shall be punished.
Article 80 (1) In soliciting subscribers for social medical corporation bonds, when an officer of a social medical corporation or a person entrusted with soliciting subscribers for social medical corporation bonds has used a prospectus related to the affairs of the social medical corporation and other matters or has used advertisements or other documents related to said subscription that include a false statement on an important matter or, where electromagnetic records (meaning records as prescribed by an Ordinance of the Ministry of Health, Labour and Welfare that are prepared in an electronic form, a magnetic form, or any other form not recognizable to human perception, which are used in information processing by computers; the same shall apply hereinafter) have been created in lieu of said documents, where such a person has supplied electromagnetic records that include a false statement on an important matter for use in said solicitation, said person shall be punished by imprisonment with work for up to five years, a fine of up to five million yen, or both.
(2) When a person undertaking the sale of social medical corporation bonds has used documents related to said sale that include a false statement on an important matter, or, where electromagnetic records have been created in lieu of said documents, when such a person has supplied electromagnetic records that include a false statement on an important matter for use in said sale, the provisions of the preceding paragraph shall apply.
Article 81 (1) When an officer of a social medical corporation, a social medical corporation's representative bondholder, or a resolution administrator has accepted, solicited, or promised to accept a financial benefit in response to a wrongful request, he/she shall be punished by imprisonment with work for up to five years or a fine of up to five million yen.
(2) A person who has given, offered, or promised to give benefits as set forth in the preceding paragraph shall be punished by imprisonment with work for up to three years or a fine of up to three million yen.
Article 82 (1) A person who, in connection with the following matters, has accepted, solicited, or promised to accept a financial benefit in response to a wrongful request shall be punished by imprisonment with work for up to five years or a fine of up to five million yen:
(i) A statement of opinion or the exercise of a voting right at a social medical corporation bondholders meeting.
(ii) The exercise of the rights of a social medical corporation bondholder who holds one-tenth or more of the total amount of social medical corporation bonds (excluding bonds that have been redeemed).
(2) The provisions of the preceding paragraph shall also apply to a person who has given, offered, or promised to give the benefit set forth in that paragraph.
Article 83 In cases as set forth in Article 81 (1) or paragraph (1) of the preceding Article, benefits accepted by the offender shall be confiscated. When it is not possible to confiscate all or part of such benefits, an equivalent value thereof shall be collected therefrom.
Article 84 (1) The crimes set forth in Article 77 through Article 79, Article 81 (1), and Article 82 (1) shall also apply to persons who committed such crimes outside Japan.
(2) The crimes set forth in Article 81 (2), and Article 82 (2) shall be governed by Article 2 of the Penal Code (Act No. 45 of 1907).
Article 85 When the person provided for in Article 78, Article 80, or Article 81 (1) is a juridical person, these provisions and the provisions of Article 79 shall apply mutatis mutandis to the director, executive officer, or any other business-administering officer or manager who has committed such an act.
Article 86 (1) A person who is or was a public officer engaged in affairs related to the submission of medical records or birth records pursuant to the provisions of Article 5 (2), Article 25 (2) or (4), or the inspection of medical records or birth records pursuant to the provisions of paragraph (1) or paragraph (3) of the same Article, who has, without justifiable grounds, divulged any secret or personal confidential information in relation to the services of physicians, dentists, or midwives which has come to his/her knowledge through the execution of his/her duties, shall be punished by imprisonment with work for up to one year or a fine of up to 500,000 yen.
(2) The provisions of the preceding paragraph shall also apply to a person who is or was a public officer other than those who have come to have knowledge of a secret in the course of their duties as set forth in the preceding paragraph, who has divulged such a secret without justifiable grounds.
(3) A person who has violated the provisions of Article 6-13 (4), Article 6-21, Article 6-22 (2), Article 30-21 (5), or Article 30-25 (6) shall be punished by imprisonment with work for up to one year or a fine of up to 500,000 yen.
Article 87 A person who falls under any of the following items shall be punished by imprisonment with work for up to six months or a fine of up to 300,000 yen:
(i) A person who has violated the provisions of Article 6-5 (1), Article 6-6 (4), Article 6-7 (1), or Article 7 (1).
(ii) A person who has violated the provisions of Article 14.
(iii) A person who has violated an order or disposition based on the provisions of Article 6-8 (2), Article 7-2 (3), Article 23-2, Article 24, Article 28, Article 29 (1), or Article 30-15 (6).
Article 88 In any of the cases listed in the following items, an officer or employee of the medical accident investigation and support center who has committed the violation shall be punished by a fine of up to 300,000 yen:
(i) When he/she has abolished all of the investigation services, etc. without obtaining the approval under Article 6-20.
(ii) When he/she has failed to make entries in the books, made false entries, or failed to preserve the books pursuant to the provisions of Article 6-23.
(iii) When he/she has failed to make a report or made a false report set forth in Article 6-24 (1), or refused, obstructed, or evaded an inspection set forth in the same paragraph.
Article 89 A person who falls under any of the following items shall be punished by a fine of up to 200,000 yen:
(i) A person who has violated the provisions of Article 3, Article 4 (3), Article 4-2 (3), Article 4-3 (3), Article 8, Article 8-2 (2), Article 9, Article 10, Article 11, Article 12, Article 16, Article 18, Article 19 (1) or (2), Article 21 (1)(ii) through (xi) or (2)(ii), Article 22 (i) or (iv) through (viii), Article 22-2 (ii) or (v), Article 22-3 (ii) or (v), or Article 27.
(ii) A person who has failed to report or submit or has falsely reported pursuant to the provisions of Article 5 (2), Article 6-8 (1), or Article 25 (1) through (4), or who has refused, obstructed, or evaded an inspection of his/her duties pursuant to the provisions of Article 6-8 (1) or Article 25 (1) through (3).
(iii) A person who has failed to post or falsely posted pursuant to the provisions of Article 14-2 (1) or (2).
Article 90 When the representative of a juridical person, or the agent, employee, or other worker of a juridical person or individual commits any one of the violations set forth in Article 87 or the preceding Article with regard to the business of such juridical person or individual, not only the offender, but said juridical person or individual, as well, shall be punished by the fine prescribed in the relevant Articles.
Article 91 Where the officer of a social medical corporation, the administrator of a social medical corporation bond registry (meaning a person pursuant to the provisions of Article 683 of the Companies Act as applied mutatis mutandis pursuant to Article 54-7), a social medical corporation bond administrator, the social medical corporation bond administrator who succeeds to the administration of social medical corporation bonds (meaning a social medical corporation bond administrator who succeeds to the affairs of a social medical corporation bond administrator pursuant to the provisions of Article 711 (1), or Article 714 (1) or (3) of the Companies Act as applied mutatis mutandis pursuant to Article 54-7), a social medical corporation's representative bondholder, or a resolution administrator falls under any one of the following items, said person shall be subject to a non-criminal fine of up to one million yen; provided, however, that this shall not apply when such an act should be made subject to criminal punishment:
(i) When the person has failed to give public notice or notice or has given improper public notice or notice under the provisions of the Companies Act as applied mutatis mutandis under this Act.
(ii) When, in violation of the provisions of the Companies Act as applied mutatis mutandis under this Act, the person has refused to allow the inspection or copying of documents or anything that shows the matters recorded in electromagnetic records in a manner prescribed by an Ordinance of the Ministry of Health, Labour and Welfare, or has refused to deliver a transcript or extract of documents, to provide matters recorded in electromagnetic records by electromagnetic means, or to deliver a document that states such matters, without justifiable grounds.
(iii) When the person has refused, obstructed, or evaded an inspection under the provisions of the Companies Act as applied mutatis mutandis under this Act.
(iv) When the person has made a false statement or concealed facts at a social medical corporation bondholders meeting.
(v) When the person has failed to enter or record matters to be entered or recorded in the social medical corporation bond registry, the minutes (meaning minutes prepared pursuant to the provisions of Article 731 (1) of the Companies Act as applied mutatis mutandis pursuant to Article 54-7; the same shall apply in the following item), or the documents or electromagnetic records set forth in Article 682 (1), or Article 695 (1) of the Companies Act as applied mutatis mutandis pursuant to Article 54-7, or has entered or recorded false matters therein.
(vi) When the person has failed to keep a social medical corporation bond registry or minutes, in violation of the provisions of Article 684 (1), or Article 731 (2) of the Companies Act as applied mutatis mutandis pursuant to Article 54-7.
(vii) When the person has issued social medical corporation bond certificates prior to the date of issue of social medical corporation bonds.
(viii) When the person has failed to issue social medical corporation bond certificates without delay, in violation of the provisions of Article 696 of the Companies Act as applied mutatis mutandis pursuant to Article 54-7.
(ix) When the person has failed to enter or has falsely entered any matter that must be entered on a social medical corporation bond certificate.
(x) When the person has issued social medical corporation bonds in violation of the provisions of Article 54-5, or has failed to appoint a social medical corporation bond administrator to succeed to the administration of social medical corporation bonds, in violation of the provisions of Article 711 (1) of the Companies Act as applied mutatis mutandis pursuant to Article 54-7.
Article 92 A person who has violated an order set forth in Article 30-13 (5) shall be subject to a non-criminal fine of up to 300,000 yen.
Article 93 In any of the cases under the each of the following items, the director(s), auditor, or liquidator of a medical corporation, or the director, auditor or liquidator of a regional medical coordination promotion corporation shall be subject to a non-criminal fine of up to 200,000 yen; provided, however, that this shall not apply when such an act should be made subject to criminal punishment:
(i) When the person has failed to complete registration pursuant to the provisions of a Cabinet Order based on this Act.
(ii) When the person has failed to keep an inventory of assets pursuant to the provisions of Article 46 (2), or has failed to enter or has falsely entered a matter that must be entered therein.
(iii) When the person has neglected to keep the minutes pursuant to the provisions of Article 57 (2) through (4) of the Act on General Incorporated Associations and General Incorporated Foundations as applied mutatis mutandis pursuant to Article 46-3-6, Article 193 (2) through (4) of the same Act as applied mutatis mutandis pursuant to Article 46-4-7, or Article 97 (1) through (3) of the same Act as applied mutatis mutandis pursuant to Article 46-7-2 (1), has failed to state or record matters that should be stated or recorded therein, has made false statements or records, or has refused inspection or copying thereof under these provisions.
(iv) When the person has failed to give public notice as prescribed in Article 51-3 (including the cases where it is applied mutatis mutandis pursuant to Article 70-14) or has given false public notice.
(v) When the person has neglected to keep the documents pursuant to the provisions of Article 51-4, paragraph (1) (including the cases where it is applied mutatis mutandis pursuant to paragraph (4) of the same Article; the same shall apply hereinafter in this item), paragraph (2) (including the cases where it is applied mutatis mutandis by replacing the terms pursuant to paragraph (4) of the same Article (including the cases where it is applied mutatis mutandis by replacing the terms pursuant to Article 70-14; the same shall apply hereinafter in this item) and Article 70-14; the same shall apply hereinafter in this item), or paragraph (3) (including the cases where it is applied mutatis mutandis by replacing the terms pursuant to Article 51-4 (4) and Article 70-14), has failed to state the matters to be stated therein, or has made false statements, or has refused inspection thereof under Article 51-4 (1) or (2) without justifiable grounds.
(vi) When the person has failed to give a notification or has given a false notification in violation of the provisions of Article 52 (1) (including the cases where it is applied mutatis mutandis pursuant to Article 70-14) or Article 54-9 (5) (including the cases where it is applied mutatis mutandis pursuant to Article 70-18 (1)).
(vii) When the person has distributed dividends of surplus, in violation of the provisions of Article 54 (including the cases where it is applied mutatis mutandis pursuant to Article 70-14).
(viii) When the person has failed to file a petition for the commencement of bankruptcy procedures pursuant to the provisions of Article 55 (5), or Article 56-10 (1) (including the cases where these provisions are applied mutatis mutandis pursuant to Article 70-15).
(ix) When the person has failed to provide the public notice pursuant to the provisions of Article 56-8 (1), or Article 56-10 (1) (including the cases where these provisions are applied mutatis mutandis pursuant to Article 70-15), or has falsely provided such public notice.
(x) When the person has neglected to keep the documents pursuant to the provisions of Article 58-3 (2) (including the cases where it is applied mutatis mutandis pursuant to Article 59-2) or Article 60-4 (2) (including the cases where it is applied mutatis mutandis pursuant to Article 61-3), has failed to state the matters to be stated therein, or has made false statements, or has refused inspection thereof under these provisions.
(xi) When the person has conducted an absorption-type merger, consolidation-type merger, absorption-type split, or incorporation-type split in violation of the provisions of Article 58-4 (1) or (3) (including the cases where these provisions are applied mutatis mutandis pursuant to Article 59-2) or Article 60-5 (1) or (3) (including the cases where these provisions are applied mutatis mutandis pursuant to Article 61-3).
(xii) When the person has failed to report or falsely reported pursuant to the provisions of Article 63 (1) (including the cases where it is applied mutatis mutandis pursuant to Article 70-20; the same shall apply hereinafter in this item), or has refused, obstructed, or evaded inspection pursuant to the provisions of the same paragraph.
(xiii) When the person has undertaken operation, in breach of an order pursuant to the provisions of Article 64 (2) (including the cases where it is applied mutatis mutandis pursuant to Article 70-20), or Article 64-2 (1).
Article 94 A person who has violated the provisions of Article 40 or Article 70-5 (4) or (5) shall be subject to a non-criminal fine of up to 100,000 yen.