第一条この法律は、労働者又はその被扶養者の業務災害（労働者災害補償保険法（昭和二十二年法律第五十号）第七条第一項第一号に規定する業務災害をいう。）以外の疾病、負傷若しくは死亡又は出産に関して保険給付を行い、もって国民の生活の安定と福祉の向上に寄与することを目的とする。

Article 1The purpose of this Act is to provide insurance benefits for sickness, injury or death other than employment injuries (meaning employment injuries as provided for in Article 7, paragraph (1), item (i) of the Industrial Accident Compensation Insurance Act (Act No. 50 of 1947)) or childbirth of a worker or a dependent thereof, thereby contributing to the stability of lives and the improvement of welfare of the people.

第二条健康保険制度については、これが医療保険制度の基本をなすものであることにかんがみ、高齢化の進展、疾病構造の変化、社会経済情勢の変化等に対応し、その他の医療保険制度及び後期高齢者医療制度並びにこれらに密接に関連する制度と併せてその在り方に関して常に検討が加えられ、その結果に基づき、医療保険の運営の効率化、給付の内容及び費用の負担の適正化並びに国民が受ける医療の質の向上を総合的に図りつつ、実施されなければならない。

Article 2The health insurance system, in view of the fact that it is the basis for the medical insurance system, must be implemented in response to the aging of the population, changes in disease structure, changes in the socioeconomic situation, etc., by constantly examining the concept of the system in conjunction with other medical insurance systems and the medical care system for elderly persons as well as systems closely related thereto, through integrated efforts by streamlining the operation of the medical insurance, optimizing the details of benefits and sharing costs, and improving the quality of medical treatment that citizens undergo based on the results thereof.

第三条この法律において「被保険者」とは、適用事業所に使用される者及び任意継続被保険者をいう。ただし、次の各号のいずれかに該当する者は、日雇特例被保険者となる場合を除き、被保険者となることができない。

Article 3(1)The term "insured person" as used in this Act means a worker employed at an applicable place of business or an insured person with optional and continued coverage;however, a person who falls under any of the following items is ineligible to be an insured person except in the case of becoming a specially-insured day laborer:

２この法律において「日雇特例被保険者」とは、適用事業所に使用される日雇労働者をいう。ただし、後期高齢者医療の被保険者等である者又は次の各号のいずれかに該当する者として厚生労働大臣の承認を受けたものは、この限りでない。

(2)The term "specially-insured day laborer" as used in this Act means a day worker who is employed at an applicable place of business;however, this does not apply to persons with late-stage elderly medical care insurance or those approved by the Minister of Health, Labour and Welfare as a person who falls under any of the following items:

３この法律において「適用事業所」とは、次の各号のいずれかに該当する事業所をいう。

(3)The term "applicable place of business" as used in this Act means a place of business which falls under any of the following items:

４この法律において「任意継続被保険者」とは、適用事業所に使用されなくなったため、又は第一項ただし書に該当するに至ったため被保険者（日雇特例被保険者を除く。）の資格を喪失した者であって、喪失の日の前日まで継続して二月以上被保険者（日雇特例被保険者、任意継続被保険者又は共済組合の組合員である被保険者を除く。）であったもののうち、保険者に申し出て、継続して当該保険者の被保険者となった者をいう。ただし、船員保険の被保険者又は後期高齢者医療の被保険者等である者は、この限りでない。

(4)The term "insured person with optional and continued coverage" as used in this Act means a worker who lost eligibility to be insured (excluding a specially-insured day laborer) due to no longer being employed at an applicable place of business or falling under the proviso to paragraph (1), had been continuously insured for two months or longer by the day immediately before the day on which the person lost eligibility (excluding a specially-insured day laborer or an insured person who is a member of a mutual aid association), and, by submitting a request to the insurer, continues to be insured by the insurer;however, this does not apply to an insured person covered by Seamen's Insurance or a person with late-stage elderly medical care insurance.

５この法律において「報酬」とは、賃金、給料、俸給、手当、賞与その他いかなる名称であるかを問わず、労働者が、労働の対償として受けるすべてのものをいう。ただし、臨時に受けるもの及び三月を超える期間ごとに受けるものは、この限りでない。

(5)The term "remuneration" as used in this Act means the wage, salary, pay, allowance, bonus, and all other payments which the worker receives as compensation for labor under whatever name the compensation is known; however, this does not apply to extraordinary wages and wages received periodically for a period exceeding three months.

６この法律において「賞与」とは、賃金、給料、俸給、手当、賞与その他いかなる名称であるかを問わず、労働者が、労働の対償として受けるすべてのもののうち、三月を超える期間ごとに受けるものをいう。

(6)The term "bonus" as used in this Act means the wage, salary, pay, allowance, bonus, and all other payments which the worker receives as compensation for labor periodically for a period exceeding three months under whatever name the compensation is known.

７この法律において「被扶養者」とは、次に掲げる者をいう。ただし、後期高齢者医療の被保険者等である者は、この限りでない。

(7)The term "dependent" as used in this Act means the persons listed below; however, this does not apply to persons with late-stage elderly medical care insurance:

８この法律において「日雇労働者」とは、次の各号のいずれかに該当する者をいう。

(8)The term "day worker" as used in this Act means a person who falls under any of the following items:

９この法律において「賃金」とは、賃金、給料、手当、賞与その他いかなる名称であるかを問わず、日雇労働者が、労働の対償として受けるすべてのものをいう。ただし、三月を超える期間ごとに受けるものは、この限りでない。

(9)The term "wage" as used in this Act means the wage, salary, allowance, bonus, and all other payments which a day worker receives as compensation for labor under whatever name the compensation is known; however, this does not apply to wages received periodically for a period exceeding three months.

１０この法律において「共済組合」とは、法律によって組織された共済組合をいう。

(10)The term "mutual aid association" as used in this Act means a mutual aid association organized pursuant to law.

第四条健康保険（日雇特例被保険者の保険を除く。）の保険者は、全国健康保険協会及び健康保険組合とする。

Article 4The insurers providing insurance (excluding insurance for specially-insured day laborers) are Japan Health Insurance Association and health insurance societies.

第五条全国健康保険協会は、健康保険組合の組合員でない被保険者（日雇特例被保険者を除く。次節、第五十一条の二、第六十三条第三項第二号、第百五十条第一項、第百七十二条第三号、第十章及び第十一章を除き、以下本則において同じ。）の保険を管掌する。

Article 5(1)Japan Health Insurance Association administers insurance for insured persons who are not members of a health insurance society (excluding specially-insured day laborers; the same applies hereinafter in the main provisions except for the following Section, Article 51-2, Article 63, paragraph (3), item (ii), Article 150, paragraph (1), Article 172, paragraph (3), and Chapters X and XI).

２前項の規定により全国健康保険協会が管掌する健康保険の事業に関する業務のうち、被保険者の資格の取得及び喪失の確認、標準報酬月額及び標準賞与額の決定並びに保険料の徴収（任意継続被保険者に係るものを除く。）並びにこれらに附帯する業務は、厚生労働大臣が行う。

(2)Of the services relating to health insurance businesses provided by Japan Health Insurance Association pursuant to the provisions of the preceding paragraph, the confirmation of acquisition and loss of eligibility to be insured, determination of standard monthly remuneration amount and standard bonus amount, collection of insurance premiums (excluding those from insured persons with optional and continued coverage), and operations incidental to these are conducted by the Minister of Health, Labour and Welfare.

第六条健康保険組合は、その組合員である被保険者の保険を管掌する。

Article 6A health insurance society administers insurance of the insured persons who are its members.

第七条同時に二以上の事業所に使用される被保険者の保険を管掌する者は、第五条第一項及び前条の規定にかかわらず、厚生労働省令で定めるところによる。

Article 7Persons who administers insurance for insured persons who are employed at two or more places of business at the same time are specified by Order of the Ministry of Health, Labour and Welfare, notwithstanding the provisions of Article 5, paragraph (1) and the preceding Article.

第七条の二健康保険組合の組合員でない被保険者（以下この節において単に「被保険者」という。）に係る健康保険事業を行うため、全国健康保険協会（以下「協会」という。）を設ける。

Article 7-2(1)In order to provide health insurance services to insured persons who are not members of a health insurance society (hereinafter simply referred to as "insured persons"), Japan Health Insurance Association (hereinafter referred to as "JHIA") is established.

２協会は、次に掲げる業務を行う。

(2)JHIA provides the services listed below:

３協会は、前項各号に掲げる業務のほか、船員保険法の規定による船員保険事業に関する業務（同法の規定により厚生労働大臣が行うものを除く。）、高齢者の医療の確保に関する法律の規定による前期高齢者納付金等（以下「前期高齢者納付金等」という。）及び同法の規定による後期高齢者支援金等（以下「後期高齢者支援金等」という。）並びに介護保険法（平成九年法律第百二十三号）の規定による納付金（以下「介護納付金」という。）の納付に関する業務を行う。

(3)Beyond the operations listed in the items of the preceding paragraph, JHIA is responsible for operations related to Seamen's Insurance business pursuant to the provisions of the Seamen's Insurance Act (excluding those conducted by the Minister of Health, Labour and Welfare pursuant to the provisions of the same Act), and operations related to payments by persons in the early stage of elderly life, etc., pursuant to the provisions of the Act on Assurance of Medical Care for Elderly People (hereinafter referred to as "payments by the young-old"), aid allowance for persons in the later stage of elderly life, etc., pursuant to the provisions of the same Act (hereinafter referred to as "aid for the old-old"), and payments pursuant to the provisions of the Long-Term Care Insurance Act (Act No. 123 of 1997) (hereinafter referred to as "long-term care payments").

第七条の三協会は、法人とする。

Article 7-3JHIA is a corporation.

第七条の四協会は、主たる事務所を東京都に、従たる事務所（以下「支部」という。）を各都道府県に設置する。

Article 7-4(1)JHIA establishes a principal office in Tokyo and secondary offices (hereinafter referred to as "branches") in each prefecture.

２協会の住所は、その主たる事務所の所在地にあるものとする。

(2)JHIA's address is the location of its principal office.

第七条の五協会の資本金は、健康保険法等の一部を改正する法律（平成十八年法律第八十三号。以下「改正法」という。）附則第十八条第二項の規定により政府から出資があったものとされた金額とする。

Article 7-5The stated capital of JHIA is the amount contributed by the government pursuant to the provisions of Article 18, paragraph (2) of the Supplementary Provisions of the Act Partially Amending the Health Insurance Act, etc. (Act No. 83 of 2006; hereinafter referred to as "Amending Act").

第七条の六協会は、定款をもって、次に掲げる事項を定めなければならない。

Article 7-6(1)JHIA must specify the particulars listed below in its articles of incorporation:

２前項の定款の変更（厚生労働省令で定める事項に係るものを除く。）は、厚生労働大臣の認可を受けなければ、その効力を生じない。

(2)No alternation to the articles of incorporation referred to in the preceding paragraph (except those pertaining to matters specified by Order of the Ministry of Health, Labour and Welfare) is effected without authorization by the Minister of Health, Labour and Welfare.

３協会は、前項の厚生労働省令で定める事項に係る定款の変更をしたときは、遅滞なく、これを厚生労働大臣に届け出なければならない。

(3)When JHIA makes any amendment to the articles of incorporation with regard to matters specified by Order of the Ministry of Health, Labour and Welfare referred to in the preceding paragraph, it must notify the Minister of Health, Labour and Welfare of the amendment without delay.

４協会は、定款の変更について第二項の認可を受けたとき、又は同項の厚生労働省令で定める事項に係る定款の変更をしたときは、遅滞なく、これを公告しなければならない。

(4)When JHIA is authorized for an amendment to the articles of incorporation referred to in paragraph (2) or makes any amendment to the articles of incorporation with regard to matters specified by Order of the Ministry of Health, Labour and Welfare referred to in the same paragraph, it must give publicly notice of the amendment without delay.

第七条の七協会は、政令で定めるところにより、登記しなければならない。

Article 7-7(1)JHIA must complete its registration as specified by Cabinet Order.

２前項の規定により登記しなければならない事項は、登記の後でなければ、これをもって第三者に対抗することができない。

(2)The matters that must be registered pursuant to the provisions of the preceding paragraph cannot be asserted against a third party until after they are registered.

第七条の八協会でない者は、全国健康保険協会という名称を用いてはならない。

Article 7-8No person other than JHIA may use the name "Japan Health Insurance Association".

第七条の九協会に、役員として、理事長一人、理事六人以内及び監事二人を置く。

Article 7-9JHIA has one president, not more than six directors, and two auditors as its officers.

第七条の十理事長は、協会を代表し、その業務を執行する。

Article 7-10(1)The president of JHIA represents JHIA and executes its operations.

２理事長に事故があるとき、又は理事長が欠けたときは、理事のうちから、あらかじめ理事長が指定する者がその職務を代理し、又はその職務を行う。

(2)If the president is incapacitated or the position of president is vacant, another director appointed by the president in advance represents the president or performs the president's duties.

３理事は、理事長の定めるところにより、理事長を補佐して、協会の業務を執行することができる。

(3)The directors may assist the president in executing the operations of JHIA as determined by the president.

４監事は、協会の業務の執行及び財務の状況を監査する。

(4)An auditor audits the execution of business and the financial status of JHIA.

第七条の十一理事長及び監事は、厚生労働大臣が任命する。

Article 7-11(1)The president and auditors are appointed by the Minister of Health, Labour and Welfare.

２厚生労働大臣は、前項の規定により理事長を任命しようとするときは、あらかじめ、第七条の十八第一項に規定する運営委員会の意見を聴かなければならない。

(2)The Minister of Health, Labour and Welfare, when intending to appoint the president pursuant to the provisions of the preceding paragraph, must hear the opinions of the Management Board in advance as provided for by Article 7-18, paragraph (1).

３理事は、理事長が任命する。

(3)The directors are appointed by the president.

４理事長は、前項の規定により理事を任命したときは、遅滞なく、厚生労働大臣に届け出るとともに、これを公表しなければならない。

(4)When the president appoints a director pursuant to the provisions of the preceding paragraph, the president must notify the Minister of Health, Labour and Welfare of the appointment and publicize it without delay.

第七条の十二役員の任期は三年とする。ただし、補欠の役員の任期は、前任者の残任期間とする。

Article 7-12(1)The term of office for an officer is three years;however, the term for a substitute officer is the remaining term of the predecessor.

２役員は、再任されることができる。

(2)An officer may be reappointed.

第七条の十三政府又は地方公共団体の職員（非常勤の者を除く。）は、役員となることができない。

Article 7-13A government official or an official of a local public entity (excluding a part-time official) is ineligible to be an officer.

第七条の十四厚生労働大臣又は理事長は、それぞれその任命に係る役員が前条の規定により役員となることができない者に該当するに至ったときは、その役員を解任しなければならない。

Article 7-14(1)When an officer appointed by the Minister of Health, Labour and Welfare or the president becomes a person who is ineligible to be an officer pursuant to the provisions of the preceding Article, the Minister of Health, Labour and Welfare or the president, respectively, must dismiss the officer.

２厚生労働大臣又は理事長は、それぞれその任命に係る役員が次の各号のいずれかに該当するとき、その他役員たるに適しないと認めるときは、その役員を解任することができる。

(2)If an officer appointed by the Minister of Health, Labour and Welfare or the president falls under any of the following items or is otherwise found to be unfit to serve as an officer, the minister or the president, respectively, may dismiss the officer:

３理事長は、前項の規定により理事を解任したときは、遅滞なく、厚生労働大臣に届け出るとともに、これを公表しなければならない。

(3)If the president dismisses a director pursuant to the provisions of the preceding paragraph, the president must notify the Minister of Health, Labour and Welfare of the dismissal and publicize it without delay.

第七条の十五役員（非常勤の者を除く。）は、営利を目的とする団体の役員となり、又は自ら営利事業に従事してはならない。ただし、厚生労働大臣の承認を受けたときは、この限りでない。

Article 7-15An officer (excluding a part-time officer) must not serve as an officer of an organization for profit or engage in a business for profit independently;however, this does not apply if the officer obtains approval from the Minister of Health, Labour and Welfare.

第七条の十六協会と理事長又は理事との利益が相反する事項については、これらの者は、代表権を有しない。この場合には、監事が協会を代表する。

Article 7-16Regarding any matter in which the president or the director has a conflict of interest with the JHIA, the president or the director have no authority of representation. In this case, an auditor represents JHIA.

第七条の十七理事長は、理事又は職員のうちから、協会の業務の一部に関し一切の裁判上又は裁判外の行為をする権限を有する代理人を選任することができる。

Article 7-17The president may appoint an agent from among the directors or employees and authorize the agent to conduct all judicial or extra-judicial acts concerning a part of the operations of JHIA.

第七条の十八事業主（被保険者を使用する適用事業所の事業主をいう。以下この節において同じ。）及び被保険者の意見を反映させ、協会の業務の適正な運営を図るため、協会に運営委員会を置く。

Article 7-18(1)In order to reflect opinions of employers (meaning employers of an applicable place of business at which insured persons are employed; the same applies hereinafter in this section) and insured persons, and to ensure that JHIA's operations are appropriate, JHIA has a management board.

２運営委員会の委員は、九人以内とし、事業主、被保険者及び協会の業務の適正な運営に必要な学識経験を有する者のうちから、厚生労働大臣が各同数を任命する。

(2)The management board has nine or less members who are appointed by the Minister of Health, Labor and Welfare from among employers, insured persons, and persons with relevant knowledge and experience for properly operating JHIA.

３前項の委員の任期は、二年とする。

(3)The term of the members in the preceding paragraph is two years.

４第七条の十二第一項ただし書及び第二項の規定は、運営委員会の委員について準用する。

(4)The proviso to Article 7-12, paragraph (1) and the provisions of paragraph (2) of the same Article apply mutatis mutandis to members of the management board.

第七条の十九次に掲げる事項については、理事長は、あらかじめ、運営委員会の議を経なければならない。

Article 7-19(1)With regard to the particulars listed below, the president must obtain a resolution at the management board in advance:

２前項に規定する事項のほか、運営委員会は、理事長の諮問に応じ、又は必要と認める事項について、理事長に建議することができる。

(2)Beyond the matters prescribed in the preceding paragraph, the management board may consult with the president and make proposals to the president when it finds it necessary.

３前二項に定めるもののほか、運営委員会の組織及び運営に関し必要な事項は、厚生労働省令で定める。

(3)Beyond the matters covered by the preceding two paragraphs, other matters relating to the organization and operation of the management board are specified by Order of the Ministry of Health, Labour and Welfare.

第七条の二十運営委員会の委員は、刑法（明治四十年法律第四十五号）その他の罰則の適用については、法令により公務に従事する職員とみなす。

Article 7-20A member of the management board is deemed to be an official engaged in public service under acts and regulations, with respect to the application of the Penal Code (Act No. 45 of 1907) and other penal provisions.

第七条の二十一協会は、都道府県ごとの実情に応じた業務の適正な運営に資するため、支部ごとに評議会を設け、当該支部における業務の実施について、評議会の意見を聴くものとする。

Article 7-21(1)In order to contribute to proper operations that meet prefectural demands, JHIA establishes a council for each branch and hears the opinions of each council about the operation status at its branch.

２評議会の評議員は、定款で定めるところにより、当該評議会が設けられる支部の都道府県に所在する適用事業所（第三十四条第一項に規定する一の適用事業所を含む。以下同じ。）の事業主及び被保険者並びに当該支部における業務の適正な実施に必要な学識経験を有する者のうちから、支部の長（以下「支部長」という。）が委嘱する。

(2)The council members are commissioned by the head of their branch (hereinafter referred to as "branch head") pursuant to the articles of incorporation from among employers and insured persons at an applicable place of business (including an applicable place of business prescribed in Article 34, paragraph (1); the same applies hereinafter) located in the prefecture in which the council is established as well as persons with relevant knowledge and experience for properly operating the branch.

第七条の二十二協会は、業務を執行するために必要な事項で厚生労働省令で定めるものについて、運営規則を定めるものとする。

Article 7-22(1)JHIA is to determine operation rules with regard to matters necessary for the execution of duties specified by Order of the Ministry of Health, Labour and Welfare.

２理事長は、運営規則を変更しようとするときは、あらかじめ、厚生労働大臣に届け出なければならない。

(2)The president, when intending to make a change to the operation rules, must notify the Minister of Health, Labour and Welfare in advance.

第七条の二十三協会の職員は、理事長が任命する。

Article 7-23JHIA's employees are appointed by the president.

第七条の二十四第七条の二十の規定は、協会の役員及び職員について準用する。

Article 7-24The provisions of Article 7-20 apply mutatis mutandis to JHIA's officers and officials.

第七条の二十五協会の事業年度は、毎年四月一日に始まり、翌年三月三十一日に終わる。

Article 7-25JHIA's business year begins on April 1 each year and ends on March 31 of the following year.

第七条の二十六協会の会計は、厚生労働省令で定めるところにより、原則として企業会計原則によるものとする。

Article 7-26JHIA's accounting is to be conducted pursuant to corporate accounting principles, as a general rule, pursuant to Order of the Ministry of Health, Labour and Welfare.

第七条の二十七協会は、毎事業年度、事業計画及び予算を作成し、当該事業年度開始前に、厚生労働大臣の認可を受けなければならない。これを変更しようとするときも、同様とする。

Article 7-27JHIA must prepare a business plan and budget for every business year and obtain authorization from the Minister of Health, Labour, and Welfare prior to the beginning of the relevant business year. The same applies when JHIA intends to make a change to the business plan or budget.

第七条の二十八協会は、毎事業年度の決算を翌事業年度の五月三十一日までに完結しなければならない。

Article 7-28(1)JHIA must complete the settlement for each business year by May 31 in the following business year.

２協会は、毎事業年度、貸借対照表、損益計算書、利益の処分又は損失の処理に関する書類その他厚生労働省令で定める書類及びこれらの附属明細書（以下「財務諸表」という。）を作成し、これに当該事業年度の事業報告書及び決算報告書（以下この条及び第二百十七条の二第四号において「事業報告書等」という。）を添え、監事及び次条第二項の規定により選任された会計監査人の意見を付けて、決算完結後二月以内に厚生労働大臣に提出し、その承認を受けなければならない。

(2)For each business year, JHIA must prepare a balance sheet, a profit and loss statement, documents concerning the appropriation of profits and the disposal of losses, other documents specified by Order of the Minister of Health, Labour and Welfare, and any annex statements thereof (hereinafter collectively referred to as "financial statements"), accompanied by the business report and statement of accounts for the relevant business year (referred to as "business reports" hereinafter in this Article and Article 217-2, item (iv)) and with statements by the auditor and the accounting auditor selected pursuant to the provisions of paragraph (2) of the following Article attached, and submit them to the Minister of Health, Labour and Welfare within two months after completion of the settlement to obtain approval from the minister.

３財務諸表及び事業報告書等には、支部ごとの財務及び事業の状況を示すために必要な事項として厚生労働省令で定めるものを記載しなければならない。

(3)Financial statements and business reports must contain required information to show the financial and business status of each branch as specified by Order of the Ministry of Health, Labour and Welfare.

４協会は、第二項の規定による厚生労働大臣の承認を受けたときは、遅滞なく、財務諸表を官報に公告し、かつ、財務諸表及び事業報告書等並びに同項の監事及び会計監査人の意見を記載した書面を、各事務所に備えて置き、厚生労働省令で定める期間、一般の閲覧に供しなければならない。

(4)When JHIA obtains the approval from the Minister of Health, Labour, and Welfare pursuant to the provisions of paragraph (2), it must provide public notice of the financial statements published in an official gazette without delay, maintain those financial statements and business reports as well as written statements by the auditor and accounting auditor referred to in the same paragraph at each office, and provide public access to them for a period specified by Order of the Ministry of Health, Labour, and Welfare.

第七条の二十九協会は、財務諸表、事業報告書（会計に関する部分に限る。）及び決算報告書について、監事の監査のほか、会計監査人の監査を受けなければならない。

Article 7-29(1)JHIA must be audited by an accounting auditor, beyond being audited by an auditor, with regard to the financial statements, the business report (limited to the portion related to accounting), and the statement of accounts.

２会計監査人は、厚生労働大臣が選任する。

(2)An accounting auditor is appointed by the Minister of Health, Labour and Welfare.

３会計監査人は、公認会計士（公認会計士法（昭和二十三年法律第百三号）第十六条の二第五項に規定する外国公認会計士を含む。）又は監査法人でなければならない。

(3)An accounting auditor must be a certified public accountant (including a foreign certified public accountant provided for in Article 16-2, paragraph (5) of the Certified Public Accountants Act (Act No. 103 of 1948)) or auditing corporation.

４公認会計士法の規定により、財務諸表について監査をすることができない者は、会計監査人となることができない。

(4)A person who is ineligible to audit financial statements pursuant to the provisions of the Certified Public Accountant Act is ineligible to become an accounting auditor.

５会計監査人の任期は、その選任の日以後最初に終了する事業年度の財務諸表についての厚生労働大臣の前条第二項の承認の時までとする。

(5)The term of office of an accounting auditor is until the Minister of Health, Labour and Welfare gives approval under paragraph (2) of the preceding Article for financial statements for the first business year that ends after the date of the appointment.

６厚生労働大臣は、会計監査人が次の各号のいずれかに該当するときは、その会計監査人を解任することができる。

(6)If an accounting auditor falls under any of the following items, the Minister of Health, Labour and Welfare may dismiss the accounting auditor:

第七条の三十厚生労働大臣は、協会の事業年度ごとの業績について、評価を行わなければならない。

Article 7-30(1)The Minister of Health, Labour and Welfare must evaluate JHIA's operational performance in each business year.

２厚生労働大臣は、前項の評価を行ったときは、遅滞なく、協会に対し、当該評価の結果を通知するとともに、これを公表しなければならない。

(2)When the Minister of Health, Labour and Welfare conducts the evaluation referred to in the preceding paragraph, the Minister must give notice of the results to JHIA and provide public notice thereof without delay.

第七条の三十一協会は、その業務に要する費用に充てるため必要な場合において、厚生労働大臣の認可を受けて、短期借入金をすることができる。

Article 7-31(1)JHIA may incur short-term debt with authorization from the Minister of Health, Labour and Welfare if it is necessary for the allocation of expenses for its operations.

２前項の規定による短期借入金は、当該事業年度内に償還しなければならない。ただし、資金の不足のため償還することができないときは、その償還することができない金額に限り、厚生労働大臣の認可を受けて、これを借り換えることができる。

(2)Short-term debt pursuant to the provisions of the preceding paragraph must be repaid within the relevant business year; provided, however that if the short-term debt fails to be repaid due to a lack of funds, only the amount of funds lacking may be refinanced, after obtaining authorization from the Minister of Health, Labour, and Welfare.

３前項ただし書の規定により借り換えた短期借入金は、一年以内に償還しなければならない。

(3)Short-term debt that is refinanced pursuant to the proviso to the preceding paragraph must be repaid within one year.

第七条の三十二政府は、法人に対する政府の財政援助の制限に関する法律（昭和二十一年法律第二十四号）第三条の規定にかかわらず、国会の議決を経た金額の範囲内で、その業務の円滑な運営に必要があると認めるときは、前条の規定による協会の短期借入金に係る債務について、必要と認められる期間の範囲において、保証することができる。

Article 7-32Notwithstanding the provisions of Article 3 of the Act on Limitations of Government Financial Assistance to Corporations (Act No. 24 of 1946), when the national government determines it necessary for the smooth operation of its services, it may provide guarantees within the limit of an amount approved by the Diet and within the period determined to be necessary with regard to liabilities pertaining to short-term debt incurred by JHIA pursuant to the provisions of the preceding Article.

第七条の三十三協会の業務上の余裕金の運用は、政令で定めるところにより、事業の目的及び資金の性質に応じ、安全かつ効率的にしなければならない。

Article 7-33JHIA's operational surplus funds must be safely and efficiently operated according to the purpose and nature of the funds as specified by Cabinet Order.

第七条の三十四協会は、厚生労働省令で定める重要な財産を譲渡し、又は担保に供しようとするときは、厚生労働大臣の認可を受けなければならない。

Article 7-34When intending to transfer or provide as collateral important property specified by Order of the Ministry of Health, Labour and Welfare, JHIA must obtain authorization from the Minister of Health, Labour and Welfare.

第七条の三十五協会の役員に対する報酬及び退職手当は、その役員の業績が考慮されるものでなければならない。

Article 7-35(1)The remuneration and retirement allowance for JHIA's officers must take into consideration the officers' performance.

２協会は、その役員に対する報酬及び退職手当の支給の基準を定め、これを厚生労働大臣に届け出るとともに、公表しなければならない。これを変更したときも、同様とする。

(2)JHIA must specify standards for the payment of the remuneration and retirement allowance for its officers, notify the Minister of Health, Labour and Welfare of the standards, and publicize them. The same applies when JHIA revises the standards.

第七条の三十六協会の職員の給与は、その職員の勤務成績が考慮されるものでなければならない。

Article 7-36(1)The salaries of JHIA's employees must take into consideration the employees' work performance.

２協会は、その職員の給与及び退職手当の支給の基準を定め、これを厚生労働大臣に届け出るとともに、公表しなければならない。これを変更したときも、同様とする。

(2)JHIA must specify standards for the payment of salaries and retirement allowance for its employees, notify the Minister of Health, Labour and Welfare of the standards, and publicize them. The same applies when JHIA revises the standards.

第七条の三十七協会の役員若しくは職員又はこれらの職にあった者は、健康保険事業に関して職務上知り得た秘密を正当な理由がなく漏らしてはならない。

Article 7-37(1)A current or former officer or official of JHIA must not divulge confidential information concerning the health insurance business learned in the course of duty without justifiable reasons.

２前項の規定は、協会の運営委員会の委員又は委員であった者について準用する。

(2)The provisions of the preceding paragraph apply mutatis mutandis to a person who is, or has been, a member of JHIA's management board.

第七条の三十八厚生労働大臣は、協会について、必要があると認めるときは、その事業及び財産の状況に関する報告を徴し、又は当該職員をして協会の事務所に立ち入って関係者に質問させ、若しくは実地にその状況を検査させることができる。

Article 7-38(1)When the Minister of Health, Labour and Welfare finds it necessary in relation to JHIA, the Minister may collect reports on the status of its business or property, or have the ministry's officials enter JHIA's office to ask persons concerned questions or to inspect that status.

２前項の規定によって質問又は検査を行う当該職員は、その身分を示す証明書を携帯し、かつ、関係者の請求があるときは、これを提示しなければならない。

(2)The relevant official who asks questions or conducts inspections pursuant to the provisions of the preceding paragraph must carry an identification card and present it at the request of any person concerned.

３第一項の規定による権限は、犯罪捜査のために認められたものと解釈してはならない。

(3)The authority under paragraph (1) must not be construed as being granted for criminal investigation.

第七条の三十九厚生労働大臣は、協会の事業若しくは財産の管理若しくは執行が法令、定款若しくは厚生労働大臣の処分に違反していると認めるとき、確保すべき収入を不当に確保せず、不当に経費を支出し、若しくは不当に財産を処分し、その他協会の事業若しくは財産の管理若しくは執行が著しく適正を欠くと認めるとき、又は協会の役員がその事業若しくは財産の管理若しくは執行を明らかに怠っていると認めるときは、期間を定めて、協会又はその役員に対し、その事業若しくは財産の管理若しくは執行について違反の是正又は改善のため必要な措置を採るべき旨を命ずることができる。

Article 7-39(1)If the Minister of Health, Labour and Welfare finds that JHIA's management or execution of its business or assets violates any law or regulation, its articles of incorporation, or any disposition of the Minister of Health, Labour and Welfare, or that JHIA has unjustly failed to secure income that it should have secured, has unjustly incurred expenses, has unjustly disposed of its assets or has otherwise significantly failed to appropriately manage or execute its business or assets, or that the officers of JHIA have evidently failed to manage or execute its business or assets, then the Minister may order JHIA or its officers to take measures necessary to rectify the violation or improve the management or performance of its business or assets within a specified period.

２協会又はその役員が前項の命令に違反したときは、厚生労働大臣は、協会に対し、期間を定めて、当該違反に係る役員の全部又は一部の解任を命ずることができる。

(2)If JHIA or its officers violate an order referred to in the preceding paragraph, the Minister of Health, Labour and Welfare may order JHIA to dismiss all or some of its officers involved in the violation after a certain period.

３協会が前項の命令に違反したときは、厚生労働大臣は、同項の命令に係る役員を解任することができる。

(3)If JHIA violates an order referred to in the preceding paragraph, the Minister of Health, Labour and Welfare may dismiss the officers to which the order pertained.

第七条の四十協会の解散については、別に法律で定める。

Article 7-40The rules for the dissolution of JHIA are provided separately by law.

第七条の四十一この法律及びこの法律に基づく政令に規定するもののほか、協会の財務及び会計その他協会に関し必要な事項は、厚生労働省令で定める。

Article 7-41Beyond what is provided for in this Act and any Cabinet Order based on this Act, matters concerning the finance and accounting of JHIA, and other necessary matters are specified by Order of the Ministry of Health, Labour and Welfare.

第七条の四十二厚生労働大臣は、次の場合には、あらかじめ、財務大臣に協議しなければならない。

Article 7-42The Minister of Health, Labour, and Welfare must consult with the Minister of Finance in advance, in the following cases:

第八条健康保険組合は、適用事業所の事業主、その適用事業所に使用される被保険者及び任意継続被保険者をもって組織する。

Article 8A health insurance society is composed of employers of applicable places of business, insured persons employed at the applicable places of business, and insured persons with optional and continued coverage.

第九条健康保険組合は、法人とする。

Article 9(1)A health insurance society is a corporation.

２健康保険組合の住所は、その主たる事務所の所在地にあるものとする。

(2)The address of a health insurance society is at the location of its principal office.

第十条健康保険組合は、その名称中に健康保険組合という文字を用いなければならない。

Article 10(1)A health insurance society must use the characters "健康保険組合" (pronounced "kenko hoken kumiai" and literally meaning "health insurance society") in its name.

２健康保険組合でない者は、健康保険組合という名称を用いてはならない。

(2)No person other than a health insurance society may use the name "健康保険組合".

第十一条一又は二以上の適用事業所について常時政令で定める数以上の被保険者を使用する事業主は、当該一又は二以上の適用事業所について、健康保険組合を設立することができる。

Article 11(1)An employer who has one or more applicable places of business regularly employing a total number of insured persons equal to or above a figure specified by Cabinet Order may establish a health insurance society for those applicable places of business.

２適用事業所の事業主は、共同して健康保険組合を設立することができる。この場合において、被保険者の数は、合算して常時政令で定める数以上でなければならない。

(2)Employers of applicable places of business may jointly establish a health insurance society.In this case, the total number of insured persons must always be no less than the number specified by Cabinet Order.

第十二条適用事業所の事業主は、健康保険組合を設立しようとするときは、健康保険組合を設立しようとする適用事業所に使用される被保険者の二分の一以上の同意を得て、規約を作り、厚生労働大臣の認可を受けなければならない。

Article 12(1)When intending to establish a health insurance society, the employer of an applicable place of business must prepare a constitution with the consent of half or more of the insured persons employed at the applicable place of business for which the health insurance society is to be established, and obtain authorization from the Minister of Health, Labour and Welfare.

２二以上の適用事業所について健康保険組合を設立しようとする場合においては、前項の同意は、各適用事業所について得なければならない。

(2)When intending to establish a health insurance society for two or more applicable places of business, the consent in the preceding paragraph must be obtained for each of those places of business.

第十三条第三十一条第一項の規定による認可の申請と同時に健康保険組合の設立の認可の申請を行う場合にあっては、前二条中「適用事業所」とあるのは「適用事業所となるべき事業所」と、「被保険者」とあるのは「被保険者となるべき者」とする。

Article 13If an application for the establishment of a health insurance society is submitted at the same time as an application pursuant to the provisions of Article 31, paragraph (1), the phrase "applicable place of business" in the preceding two Articles is replaced with "place that will be an applicable place of business" and "insured persons" with "persons to be insured".

第十四条厚生労働大臣は、一又は二以上の適用事業所（第三十一条第一項の規定によるものを除く。）について常時政令で定める数以上の被保険者を使用する事業主に対し、健康保険組合の設立を命ずることができる。

Article 14(1)The Minister of Health, Labour and Welfare may order an employer who has one or more applicable places of business (excluding those pursuant to Article 31, paragraph (1)) regularly employing a total number of insured persons equal to or above the figure specified by Cabinet Order to establish a health insurance society.

２前項の規定により健康保険組合の設立を命ぜられた事業主は、規約を作り、その設立について厚生労働大臣の認可を受けなければならない。

(2)An employer who has been ordered to establish a health insurance society pursuant to the provisions of the preceding paragraph must prepare a constitution for the society and obtain authorization from the Minister of Health, Labour and Welfare for the establishment.

第十五条健康保険組合は、設立の認可を受けた時に成立する。

Article 15A health insurance society is incorporated when it receives authorization for its establishment.

第十六条健康保険組合は、規約において、次に掲げる事項を定めなければならない。

Article 16(1)A health insurance society must specify the particulars listed below in its constitution:

２前項の規約の変更（厚生労働省令で定める事項に係るものを除く。）は、厚生労働大臣の認可を受けなければ、その効力を生じない。

(2)No change to the health insurance society's constitution referred to in the preceding paragraph (except those pertaining to matters specified by Order of the Ministry of Health, Labour and Welfare) has effect without the authorization of the Minister of Health, Labour and Welfare.

３健康保険組合は、前項の厚生労働省令で定める事項に係る規約の変更をしたときは、遅滞なく、これを厚生労働大臣に届け出なければならない。

(3)If a health insurance society makes an amendment to its constitution with regard to matters specified by Order of the Ministry of Health, Labour and Welfare referred to in paragraph (1), it must notify the Minister of Health, Labour and Welfare of the amendment without delay.

第十七条健康保険組合が設立された適用事業所（以下「設立事業所」という。）の事業主及びその設立事業所に使用される被保険者は、当該健康保険組合の組合員とする。

Article 17(1)The employer of an applicable place of business for which a health insurance society is established (hereinafter referred to as the "establishment") and insured persons who are employed at the establishment are members of the health insurance society.

２前項の被保険者は、当該設立事業所に使用されなくなったときであっても、任意継続被保険者であるときは、なお当該健康保険組合の組合員とする。

(2)An insured person referred to in the preceding paragraph who has optional and continued coverage is a member of the health insurance society even if the person is no longer employed at the establishment.

第十八条健康保険組合に、組合会を置く。

Article 18(1)A health insurance society has society meetings.

２組合会は、組合会議員をもって組織する。

(2)A society meeting is comprised of society meeting members.

３組合会議員の定数は、偶数とし、その半数は、設立事業所の事業主において設立事業所の事業主（その代理人を含む。）及び設立事業所に使用される者のうちから選定し、他の半数は、被保険者である組合員において互選する。

(3)The fixed number of society meeting members is an even number; half of the members are selected from among employers of establishments (including their agents) and workers employed at establishments, and the other half are elected by vote from among society members who are insured persons.

第十九条次に掲げる事項は、組合会の議決を経なければならない。

Article 19The matters listed below must be determined by a society meeting:

第二十条組合会は、健康保険組合の事務に関する書類を検査し、理事若しくは監事の報告を請求し、又は事務の管理、議決の執行若しくは出納を検査することができる。

Article 20(1)A society meeting may inspect documents concerning the health insurance society's affairs, request reports from directors or auditors, or inspect the management of affairs, execution of decisions, or revenue and expenditure of the society.

２組合会は、組合会議員のうちから選任した者に、前項の組合会の権限に属する事項を行わせることができる。

(2)A society meeting may have a person appointed from among the society meeting members carry out any of the matters under the authority of the society meeting as referred to in the preceding paragraph.

第二十一条健康保険組合に、役員として理事及び監事を置く。

Article 21(1)A health insurance society has directors and auditors as its officers.

２理事の定数は、偶数とし、その半数は設立事業所の事業主の選定した組合会議員において、他の半数は被保険者である組合員の互選した組合会議員において、それぞれ互選する。

(2)The fixed number of directors is an even number; half of them are elected by votes cast by society meeting members selected by the employer of the establishment, and the other half are elected by votes cast by the society meeting members elected by vote from among society members who are insured persons.

３理事のうち一人を理事長とし、設立事業所の事業主の選定した組合会議員である理事のうちから、理事が選挙する。

(3)The president is elected by the directors from among the directors who are society meeting members selected by the employer of the establishment.

４監事は、組合会において、設立事業所の事業主の選定した組合会議員及び被保険者である組合員の互選した組合会議員のうちから、それぞれ一人を選挙する。

(4)At a society meeting, one auditor is elected by votes from among the society meeting members selected by the employers of the establishment, and the other auditor is elected from among society meeting members elected by vote from among society members who are insured persons.

５監事は、理事又は健康保険組合の職員と兼ねることができない。

(5)An auditor may not act concurrently as a director or official of a health insurance society.

第二十二条理事長は、健康保険組合を代表し、その業務を執行する。理事長に事故があるとき、又は理事長が欠けたときは、設立事業所の事業主の選定した組合会議員である理事のうちから、あらかじめ理事長が指定する者がその職務を代理し、又はその職務を行う。

Article 22(1)The president of a health insurance society represents the health insurance society and executes its operations. If the president is incapacitated or the position of president is vacant, another director who is a society meeting member selected by the employer of the establishment and appointed by the president in advance represents or performs the president's duties.

２健康保険組合の業務は、規約に別段の定めがある場合を除くほか、理事の過半数により決し、可否同数のときは、理事長の決するところによる。

(2)Unless otherwise specified in the constitution, the operations of the health insurance society are determined by the majority of the directors, and by the president in the event of a tie.

３理事は、理事長の定めるところにより、理事長を補佐して、健康保険組合の業務を執行することができる。

(3)The directors may assist the president in executing the operations of the health insurance society as determined by the president.

４監事は、健康保険組合の業務の執行及び財産の状況を監査する。

(4)An auditor audits the execution of business and the status of the property of the health insurance society.

第二十二条の二第七条の三十七第一項の規定は、健康保険組合の役員及び職員について準用する。

Article 22-2The provisions of Article 7-37, paragraph (1) apply mutatis mutandis to officers and officials of the health insurance societies.

第二十三条健康保険組合は、合併しようとするときは、組合会において組合会議員の定数の四分の三以上の多数により議決し、厚生労働大臣の認可を受けなければならない。

Article 23(1)A merger of a health insurance society must be adopted through a resolution by a three-quarter majority of the fixed number of society meeting members in a society meeting and authorization therefore must be obtained from the Minister of Health, Labour and Welfare.

２合併によって健康保険組合を設立するには、各健康保険組合がそれぞれ組合会において役員又は組合会議員のうちから選任した設立委員が共同して規約を作り、その他設立に必要な行為をしなければならない。

(2)In order to establish a health insurance society by a merger, committee members selected by each health insurance society to be merged from among officers or society meeting members in each of the society meetings must jointly prepare the constitution and take other actions necessary for the establishment.

３合併により設立された健康保険組合又は合併後存続する健康保険組合は、合併により消滅した健康保険組合の権利義務を承継する。

(3)A health insurance society established by a merger or that remains after a merger succeeds to the rights and obligations of a health insurance society extinguished due to the merger.

第二十四条健康保険組合は、分割しようとするときは、組合会において組合会議員の定数の四分の三以上の多数により議決し、厚生労働大臣の認可を受けなければならない。

Article 24(1)Any split of a health insurance society must be adopted through a resolution by a three-quarter majority of the fixed number of society meeting members in a society meeting and authorization therefor must be obtained from the Minister of Health, Labour and Welfare.

２健康保険組合の分割は、設立事業所の一部について行うことはできない。

(2)A split of a health insurance society cannot be applied to a part of an establishment.

３分割を行う場合においては、分割により設立される健康保険組合の組合員となるべき被保険者又は分割後存続する健康保険組合の組合員である被保険者の数が、第十一条第一項（健康保険組合を共同して設立している場合にあっては、同条第二項）の政令で定める数以上でなければならない。

(3)In performing a split, the number of insured persons who are to be society members of a health insurance society established by the split or insured persons who are society members of a health insurance society that remains after the split must be no less than the number specified by Cabinet Order under Article 11, paragraph (1) (paragraph (2) of the same Article if the health insurance society is jointly established).

４分割によって健康保険組合を設立するには、分割により設立される健康保険組合の設立事業所となるべき適用事業所の事業主が規約を作り、その他設立に必要な行為をしなければならない。

(4)In order to establish a health insurance society by a split, employers of applicable places of business that are to be an establishment must prepare the constitution and take other actions necessary for the establishment.

５分割により設立された健康保険組合は、分割により消滅した健康保険組合又は分割後存続する健康保険組合の権利義務の一部を承継する。

(5)A health insurance society established by a split succeeds to some of the rights and obligations of a health insurance society extinguished due to the split or of a health insurance society that remains after the split.

６前項の規定により承継する権利義務の限度は、分割の議決とともに議決し、厚生労働大臣の認可を受けなければならない。

(6)The limit to the rights and obligations succeeded to pursuant to the provisions of the preceding paragraph must be decided as a part of the resolution on the split and authorization therefor must be obtained from the Minister of Health, Labour and Welfare.

第二十五条健康保険組合がその設立事業所を増加させ、又は減少させようとするときは、その増加又は減少に係る適用事業所の事業主の全部及びその適用事業所に使用される被保険者の二分の一以上の同意を得なければならない。

Article 25(1)When intending to increase or decrease its number of establishments, a health insurance society must obtain consent from all employers of applicable places of business to which the increase or decrease pertains and from half or more of the insured persons employed at the applicable places of business.

２第三十一条第一項の規定による認可の申請があった事業所に係る設立事業所の増加に関する規約の変更の認可の申請を行う場合にあっては、前項中「被保険者」とあるのは、「被保険者となるべき者」とする。

(2)In the case of an application to make changes to the constitution relating to an increase in the number of establishments of a health insurance society which has applied for the authorization pursuant to the provisions of Article 31, paragraph (1), the phrase "insured persons" in the preceding paragraph is replaced with "persons to be insured".

３第一項の規定により健康保険組合が設立事業所を減少させるときは、健康保険組合の被保険者である組合員の数が、設立事業所を減少させた後においても、第十一条第一項（健康保険組合を共同して設立している場合にあっては、同条第二項）の政令で定める数以上でなければならない。

(3)When a health insurance society decreases its number of establishments pursuant to the provisions of paragraph (1), the number of members who are insured persons of the health insurance society must be no less than the number specified by Cabinet Order under Article 11, paragraph (1) (paragraph (2) of the same Article if the health insurance society is jointly established) even after the number of establishments has been decreased.

４第十二条第二項の規定は、第一項の被保険者の同意を得る場合について準用する。

(4)The provisions of Article 12, paragraph (2) apply mutatis mutandis when consent from insured persons is obtained under paragraph (1).

第二十六条健康保険組合は、次に掲げる理由により解散する。

Article 26(1)A health insurance society is dissolved for any of the reasons listed below:

２健康保険組合は、前項第一号又は第二号に掲げる理由により解散しようとするときは、厚生労働大臣の認可を受けなければならない。

(2)Authorization must be obtained from the Minister of Health, Labour and Welfare for the dissolution of a health insurance society for a reason listed in item (i) or (ii) of the preceding paragraph.

３健康保険組合が解散する場合において、その財産をもって債務を完済することができないときは、当該健康保険組合は、設立事業所の事業主に対し、政令で定めるところにより、当該債務を完済するために要する費用の全部又は一部を負担することを求めることができる。

(3)If a health insurance society is dissolved and it is unable to pay its debts in full with its property, the health insurance society may request the employers of the establishments to bear all or part of the expenses required to pay its debts in full as specified by Cabinet Order.

４協会は、解散により消滅した健康保険組合の権利義務を承継する。

(4)JHIA succeeds to the rights and obligations of a health insurance society extinguished due to dissolution.

第二十七条削除

Article 27Deleted

第二十八条健康保険事業の収支が均衡しない健康保険組合であって、政令で定める要件に該当するものとして厚生労働大臣の指定を受けたもの（以下この条及び次条において「指定健康保険組合」という。）は、政令で定めるところにより、その財政の健全化に関する計画（以下この条において「健全化計画」という。）を定め、厚生労働大臣の承認を受けなければならない。これを変更しようとするときも、同様とする。

Article 28(1)A health insurance society whose income and expenditure for health insurance services is imbalanced and which is designated by the Minister of Health, Labour and Welfare as meeting the requirements specified by Cabinet Order (hereinafter referred to as a "designated health insurance society" in this and the following Articles) must formulate a plan to improve its soundness (hereinafter referred to as "soundness improvement plan" in this Article) and obtain approval therefor from the Minister of Health, Labour and Welfare, as specified by Cabinet Order. The same applies when a health insurance society revises a soundness improvement plan.

２前項の承認を受けた指定健康保険組合は、当該承認に係る健全化計画に従い、その事業を行わなければならない。

(2)A designated health insurance society that receives the approval referred to in the provisions of the preceding paragraph must provide health insurance services in accordance with the approved soundness improvement plan.

３厚生労働大臣は、第一項の承認を受けた指定健康保険組合の事業及び財産の状況により、その健全化計画を変更する必要があると認めるときは、当該指定健康保険組合に対し、期限を定めて、当該健全化計画の変更を求めることができる。

(3)If the Minister of Health, Labour and Welfare finds it necessary to change a soundness improvement plan due to the status of business and property of a designated health insurance society that has received the approval referred to in paragraph (1), the Minster may request the designated health insurance society to change the soundness improvement plan within a specified period.

第二十九条第七条の三十八及び第七条の三十九の規定は、健康保険組合について準用する。この場合において、同条第一項中「厚生労働大臣は」とあるのは「厚生労働大臣は、第二十九条第一項において準用する前条の規定により報告を徴し、又は質問し、若しくは検査した場合において」と、「定款」とあるのは「規約」と読み替えるものとする。

Article 29(1)The provisions of Articles 7-38 and 7-39 apply mutatis mutandis to health insurance societies.In this case, the phrase "Minister of Health, Labour and Welfare" in Article 7-39, paragraph (1) is to be replaced with "Minister of Health, Labour and Welfare, when collecting reports, asking questions, or conducting inspections pursuant to the provisions of the preceding Article as applied mutatis mutandis to Article 29, paragraph (1)", and the phrase "articles of incorporation" is to be replaced with "constitution".

２健康保険組合が前項において準用する第七条の三十九第一項の規定による命令に違反したとき、又は前条第二項の規定に違反した指定健康保険組合、同条第三項の求めに応じない指定健康保険組合その他政令で定める指定健康保険組合の事業若しくは財産の状況によりその事業の継続が困難であると認めるときは、厚生労働大臣は、当該健康保険組合の解散を命ずることができる。

(2)If a health insurance society violates an order pursuant to the provisions of Article 7-39, paragraph (1) as applied mutatis mutandis to the preceding paragraph, or if it is found that the continuation of business of a designated health insurance society which has violated the provisions of paragraph (2) of the preceding Article, of a designated health insurance society which fails to follow the request referred to in paragraph (3) of the same Article, or of another designated health insurance society as specified by Cabinet Order is difficult due to the status of services or property or other reasons, the Minister of Health, Labour and Welfare may order the dissolution of the health insurance society.

第三十条この節に規定するもののほか、健康保険組合の管理、財産の保管その他健康保険組合に関して必要な事項は、政令で定める。

Article 30Beyond what is provided for in this Chapter, the management of health insurance societies, the retention of their assets, and other necessary matters concerning health insurance societies are specified by Cabinet Order.

第三十一条適用事業所以外の事業所の事業主は、厚生労働大臣の認可を受けて、当該事業所を適用事業所とすることができる。

Article 31(1)An employer of a non-applicable place of business may operate the place of business as an applicable place of business with authorization from the Minister of Health, Labour and Welfare.

２前項の認可を受けようとするときは、当該事業所の事業主は、当該事業所に使用される者（被保険者となるべき者に限る。）の二分の一以上の同意を得て、厚生労働大臣に申請しなければならない。

(2)When intending to obtain the authorization referred to in the preceding paragraph, the employer of a place of business must, with the consent of half or more of the workers employed at the place of business (limited to those to be insured persons), apply to the Minister of Health, Labour and Welfare for the authorization.

第三十二条適用事業所が、第三条第三項各号に該当しなくなったときは、その事業所について前条第一項の認可があったものとみなす。

Article 32If an applicable place of business no longer falls under the items of Article 3, paragraph (3), it is deemed to be authorized under paragraph (1) of the preceding Article.

第三十三条第三十一条第一項の事業所の事業主は、厚生労働大臣の認可を受けて、当該事業所を適用事業所でなくすることができる。

Article 33(1)An employer of a place of business under Article 31, paragraph (1) may make the place of business a non-applicable place of business with authorization from the Minister of Health, Labour and Welfare.

２前項の認可を受けようとするときは、当該事業所の事業主は、当該事業所に使用される者（被保険者である者に限る。）の四分の三以上の同意を得て、厚生労働大臣に申請しなければならない。

(2)When intending to obtain the authorization referred to in the preceding paragraph, the employer of the place of business must, with the consent of three-quarters or more of the workers employed at the place of business (limited to insured persons), apply to the Minister of Health, Labour and Welfare for the authorization.

第三十四条二以上の適用事業所の事業主が同一である場合には、当該事業主は、厚生労働大臣の承認を受けて、当該二以上の事業所を一の適用事業所とすることができる。

Article 34(1)When the employer of two or more applicable places of business is the same, the employer may merge the two or more places of business into one applicable place of business with approval from the Minister of Health, Labour and Welfare.

２前項の承認があったときは、当該二以上の適用事業所は、適用事業所でなくなったものとみなす。

(2)When the approval referred to in the preceding paragraph is obtained, the relevant two or more places for business are no longer deemed to be applicable places for business.

第三十五条被保険者（任意継続被保険者を除く。以下この条から第三十八条までにおいて同じ。）は、適用事業所に使用されるに至った日若しくはその使用される事業所が適用事業所となった日又は第三条第一項ただし書の規定に該当しなくなった日から、被保険者の資格を取得する。

Article 35An insured person (excluding insured persons with optional and continued coverage; the same applies hereinafter from this Article through Article 38) obtains eligibility as an insured person from the day on which the person has become an employee of an applicable place of business, the day on which the place of business employing the person has become an applicable place of business, or the day on which the provisions of the proviso to Article 3, paragraph (1) are no longer applicable.

第三十六条被保険者は、次の各号のいずれかに該当するに至った日の翌日（その事実があった日に更に前条に該当するに至ったときは、その日）から、被保険者の資格を喪失する。

Article 36An insured person loses eligibility as an insured person from the day immediately after the day on which the person falls under any of the following items (or the day on which the respective fact arises if the person also falls under the preceding Article):

第三十七条第三条第四項の申出は、被保険者の資格を喪失した日から二十日以内にしなければならない。ただし、保険者は、正当な理由があると認めるときは、この期間を経過した後の申出であっても、受理することができる。

Article 37(1)A request referred to in Article 3, paragraph (4) must be made within 20 days after the date on which eligibility as an insured person is lost;however, when finding a justifiable reason, the insurer may accept a request even after the day on which that period expires.

２第三条第四項の申出をした者が、初めて納付すべき保険料をその納付期日までに納付しなかったときは、同項の規定にかかわらず、その者は、任意継続被保険者とならなかったものとみなす。ただし、その納付の遅延について正当な理由があると保険者が認めたときは、この限りでない。

(2)If the person who made a request referred to in Article 3, paragraph (4) fails to pay the first insurance premium by the due date, the person is deemed to not have become an insured person with optional and continued coverage, notwithstanding the provisions of the same paragraph;however, this does not apply if the insurer finds a justifiable reason for the delay in payment.

第三十八条任意継続被保険者は、次の各号のいずれかに該当するに至った日の翌日（第四号から第六号までのいずれかに該当するに至ったときは、その日）から、その資格を喪失する。

Article 38An insured person with optional and continued payment loses eligibility from the day immediately after the day on which the person fell under any of the following items (in the case any of the items (iv) through (vi) from the day on which the person fell under the item):

第三十九条被保険者の資格の取得及び喪失は、保険者等（被保険者が協会が管掌する健康保険の被保険者である場合にあっては厚生労働大臣、被保険者が健康保険組合が管掌する健康保険の被保険者である場合にあっては当該健康保険組合をいう。第百六十四条第二項及び第三項、第百八十条第一項、第二項及び第四項並びに第百八十一条第一項を除き、以下同じ。）の確認によって、その効力を生ずる。ただし、第三十六条第四号に該当したことによる被保険者の資格の喪失並びに任意継続被保険者の資格の取得及び喪失は、この限りでない。

Article 39(1)The acquisition or loss of eligibility as an insured person takes effect through confirmation by an insurer (meaning the Minister of Health, Labour and Welfare if the person is an insured person with optional and continued coverage under the health insurance program administered by JHIA; a health insurance society if the insured person is under the health insurance program administered by the health insurance society; or otherwise, the Minister of Health, Labour and Welfare; the same applies hereinafter excluding in Article 164, paragraphs (2) and (3), Article 180, paragraph (1), paragraph (2) and paragraph (4), and Article 181, paragraph (1));however, this does not apply to the loss of eligibility as an insured person due to falling under Article 36, item (iv) or the acquisition or loss of eligibility as an insured person with optional continued coverage.

２前項の確認は、第四十八条の規定による届出若しくは第五十一条第一項の規定による請求により、又は職権で行うものとする。

(2)The confirmation referred to in the preceding paragraph is to be made by a notification pursuant to the provisions of Article 48, a request pursuant to the provisions of Article 51, paragraph (1), or sua sponte.

３第一項の確認については、行政手続法（平成五年法律第八十八号）第三章（第十二条及び第十四条を除く。）の規定は、適用しない。

(3)With regard to the confirmation referred to in paragraph (1), the provisions of Chapter III (excluding Articles 12 and 14) of the Administrative Procedure Act (Act No. 88 of 1993) do not apply.

第四十条標準報酬月額は、被保険者の報酬月額に基づき、次の等級区分（次項の規定により等級区分の改定が行われたときは、改定後の等級区分）によって定める。

Article 40(1)The standard monthly remuneration amount is determined based on the insured person's monthly remuneration amount according to the following grading (if the grading has been revised pursuant to the provisions of the following paragraph, the revised grading).

２毎年三月三十一日における標準報酬月額等級の最高等級に該当する被保険者数の被保険者総数に占める割合が百分の一・五を超える場合において、その状態が継続すると認められるときは、その年の九月一日から、政令で、当該最高等級の上に更に等級を加える標準報酬月額の等級区分の改定を行うことができる。ただし、その年の三月三十一日において、改定後の標準報酬月額等級の最高等級に該当する被保険者数の同日における被保険者総数に占める割合が百分の〇・五を下回ってはならない。

(2)If the ratio of the number of insured persons with the highest grade of standard monthly remuneration amount to the total number of insured persons on March 31 in a year exceeds 0.015 and that status is found to continue, the grading of the standard monthly remuneration amount may be revised by adding another grade to that highest grade by Cabinet Order from September 1 in the same year; provided, however, that the ratio of the number of insured persons with the highest grade of the revised standard monthly remuneration amount to the total number of insured persons must not be less than 0.005 on March 31 in the same year.

３厚生労働大臣は、前項の政令の制定又は改正について立案を行う場合には、社会保障審議会の意見を聴くものとする。

(3)When planning the establishment or amendment of Cabinet Order referred to in the preceding paragraph, the Minister of Health, Labour and Welfare is to hear the opinions of the Social Security Council.

第四十一条保険者等は、被保険者が毎年七月一日現に使用される事業所において同日前三月間（その事業所で継続して使用された期間に限るものとし、かつ、報酬支払の基礎となった日数が十七日（厚生労働省令で定める者にあっては、十一日。第四十三条第一項、第四十三条の二第一項及び第四十三条の三第一項において同じ。）未満である月があるときは、その月を除く。）に受けた報酬の総額をその期間の月数で除して得た額を報酬月額として、標準報酬月額を決定する。

Article 41(1)An insurer determines the standard monthly remuneration amount based on the monthly remuneration amount which is obtained by dividing the total amount of remuneration received by the insured person at the place of business at which the person is employed as of July 1 each year for the preceding three-month period (limited to a period of consecutive employment at the place of business, and excluding any month in which the number of days based on which remuneration is paid is less than 17 days (11 days for persons specified by Order of the Ministry of Health, Labour and Welfare; the same applies in Article 43, paragraph (1), Article 43-2, paragraph (1) and Article 43-3, paragraph (1))) by three.

２前項の規定によって決定された標準報酬月額は、その年の九月から翌年の八月までの各月の標準報酬月額とする。

(2)A standard monthly remuneration amount determined pursuant to the provisions of the preceding paragraph is the standard monthly remuneration amount of each month from September in the relevant year until August in the following year.

３第一項の規定は、六月一日から七月一日までの間に被保険者の資格を取得した者及び第四十三条、第四十三条の二又は第四十三条の三の規定により七月から九月までのいずれかの月から標準報酬月額を改定され、又は改定されるべき被保険者については、その年に限り適用しない。

(3)Regarding persons who obtained eligibility as an insured person during the period between June 1 and July 1 or insured persons whose standard monthly remuneration amount has been or is to be revised in any month from July through September pursuant to the provisions of Articles 43, 43-2 or 43-3, the provisions of paragraph (1) do not apply during that year.

第四十二条保険者等は、被保険者の資格を取得した者があるときは、次に掲げる額を報酬月額として、標準報酬月額を決定する。

Article 42(1)When a person who obtains eligibility as an insured person, the insurer determines the standard monthly remuneration amount with the amounts listed below as the monthly remuneration amount:

２前項の規定によって決定された標準報酬月額は、被保険者の資格を取得した月からその年の八月（六月一日から十二月三十一日までの間に被保険者の資格を取得した者については、翌年の八月）までの各月の標準報酬月額とする。

(2)A standard monthly remuneration amount determined pursuant to the provisions of the preceding paragraph is the standard monthly remuneration amount of each month since the day on which the person obtained eligibility as an insured person until August in that year (August in the following year if the person obtained eligibility as an insured person between July 1 to December 31).

第四十三条保険者等は、被保険者が現に使用される事業所において継続した三月間（各月とも、報酬支払の基礎となった日数が、十七日以上でなければならない。）に受けた報酬の総額を三で除して得た額が、その者の標準報酬月額の基礎となった報酬月額に比べて、著しく高低を生じた場合において、必要があると認めるときは、その額を報酬月額として、その著しく高低を生じた月の翌月から、標準報酬月額を改定することができる。

Article 43(1)If the amount obtained by dividing the total amount of remuneration received for three consecutive months at the place of business employing an insured person (in each month, the number of days based on which remuneration is paid must be no less than 17 days) by three is significantly higher or lower than the person's monthly remuneration that is the basis of the standard monthly remuneration amount and the insurer finds it necessary, the insurer may revise the standard monthly remuneration amount by setting the first-mentioned amount as the monthly remuneration amount starting from the month following the months in which the monthly remuneration amount was significantly high or low.

２前項の規定によって改定された標準報酬月額は、その年の八月（七月から十二月までのいずれかの月から改定されたものについては、翌年の八月）までの各月の標準報酬月額とする。

(2)A standard monthly remuneration amount revised pursuant to the provisions of the preceding paragraph is the standard monthly remuneration amount for each month until August in that year (until August in the following year for a revision in any month from July to December).

第四十三条の二保険者等は、育児休業、介護休業等育児又は家族介護を行う労働者の福祉に関する法律（平成三年法律第七十六号）第二条第一号に規定する育児休業、同法第二十三条第二項の育児休業に関する制度に準ずる措置若しくは同法第二十四条第一項（第二号に係る部分に限る。）の規定により同項第二号に規定する育児休業に関する制度に準じて講ずる措置による休業又は政令で定める法令に基づく育児休業（以下「育児休業等」という。）を終了した被保険者が、当該育児休業等を終了した日（以下この条において「育児休業等終了日」という。）において当該育児休業等に係る三歳に満たない子を養育する場合において、その使用される事業所の事業主を経由して厚生労働省令で定めるところにより保険者等に申出をしたときは、第四十一条の規定にかかわらず、育児休業等終了日の翌日が属する月以後三月間（育児休業等終了日の翌日において使用される事業所で継続して使用された期間に限るものとし、かつ、報酬支払の基礎となった日数が十七日未満である月があるときは、その月を除く。）に受けた報酬の総額をその期間の月数で除して得た額を報酬月額として、標準報酬月額を改定する。ただし、育児休業等終了日の翌日に次条第一項に規定する産前産後休業を開始している被保険者は、この限りでない。

Article 43-2(1)If childcare leave prescribed in Article 2, item (i) of the Act on the Welfare of Workers Taking Child Care or Family Care Leave to Care for Children or Other Family Members (Act No. 76 of 1991), leave through a measure equivalent to the system for childcare leave prescribed in Article 23, paragraph (2) of the same Act or a measure taken in the same manner as the system for childcare leave prescribed in item (ii) of the same paragraph pursuant to the provisions of Article 24, paragraph (1) of the same Act, or childcare leave based on laws and regulations specified by Cabinet Order (hereinafter referred to as "childcare leave") taken by an insured person ends and the person is taking care of a child less than three years of age to which the childcare leave pertains on the last day of the childcare leave (referred to as "last day of childcare leave" hereinafter in this Article) after submitting a request to the insurer via the employer of the place of business employing the person as specified by Order of the Ministry of Health, Labour and Welfare, the standard monthly remuneration amount is revised by setting the amount obtained by dividing the total amount of remuneration received for the three months (limited to a period of consecutive employment at the place of business employing the person on the day following the last day of childcare leave; and excluding any month in which the number of days based on which remuneration is paid is less than 17 days) following the month which includes the day following the last day of childcare leave by three as the monthly remuneration amount, notwithstanding the provisions of Article 41; provided, however, that this does not apply to an insured person who commences the maternity leave prescribed in paragraph (1) of the following Article on the day following the last day of childcare leave.

２前項の規定によって改定された標準報酬月額は、育児休業等終了日の翌日から起算して二月を経過した日の属する月の翌月からその年の八月（当該翌月が七月から十二月までのいずれかの月である場合は、翌年の八月）までの各月の標準報酬月額とする。

(2)A standard monthly remuneration amount revised pursuant to the provisions of the preceding paragraph is the standard monthly remuneration amount for each month since the month following the month which includes the day on which two years have elapsed since the day following the last day of childcare leave until August in that year (August in the following year if that following month is any of September to December).

第四十三条の三保険者等は、産前産後休業（出産の日（出産の日が出産の予定日後であるときは、出産の予定日）以前四十二日（多胎妊娠の場合においては、九十八日）から出産の日後五十六日までの間において労務に服さないこと（妊娠又は出産に関する事由を理由として労務に服さない場合に限る。）をいう。以下同じ。）を終了した被保険者が、当該産前産後休業を終了した日（以下この条において「産前産後休業終了日」という。）において当該産前産後休業に係る子を養育する場合において、その使用される事業所の事業主を経由して厚生労働省令で定めるところにより保険者等に申出をしたときは、第四十一条の規定にかかわらず、産前産後休業終了日の翌日が属する月以後三月間（産前産後休業終了日の翌日において使用される事業所で継続して使用された期間に限るものとし、かつ、報酬支払の基礎となった日数が十七日未満である月があるときは、その月を除く。）に受けた報酬の総額をその期間の月数で除して得た額を報酬月額として、標準報酬月額を改定する。ただし、産前産後休業終了日の翌日に育児休業等を開始している被保険者は、この限りでない。

Article 43-3(1)If maternity leave (meaning not engaging in labor for the period from 42 days (98 days in the case of multiple fetuses) before the day of childbirth (the due date of childbirth if the day of childbirth is after the due date of childbirth); hereinafter the same applies) to 56 days after the day of childbirth) taken by an insured person ends and the person is taking care of a child less than three years of age to which the maternity leave pertains on the last day of the maternity leave (referred to as "last day of maternity leave" hereinafter in this Article) after submitting a request to the insurer via the employer of the place of business employing the person as specified by Order of the Ministry of Health, Labour and Welfare, the standard monthly remuneration amount is revised by setting the amount obtained by dividing the total amount of remuneration received for the three months (limited to a period of consecutive employment at the place of business employing the person on the day following the last day of maternity leave; and excluding any month in which the number of days based on which remuneration is paid is less than 17 days) following the month which includes the day following the last day of maternity leave by three as the monthly remuneration amount, notwithstanding the provisions Article 41; provided, however, that this does not apply to an insured person who commences childcare leave on the day following the last day of maternity leave.

２前項の規定によって改定された標準報酬月額は、産前産後休業終了日の翌日から起算して二月を経過した日の属する月の翌月からその年の八月（当該翌月が七月から十二月までのいずれかの月である場合は、翌年の八月）までの各月の標準報酬月額とする。

(2)A standard monthly remuneration amount revised pursuant to the provisions of the preceding paragraph is the standard monthly remuneration amount for each month since the month following the month which includes the day on which two years have elapsed since the day following the last day of maternity leave until August in that year (August in the following year if that following month is any of September to December).

第四十四条保険者等は、被保険者の報酬月額が、第四十一条第一項、第四十二条第一項、第四十三条の二第一項若しくは前条第一項の規定によって算定することが困難であるとき、又は第四十一条第一項、第四十二条第一項、第四十三条第一項、第四十三条の二第一項若しくは前条第一項の規定によって算定した額が著しく不当であると認めるときは、これらの規定にかかわらず、その算定する額を当該被保険者の報酬月額とする。

Article 44(1)If it is difficult to calculate an insured person's monthly remuneration amount pursuant to the provisions of Article 41, paragraph (1), Article 42, paragraph (1), Article 43-2, paragraph (1) or paragraph (1) of the preceding Article, or if the amount calculated pursuant to the provisions of Article 41, paragraph (1), Article 42, paragraph (1), Article 43, paragraph (1), Article 43-2, paragraph (1) or paragraph (1) of the preceding Article is found to be significantly unjustifiable, notwithstanding these provisions, the insured person's monthly remuneration amount is an amount determined by the insurer.

２前項の場合において、保険者が健康保険組合であるときは、同項の算定方法は、規約で定めなければならない。

(2)In the case of the preceding paragraph, if the insurer is a health insurance society, the calculation method in the same paragraph must be specified by the constitution.

３同時に二以上の事業所で報酬を受ける被保険者について報酬月額を算定する場合においては、各事業所について、第四十一条第一項、第四十二条第一項、第四十三条第一項、第四十三条の二第一項若しくは前条第一項又は第一項の規定によって算定した額の合算額をその者の報酬月額とする。

(3)In calculating the monthly remuneration amount for an insured person who receives remuneration at two or more places of business at the same time, the total sum of the amounts calculated pursuant to the provisions of Article 41, paragraph (1), Article 42, paragraph (1), Article 43, paragraph (1), Article 43-2, paragraph (1), or paragraph (1) of the preceding Article or paragraph (1) is the person's monthly remuneration amount.

第四十五条保険者等は、被保険者が賞与を受けた月において、その月に当該被保険者が受けた賞与額に基づき、これに千円未満の端数を生じたときは、これを切り捨てて、その月における標準賞与額を決定する。ただし、その月に当該被保険者が受けた賞与によりその年度（毎年四月一日から翌年三月三十一日までをいう。以下同じ。）における標準賞与額の累計額が五百七十三万円（第四十条第二項の規定による標準報酬月額の等級区分の改定が行われたときは、政令で定める額。以下この項において同じ。）を超えることとなる場合には、当該累計額が五百七十三万円となるようその月の標準賞与額を決定し、その年度においてその月の翌月以降に受ける賞与の標準賞与額は零とする。

Article 45(1)An insurer determines the standard bonus amount in a month based on the amount of bonus received by the insured in the month in which the person received the bonus by rounding the amount down to the nearest 1,000 yen; provided, however, that if the cumulative amount of standard bonus during that fiscal year (from April 1 to the following March 31; the same applies hereinafter) exceeds 5,730,000 yen (an amount specified by Cabinet Order if the standard monthly remuneration amount grading has been revised pursuant to the provisions of Article 40, paragraph (2); the same applies in this paragraph) due to the bonus received by the insured person in that month, the standard bonus amount for the month is determined so that the cumulative amount is 5,730,000 yen and the standard amount of bonus received after the following month in the fiscal year is zero.

２第四十条第三項の規定は前項の政令の制定又は改正について、前条の規定は標準賞与額の算定について準用する。

(2)The provisions of Article 40, paragraph (3) apply mutatis mutandis to the establishment or amendment of Cabinet Order referred to in the preceding paragraph and the provisions of the preceding Article apply mutatis mutandis to the calculation of the amount of standard bonus.

第四十六条報酬又は賞与の全部又は一部が、通貨以外のもので支払われる場合においては、その価額は、その地方の時価によって、厚生労働大臣が定める。

Article 46(1)When all or part of remuneration or bonus should be paid other than in currency, the amount is specified by the Minister of Health, Labour and Welfare based on the local market price.

２健康保険組合は、前項の規定にかかわらず、規約で別段の定めをすることができる。

(2)A health insurance society may establish different standards in its constitution notwithstanding the provisions of the preceding paragraph.

第四十七条任意継続被保険者の標準報酬月額については、第四十一条から第四十四条までの規定にかかわらず、次の各号に掲げる額のうちいずれか少ない額をもって、その者の標準報酬月額とする。

Article 47Notwithstanding the provisions of Articles 41 through 44, with respect to the standard monthly remuneration amount of an insured person with optional and continued coverage, the smaller amount between the amounts listed in the following items is the person's standard monthly remuneration amount:

第四十八条適用事業所の事業主は、厚生労働省令で定めるところにより、被保険者の資格の取得及び喪失並びに報酬月額及び賞与額に関する事項を保険者等に届け出なければならない。

Article 48The employer of an applicable place of business must notify the insurer of particulars relating to the acquisition and loss of eligibility as an insured person as well as the monthly remuneration amount and bonus amount pursuant to Order of the Ministry of Health, Labour and Welfare.

第四十九条厚生労働大臣は、第三十三条第一項の規定による認可を行ったときは、その旨を当該事業主に通知するものとし、保険者等は、第三十九条第一項の規定による確認又は標準報酬（標準報酬月額及び標準賞与額をいう。以下同じ。）の決定若しくは改定を行ったときは、その旨を当該事業主に通知しなければならない。

Article 49(1)When the Minister of Health, Labour and Welfare gives authorization pursuant to the provisions of Article 33, paragraph (1), the Minister must notify the employer to that effect, and the insurer, upon performing confirmation pursuant to Article 39, paragraph (1), or determining or revising the standard remuneration amount (meaning the standard monthly remuneration amount and standard monthly bonus amount; the same applies hereinafter), must notify the employer to that effect.

２事業主は、前項の通知があったときは、速やかに、これを被保険者又は被保険者であった者に通知しなければならない。

(2)When a notice referred to in the preceding item is given, the employer must promptly notify the person who is or was insured.

３被保険者が被保険者の資格を喪失した場合において、その者の所在が明らかでないため前項の通知をすることができないときは、事業主は、厚生労働大臣又は保険者等にその旨を届け出なければならない。

(3)When an insured person loses eligibility as an insured person and a notice referred to in the preceding paragraph cannot be given since the whereabouts of the person are unknown, the employer must notify the Minister of Health, Labour and Welfare and the insurer to that effect.

４厚生労働大臣は、前項の届出があったときは、所在が明らかでない者について第一項の規定により事業主に通知した事項を公告するものとし、保険者等は、前項の届出があったときは、所在が明らかでない者について第一項の規定により事業主に通知した事項を公告しなければならない。

(4)When the notification referred to in the preceding paragraph is given, the Minister of Health, Labour and Welfare and the insurer must give public notice of the matters stated in the notification given to the employer pursuant to the provisions of paragraph (1) about the person whose whereabouts are unknown.

５厚生労働大臣は、事業所が廃止された場合その他やむを得ない事情のため第一項の通知をすることができない場合においては、同項の通知に代えて、その通知すべき事項を公告するものとし、保険者等は、事業所が廃止された場合その他やむを得ない事情のため同項の通知をすることができない場合においては、同項の通知に代えて、その通知すべき事項を公告しなければならない。

(5)If the Minister of Health, Labour and Welfare and the insurer fail to give a notice referred to in paragraph (1) due to abolishment of the place of business or other unavoidable circumstances, they must make a public notice of the matters to be notified in lieu of the notice referred to in paragraph (1).

第五十条保険者等は、第四十八条の規定による届出があった場合において、その届出に係る事実がないと認めるときは、その旨をその届出をした事業主に通知しなければならない。

Article 50(1)When a notification is given pursuant to the provisions of Article 48, if no fact pertaining the notice is found, the insurer must give notify to that effect the employer who gave the notification.

２前条第二項から第五項までの規定は、前項の通知について準用する。

(2)The provisions of paragraphs (2) through (5) of the preceding Article apply mutatis mutandis to the notice referred to the preceding paragraph.

第五十一条被保険者又は被保険者であった者は、いつでも、第三十九条第一項の規定による確認を請求することができる。

Article 51(1)A person who is or was an insured person may at any time demand confirmation pursuant to the provisions of Article 39, paragraph (1).

２保険者等は、前項の規定による請求があった場合において、その請求に係る事実がないと認めるときは、その請求を却下しなければならない。

(2)When an insurer receives a request referred to in the provisions of Article 48, the insurer must dismiss the request if no fact pertaining to it is found.

第五十一条の二厚生労働大臣は、協会に対し、厚生労働省令で定めるところにより、被保険者の資格に関する事項、標準報酬に関する事項その他協会の業務の実施に関して必要な情報の提供を行うものとする。

Article 51-2The Minister of Health, Labour and Welfare provides information to JHIA on matters concerning the eligibility of insured persons and standard remuneration, and necessary information concerning the provision of JHIA's services, pursuant to Order of the Ministry of Health, Labour and Welfare.

第五十二条被保険者に係るこの法律による保険給付は、次のとおりとする。

Article 52Insurance benefits for an insured person provided by this Act are as follows:

第五十三条保険者が健康保険組合である場合においては、前条各号に掲げる給付に併せて、規約で定めるところにより、保険給付としてその他の給付を行うことができる。

Article 53If the insurer is a health insurance society, other benefits may be made as insurance benefits beyond the insurance benefits listed in the items of the preceding Article, as prescribed in the constitution.

第五十三条の二被保険者又はその被扶養者が法人の役員（業務を執行する社員、取締役、執行役又はこれらに準ずる者をいい、相談役、顧問その他いかなる名称を有する者であるかを問わず、法人に対し業務を執行する社員、取締役、執行役又はこれらに準ずる者と同等以上の支配力を有するものと認められる者を含む。以下この条において同じ。）であるときは、当該被保険者又はその被扶養者のその法人の役員としての業務（被保険者の数が五人未満である適用事業所に使用される法人の役員としての業務であって厚生労働省令で定めるものを除く。）に起因する疾病、負傷又は死亡に関して保険給付は、行わない。

Article 53-2If an insured person or a dependent thereof is an officer of a corporation (meaning an employee, director, executive officer who executes business, or person in an equivalent position, including those recognized as having the same or greater influence over a corporation as employees who execute business, directors, corporate officers, or person in an equivalent position, regardless of their titles, such as counselor, consultant, etc.; the same applies hereinafter in this Article), insurance benefits are not paid for sickness, injury or death resulting from the duty of the insured person or the person's dependent as an officer of the corporation (excluding duties as an officer of a corporation that is used as an applicable place of business in which the number of insured persons is less than five and is specified by Order of the Ministry of Health, Labor and Welfare).

第五十四条被保険者に係る家族療養費（第百十条第七項において準用する第八十七条第一項の規定により支給される療養費を含む。）、家族訪問看護療養費、家族移送費、家族埋葬料又は家族出産育児一時金の支給は、同一の疾病、負傷、死亡又は出産について、次章の規定により療養の給付又は入院時食事療養費、入院時生活療養費、保険外併用療養費、療養費、訪問看護療養費、移送費、埋葬料若しくは出産育児一時金の支給を受けたときは、その限度において、行わない。

Article 54Dependent's medical expenses (including medical expenses paid pursuant to the provisions of Article 87, paragraph (1) as applied mutatis mutandis to Article 110, paragraph (7)), dependent's medical expenses for home-nursing, dependent's transport expenses, dependent's burial charges, or lump-sum allowance for dependent's childbirth and childcare in relation to an insured person are not paid to that extent if the insured person received medical benefits or dietary treatment expense for inpatients, living support expenses for inpatients, medical expenses combined with treatment outside insurance coverage, medical expenses, medical expenses for home-nursing, transport expenses, burial charges, or lump-sum allowance for childbirth and childcare for the same sickness, injury, death, or child birth pursuant to the provisions of the following Article.

第五十五条被保険者に係る療養の給付又は入院時食事療養費、入院時生活療養費、保険外併用療養費、療養費、訪問看護療養費、移送費、傷病手当金、埋葬料、家族療養費、家族訪問看護療養費、家族移送費若しくは家族埋葬料の支給は、同一の疾病、負傷又は死亡について、労働者災害補償保険法、国家公務員災害補償法（昭和二十六年法律第百九十一号。他の法律において準用し、又は例による場合を含む。）又は地方公務員災害補償法（昭和四十二年法律第百二十一号）若しくは同法に基づく条例の規定によりこれらに相当する給付を受けることができる場合には、行わない。

Article 55(1)Benefits for medical treatment, or dietary treatment expenses for inpatients, living support expenses for inpatients, medical expenses combined with treatment outside insurance coverage, medical expenses, medical expenses for home-nursing, transport expenses, injury and sickness allowance, burial charges, dependent's medical expenses, dependent's medical expenses for home-nursing, dependent's transport expenses, or dependent's burial charges in relation to an insured person are not paid if the insured person may receive payment corresponding to those for the same sickness, injury, or death pursuant to the provisions of the Worker Disaster Compensation Insurance Act, the National Public Employees Accident Compensation Act (Act No. 191 of 1951; including when this is applied mutatis mutandis to other laws and the same rule governs), the Local Public Servants Accident Compensation Act (Act No. 121 of 1967), or order based on the same Act.

２被保険者に係る療養の給付又は入院時食事療養費、入院時生活療養費、保険外併用療養費、療養費、訪問看護療養費、家族療養費若しくは家族訪問看護療養費の支給は、同一の疾病又は負傷について、介護保険法の規定によりこれらに相当する給付を受けることができる場合には、行わない。

(2)Benefits for medical treatment, or expenses for dietary treatment for inpatients, living support expenses for inpatients, medical expenses combined with treatment outside insurance coverage, medical expenses, medical expenses for home-nursing, dependent's medical expenses, or dependent's medical expenses for home-nursing in relation to an insured person are not be paid if the insured person is eligible for benefits equivalent thereto for the same illness or injury pursuant to the provisions of the Long-Term Care Insurance Act.

３被保険者に係る療養の給付又は入院時食事療養費、入院時生活療養費、保険外併用療養費、療養費、訪問看護療養費、移送費、家族療養費、家族訪問看護療養費若しくは家族移送費の支給は、同一の疾病又は負傷について、他の法令の規定により国又は地方公共団体の負担で療養又は療養費の支給を受けたときは、その限度において、行わない。

(3)Benefits for medical treatment, or expenses for dietary treatment for inpatients, living support expenses for inpatients, medical expenses combined with treatment outside insurance coverage, medical expenses, medical expenses for home-nursing, transport expenses, dependent's medical expenses, dependent's medical expenses for home-nursing, or dependent's transport expenses in relation to an insured person are not paid made to that extent in cases if the insured person received medical treatment or medical expenses for the same sickness or injury from the national government or local government pursuant to the provisions of other laws and regulations.

第五十六条入院時食事療養費、入院時生活療養費、保険外併用療養費、療養費、訪問看護療養費、移送費、傷病手当金、埋葬料、出産育児一時金、出産手当金、家族療養費、家族訪問看護療養費、家族移送費、家族埋葬料及び家族出産育児一時金の支給は、その都度、行わなければならない。第百条第二項（第百五条第二項において準用する場合を含む。）の規定による埋葬に要した費用に相当する金額の支給についても、同様とする。

Article 56(1)Dietary treatment expenses for inpatients, living support expenses for inpatients, medical expenses combined with treatment outside insurance coverage, medical expenses, medical expenses for home-nursing, transport expenses, injury and sickness allowance, burial charges, lump-sum allowance for childbirth and childcare, childbirth allowance, dependent's medical expenses, dependent's medical expenses for home-nursing, dependent's transport expenses, dependent's burial charges, and lump-sum allowance for dependent's childbirth and childcare must be paid on each occasion. This also applies to the payment of an amount equivalent to the cost of burial charges pursuant to the provisions of Article 100, paragraph (2) (including when applied mutatis mutandis to Article 105, paragraph (2)).

２傷病手当金及び出産手当金の支給は、前項の規定にかかわらず、毎月一定の期日に行うことができる。

(2)Injury and sickness allowance and childbirth allowance may be paid by a fixed date in every month notwithstanding the provisions of the preceding paragraph.

第五十七条保険者は、給付事由が第三者の行為によって生じた場合において、保険給付を行ったときは、その給付の価額（当該保険給付が療養の給付であるときは、当該療養の給付に要する費用の額から当該療養の給付に関し被保険者が負担しなければならない一部負担金に相当する額を控除した額。次条第一項において同じ。）の限度において、保険給付を受ける権利を有する者（当該給付事由が被保険者の被扶養者について生じた場合には、当該被扶養者を含む。次項において同じ。）が第三者に対して有する損害賠償の請求権を取得する。

Article 57(1)When the grounds for an expense claim is caused consist of an act by a third party and an insurer provides insurance benefits, the insurer obtains the right to claim compensation for damages held by the person entitled to receive the benefits (if the grounds for an expense claim lie with a dependent of the insured person, the dependent is included; the same applies hereinafter in the following paragraph) against the third party, to the extent of the amount of the benefits (when the insurance benefits are benefits for medical treatment, the amount calculated by deducting, from the cost of the benefits for medical treatment, the amount of co-payment to be borne by the person with respect to the benefits for medical treatment; the same applies hereinafter in paragraph (1) of the following Article).

２前項の場合において、保険給付を受ける権利を有する者が第三者から同一の事由について損害賠償を受けたときは、保険者は、その価額の限度において、保険給付を行う責めを免れる。

(2)In the case referred to in the preceding paragraph, if the person entitled to receive the insurance benefits receives compensation for damages on the same ground from the third party, the insurer is exempt from the responsibility to pay the insurance benefit to the extent of the amount of the compensation.

第五十八条偽りその他不正の行為によって保険給付を受けた者があるときは、保険者は、その者からその給付の価額の全部又は一部を徴収することができる。

Article 58(1)When a person receives an insurance benefit by means of deception or other wrongful conduct, the insurer may collect all or part of the amount of the benefit from the person.

２前項の場合において、事業主が虚偽の報告若しくは証明をし、又は第六十三条第三項第一号に規定する保険医療機関において診療に従事する第六十四条に規定する保険医若しくは第八十八条第一項に規定する主治の医師が、保険者に提出されるべき診断書に虚偽の記載をしたため、その保険給付が行われたものであるときは、保険者は、当該事業主、保険医又は主治の医師に対し、保険給付を受けた者に連帯して前項の徴収金を納付すべきことを命ずることができる。

(2)In the case referred to in the preceding paragraph, if the insurance benefit is granted because the employer made a false report or certificate, or because a physician providing health insurance treatment as prescribed in Article 64 at a medical institution providing services covered by health insurance as prescribed in Article 63, paragraph (3), item (i) or an attending physician as prescribed in Article 88, paragraph (1) has made a false entry on the medical certificate to be submitted to the insurer, the insurer may order the employer, physician providing health insurance treatement, or attending physician to pay the money to be collected pursuant to the preceding paragraph jointly and severally with the person who received the insurance benefit.

３保険者は、第六十三条第三項第一号に規定する保険医療機関若しくは保険薬局又は第八十八条第一項に規定する指定訪問看護事業者が偽りその他不正の行為によって療養の給付に関する費用の支払又は第八十五条第五項（第八十五条の二第五項及び第八十六条第四項において準用する場合を含む。）、第八十八条第六項（第百十一条第三項において準用する場合を含む。）若しくは第百十条第四項の規定による支払を受けたときは、当該保険医療機関若しくは保険薬局又は指定訪問看護事業者に対し、その支払った額につき返還させるほか、その返還させる額に百分の四十を乗じて得た額を支払わせることができる。

(3)If a medical institution providing services covered by health insurance or a pharmacy providing services covered by health insurance as prescribed in Article 63, paragraph (3), item (i) or a designated home-nursing provider as prescribed in Article 88, paragraph (1) receives, by means of deception or other wrongful conduct, any payment of expenses relating to benefits for medical treatment or any payment pursuant to the provisions of Article 85, paragraph (5) (including when applied mutatis mutandis to Article 85-2, paragraph (5) or Article 86, paragraph (4)), Article 88, paragraph (6) (including when applied mutatis mutandis to Article 111, paragraph (3)) or Article 110, paragraph (4), the relevant insurer may cause the medical institution, pharmacy, or designated home-nursing provider to refund the amount so paid and to pay, in addition, an amount obtained by multiplying the amount to be refunded by four-tenths.

第五十九条保険者は、保険給付に関して必要があると認めるときは、保険給付を受ける者（当該保険給付が被扶養者に係るものである場合には、当該被扶養者を含む。第百二十一条において同じ。）に対し、文書その他の物件の提出若しくは提示を命じ、又は当該職員に質問若しくは診断をさせることができる。

Article 59When finding it necessary in relation to insurance benefits, an insurer may order a person who is to receive insurance benefits (including a dependent if the insurance benefits pertain to a dependent; the same applies in Article 121) to submit or present a document or other objects or may have the insurer's official question or diagnose the person.

第六十条厚生労働大臣は、保険給付を行うにつき必要があると認めるときは、医師、歯科医師、薬剤師若しくは手当を行った者又はこれを使用する者に対し、その行った診療、薬剤の支給又は手当に関し、報告若しくは診療録、帳簿書類その他の物件の提示を命じ、又は当該職員に質問させることができる。

Article 60(1)If the Minister of Health, Labour and Welfare finds it necessary in relation to the payment of insurance benefits, the Minister may order a physician, dentist, pharmacist or person who provided medical care or a person who employs any of these to make a report or to present medical records, record books, and other documents or other objects concerning the provided medical care, provision of drugs, or medical treatment, or may order the ministry's official to ask the person questions.

２厚生労働大臣は、必要があると認めるときは、療養の給付又は入院時食事療養費、入院時生活療養費、保険外併用療養費、療養費、訪問看護療養費、家族療養費若しくは家族訪問看護療養費の支給を受けた被保険者又は被保険者であった者に対し、当該保険給付に係る診療、調剤又は第八十八条第一項に規定する指定訪問看護の内容に関し、報告を命じ、又は当該職員に質問させることができる。

(2)If the Minister of Health, Labour and Welfare finds it necessary, the Minister may order a person who is or was an insured person and who received payment of benefits for medical treatment, or expenses for dietary treatment for inpatients, living support expenses for inpatients, medical expenses combined with treatment outside insurance coverage, medical expenses, medical expenses for home-nursing, dependent's medical expenses, or dependent's medical expenses for home-nursing to make a report on or have the Ministry's official ask questions about the medical care or prescription pertaining to the insurance benefits, or designated home-nursing as prescribed in Article 88. paragraph (1).

３第七条の三十八第二項の規定は前二項の規定による質問について、同条第三項の規定は前二項の規定による権限について準用する。

(3)The provisions of Article 7-38, paragraph (2) apply mutatis mutandis to questions pursuant to the provisions of the preceding two paragraphs, and the provisions of paragraph (3) of the same Article apply mutatis mutandis to the authority granted pursuant to the provisions of the preceding two paragraphs.

第六十一条保険給付を受ける権利は、譲り渡し、担保に供し、又は差し押さえることができない。

Article 61The right to receive an insurance benefit may not be transferred, pledged as collateral, or levied.

第六十二条租税その他の公課は、保険給付として支給を受けた金品を標準として、課することができない。

Article 62Taxes and other public charges may not be imposed on the basis of money and goods received as payment of insurance benefits.

第六十三条被保険者の疾病又は負傷に関しては、次に掲げる療養の給付を行う。

Article 63(1)With regard to sickness and injury of insured persons, benefits for medical treatment are paid as listed below:

２次に掲げる療養に係る給付は、前項の給付に含まれないものとする。

(2)Benefits for the following types of medical treatment are not included in the benefits referred to in the preceding paragraph:

３第一項の給付を受けようとする者は、厚生労働省令で定めるところにより、次に掲げる病院若しくは診療所又は薬局のうち、自己の選定するものから受けるものとする。

(3)A person who intends to receive benefits under paragraph (1) is to receive the benefits from a hospital, clinic, or pharmacy that the person selects from those listed below, pursuant to Order of the Ministry of Health, Labour and Welfare:

４第二項第四号の申出は、厚生労働大臣が定めるところにより、厚生労働大臣に対し、当該申出に係る療養を行う医療法第四条の三に規定する臨床研究中核病院（保険医療機関であるものに限る。）の開設者の意見書その他必要な書類を添えて行うものとする。

(4)A request referred to in paragraph (2), item (iv), as prescribed by the Minister of Health, Labour and Welfare, is to be made to the Minister of Health, Labour and Welfare and accompanied by statements by the establisher of the core clinical research hospital provided for by Article 4-3 of the Medial Care Act (limited to a medical institution providing services covered by health insurance) which provides the medical treatment to which the request pertains and other necessary documents.

５厚生労働大臣は、第二項第四号の申出を受けた場合は、当該申出について速やかに検討を加え、当該申出に係る療養が同号の評価を行うことが必要な療養と認められる場合には、当該療養を患者申出療養として定めるものとする。

(5)When the Minister of Health, Labour and Welfare receives a request under paragraph (2), item (iv), the Minister of Health, Labour and Welfare is to promptly examine the request and specify the medical treatment pertaining to the request as patient-requested treatment if it is found to require the evaluation provided for in that item.

６厚生労働大臣は、前項の規定により第二項第四号の申出に係る療養を患者申出療養として定めることとした場合には、その旨を当該申出を行った者に速やかに通知するものとする。

(6)If Minister of Health, Labour and Welfare determines that the medical treatment to which the application referred to in paragraph (2), item (iv) pertains pursuant to the provisions of the preceding paragraph is patient-requested treatment, the Minister is to promptly notify the applicant to that effect.

７厚生労働大臣は、第五項の規定により第二項第四号の申出について検討を加え、当該申出に係る療養を患者申出療養として定めないこととした場合には、理由を付して、その旨を当該申出を行った者に速やかに通知するものとする。

(7)If the Minister of Health, Labour and Welfare examines the application referred to in paragraph (2), item (iv) pursuant to the provisions of paragraph (5) and determines that the medical treatment pertaining to the application is not to be specified as patient-requested treatment, the Minister is to promptly notify the applicant to that effect and the reason therefor.

第六十四条保険医療機関において健康保険の診療に従事する医師若しくは歯科医師又は保険薬局において健康保険の調剤に従事する薬剤師は、厚生労働大臣の登録を受けた医師若しくは歯科医師（以下「保険医」と総称する。）又は薬剤師（以下「保険薬剤師」という。）でなければならない。

Article 64A physician or dentist engaged in medical treatment covered by health insurance at a medical institution providing services covered by health insurance or a pharmacist engaged in prescription covered by health insurance at a pharmacy providing services covered by health insurance must be a physician or dentist registered by the Minister of Health, Labour and Welfare (hereinafter collectively referred to as a "physician providing health insurance treatment") or a pharmacist registered by the Minister (hereinafter referred to as a "pharmacist filling health insurance prescriptions").

第六十五条第六十三条第三項第一号の指定は、政令で定めるところにより、病院若しくは診療所又は薬局の開設者の申請により行う。

Article 65(1)A designation referred to in Article 63, paragraph (3), item (i) is provided upon an application by the establisher who opened a hospital, clinic, or pharmacy, as specified by Cabinet Order.

２前項の場合において、その申請が病院又は病床を有する診療所に係るものであるときは、当該申請は、医療法第七条第二項に規定する病床の種別（第四項第二号及び次条第一項において単に「病床の種別」という。）ごとにその数を定めて行うものとする。

(2)In the case of the preceding paragraph, if the application pertains to a hospital or to a clinic that has beds, the application is to be made by specifying the number of beds for each classification of bed prescribed in Article 7, paragraph (2) of the Medical Care Act (simply referred to as "bed classification" in paragraph (4), item (ii), and item (i) of the following Article).

３厚生労働大臣は、第一項の申請があった場合において、次の各号のいずれかに該当するときは、第六十三条第三項第一号の指定をしないことができる。

(3)When an application referred to in paragraph (1) is filed and the application falls under any of the following items, the Minister of Health, Labour and Welfare may determine not to make the designation referred to in Article 63, paragraph (3), item (i):

４厚生労働大臣は、第二項の病院又は診療所について第一項の申請があった場合において、次の各号のいずれかに該当するときは、その申請に係る病床の全部又は一部を除いて、第六十三条第三項第一号の指定を行うことができる。

(4)When an application referred to in paragraph (1) is filed pertaining to a hospital or clinic referred to in paragraph (2) and the application falls under any of the following items, the Minister of Health, Labour and Welfare may make the designation prescribed in Article 63, paragraph (3), item (i) excluding all or some of the beds pertaining to the application:

第六十六条前条第二項の病院又は診療所の開設者は、第六十三条第三項第一号の指定に係る病床数の増加又は病床の種別の変更をしようとするときは、厚生労働省令で定めるところにより、当該病院又は診療所に係る同号の指定の変更を申請しなければならない。

Article 66(1)When intending to increase the number of beds or to alter bed classifications related to the designation pursuant to Article 63, paragraph (3), item (i), the establisher of the hospital or clinic referred to in paragraph (2) of the preceding Article must apply for a change of designation referred to in the same item pertaining to the hospital or clinic pursuant to Order of the Ministry of Health, Labour, and Welfare.

２前条第四項の規定は、前項の指定の変更の申請について準用する。

(2)The provisions of paragraph (4) of the preceding Article apply mutatis mutandis to an application for alteration of designation referred to in the preceding paragraph.

第六十七条厚生労働大臣は、保険医療機関に係る第六十三条第三項第一号の指定をしないこととするとき、若しくはその申請に係る病床の全部若しくは一部を除いて指定（指定の変更を含む。）を行おうとするとき、又は保険薬局に係る同号の指定をしないこととするときは、地方社会保険医療協議会の議を経なければならない。

Article 67When the Minister of Health, Labour and Welfare determines to not make a designation referred to in Article 63, paragraph (3), item (i) pertaining to a medical institution providing services covered by health insurance, determines to make a designation excluding all or some of the beds pertaining to that medical institution's application (including an alternation of such a designation), or determines to make a designation referred to in Article 63, paragraph (3), item (i) pertaining to a pharmacy providing services covered by health insurance, the Minister must undergo discussion at the relevant local social insurance medical council.

第六十八条第六十三条第三項第一号の指定は、指定の日から起算して六年を経過したときは、その効力を失う。

Article 68(1)A designation as referred to in Article 63, paragraph (3), item (i) expires when six years have elapsed after the day of designation.

２保険医療機関（第六十五条第二項の病院及び診療所を除く。）又は保険薬局であって厚生労働省令で定めるものについては、前項の規定によりその指定の効力を失う日前六月から同日前三月までの間に、別段の申出がないときは、同条第一項の申請があったものとみなす。

(2)With regard to a medical institution providing services covered by health insurance (excluding hospitals and clinics referred to in Article 65, paragraph (2)) or a pharmacy providing services covered by health insurance that are specified by Order of the Ministry of Health, Labour and Welfare, unless otherwise notified during the period from since six months before the expiration date of the designation pursuant to the provisions of the preceding paragraph until three months before that date, the application under Article 65, paragraph (1) is deemed to have been made.

第六十九条診療所又は薬局が医師若しくは歯科医師又は薬剤師の開設したものであり、かつ、当該開設者である医師若しくは歯科医師又は薬剤師のみが診療又は調剤に従事している場合において、当該医師若しくは歯科医師又は薬剤師について第六十四条の登録があったときは、当該診療所又は薬局について、第六十三条第三項第一号の指定があったものとみなす。ただし、当該診療所又は薬局が、第六十五条第三項又は第四項に規定する要件に該当する場合であって厚生労働大臣が同号の指定があったものとみなすことが不適当と認められるときは、この限りでない。

Article 69When a clinic or pharmacy has been established by a physician, dentist or a pharmacist who is the only person engaged in medical care or prescription there, and a registration under Article 64 has been made with respect to the physician, dentist or pharmacist, it is deemed that a designation referred to in Article 63, paragraph (3), item (i) has been made with regard to the clinic or pharmacy; provided, however, this does not apply when the clinic or pharmacy meets the requirements prescribed in Article 65, paragraphs (3) or (4) but the Minister of Health, Labour and Welfare finds it inappropriate to deem that the designation referred to in Article 63, paragraph (3), item (i) has been made.

第七十条保険医療機関又は保険薬局は、当該保険医療機関において診療に従事する保険医又は当該保険薬局において調剤に従事する保険薬剤師に、第七十二条第一項の厚生労働省令で定めるところにより、診療又は調剤に当たらせるほか、厚生労働省令で定めるところにより、療養の給付を担当しなければならない。

Article 70(1)A medical institution providing services covered by health insurance or a pharmacy providing services covered by health insurance must put physicians providing health insurance treatment who are engaging in medical care at the institution or pharmacists filling health insurance prescriptions who are engaging in prescription at the pharmacy in charge of medical care or prescription pursuant to Order of the Ministry of Health, Labour and Welfare referred to in Article 72, paragraph (1) and must be responsible for benefits for medical treatment pursuant to Order of the Ministry of Health, Labour and Welfare.

２保険医療機関又は保険薬局は、前項（第八十五条第九項、第八十五条の二第五項、第八十六条第四項、第百十条第七項及び第百四十九条において準用する場合を含む。）の規定によるほか、船員保険法、国民健康保険法、国家公務員共済組合法（昭和三十三年法律第百二十八号。他の法律において準用し、又は例による場合を含む。）又は地方公務員等共済組合法（以下「この法律以外の医療保険各法」という。）による療養の給付並びに被保険者及び被扶養者の療養並びに高齢者の医療の確保に関する法律による療養の給付、入院時食事療養費に係る療養、入院時生活療養費に係る療養及び保険外併用療養費に係る療養を担当するものとする。

(2)Beyond the provisions of the preceding item (including when applied mutatis mutandis to Article 85, paragraph (9), Article 85-2, paragraph (5), Article 86, paragraph (4), Article 110, paragraph (7), and Article 149), a medical institution providing services covered by health insurance or a pharmacy providing services covered by health insurance is responsible for benefits for medical treatment pursuant to the provisions of the Seamen's Insurance Act, National Health Insurance Act, National Public Employees Mutual Aid Association Act (Act No. 128 of 1958; including when this is applied mutatis mutandis to other laws and the same rule governs), or Local Public Employees Mutual Aid Association Act (hereinafter referred to as "medical insurance laws other than this act") as well as medical treatment for insured persons and dependents, benefits for medical treatment pursuant to the provisions of the Act on Assurance of Medical Care for Elderly People, and treatment pertaining to dietary treatment expenses for inpatients, living support expenses for inpatients, and medical expenses combined with treatment outside insurance coverage.

３保険医療機関のうち医療法第四条の二に規定する特定機能病院その他の病院であって厚生労働省令で定めるものは、患者の病状その他の患者の事情に応じた適切な他の保険医療機関を当該患者に紹介することその他の保険医療機関相互間の機能の分担及び業務の連携のための措置として厚生労働省令で定める措置を講ずるものとする。

(3)A medical institution providing services covered by health insurance which is an advanced treatment hospital prescribed by Article 4-2 of the Medial Care Act or otherwise specified by Order of the Ministry of Health, Labour and Welfare is to take measures specified by Order of the Ministry of Health, Labour and Welfare as measures for sharing functions and for operational cooperation between medical institutions providing services covered by health insurance, for instance, by referring patients to medical institutions providing services covered by health insurance appropriate for the patients' symptoms or other circumstances.

第七十一条第六十四条の登録は、医師若しくは歯科医師又は薬剤師の申請により行う。

Article 71(1)Registration under Article 64 is made upon an application by a physician, dentist or pharmacist.

２厚生労働大臣は、前項の申請があった場合において、次の各号のいずれかに該当するときは、第六十四条の登録をしないことができる。

(2)If an application referred to in the preceding paragraph that corresponds to any of the following items is filed, the Minister of Health, Labour and Welfare may not make a registration under Article 64:

３厚生労働大臣は、保険医又は保険薬剤師に係る第六十四条の登録をしないこととするときは、地方社会保険医療協議会の議を経なければならない。

(3)If the Minister of Health, Labour and Welfare determines not to make a registration referred to in Article 64 pertaining to a physician providing health insurance treatment or a pharmacist filling health insurance prescriptions, the Minister must undergo discussion at the relevant local social insurance medical council.

４第一項又は第二項に規定するもののほか、保険医及び保険薬剤師に係る第六十四条の登録に関して必要な事項は、政令で定める。

(4)Beyond what is provided for in paragraphs (1) and (2), necessary matters concerning registration referred to in Article 64 pertaining to physicians providing insurance treatment and pharmacists filling insurance prescriptions are specified by Cabinet Order.

第七十二条保険医療機関において診療に従事する保険医又は保険薬局において調剤に従事する保険薬剤師は、厚生労働省令で定めるところにより、健康保険の診療又は調剤に当たらなければならない。

Article 72(1)A physician providing health insurance treatment at a medical institution providing services covered by health insurance or a pharmacist filling health insurance prescriptions at a pharmacy providing services covered by health insurance must provide medical care or prescription services covered by health insurance pursuant to Order of the Ministry of Health, Labour and Welfare.

２保険医療機関において診療に従事する保険医又は保険薬局において調剤に従事する保険薬剤師は、前項（第八十五条第九項、第八十五条の二第五項、第八十六条第四項、第百十条第七項及び第百四十九条において準用する場合を含む。）の規定によるほか、この法律以外の医療保険各法又は高齢者の医療の確保に関する法律による診療又は調剤に当たるものとする。

(2)A physician providing health insurance treatment at a medical institution providing services covered by health insurance or a pharmacist filling health insurance prescriptions at a pharmacy providing services covered by health insurance is to be in charge of medical care or prescription pursuant to the provisions of the preceding paragraph (including when applied mutatis mutandis pursuant to Article 85, paragraph (9), Article 85-2, paragraph (5), Article 86, paragraph (4), Article 110, paragraph (7), and Article 149) and pursuant to medical insurance laws other than this act and the Act on Assurance of Medical Care for Elderly People.

第七十三条保険医療機関及び保険薬局は療養の給付に関し、保険医及び保険薬剤師は健康保険の診療又は調剤に関し、厚生労働大臣の指導を受けなければならない。

Article 73(1)A medical institution providing services covered by health insurance or a pharmacy providing services covered by health insurance, and the physician providing health insurance treatment or the pharmacist filling health insurance prescriptions, must receive guidance from the Minister of Health, Labour and Welfare with respect to benefits for medical treatment and with respect to medical care or prescription services provided under a national health insurance program, respectively.

２厚生労働大臣は、前項の指導をする場合において、必要があると認めるときは、診療又は調剤に関する学識経験者をその関係団体の指定により指導に立ち会わせるものとする。ただし、関係団体が指定を行わない場合又は指定された者が立ち会わない場合は、この限りでない。

(2)When the guidance referred to in the preceding paragraph is provided, and the Minister of Health, Labour and Welfare finds it necessary, the Minister is to have persons with knowledge and experience concerning medical care or prescription services attend during the guidance pursuant to designation by related organizations; provided, however, that this does not apply if related organizations make no designation or the designated persons do not attend.

第七十四条第六十三条第三項の規定により保険医療機関又は保険薬局から療養の給付を受ける者は、その給付を受ける際、次の各号に掲げる場合の区分に応じ、当該給付につき第七十六条第二項又は第三項の規定により算定した額に当該各号に定める割合を乗じて得た額を、一部負担金として、当該保険医療機関又は保険薬局に支払わなければならない。

Article 74(1)A person who receives benefits for medical treatment from a medical institution providing services covered by health insurance or a pharmacy providing services covered by health insurance pursuant to the provisions of Article 63, paragraph (3) must pay, in accordance with the classifications listed in the following items, an amount obtained by multiplying the amount calculated pursuant to the provisions of Article 76, paragraph (2) or (3) with respect to the benefit by the ratio specified in the relevant item below, as the person's co-payment to the medical institution or the pharmacy when receiving the benefit:

２保険医療機関又は保険薬局は、前項の一部負担金（第七十五条の二第一項第一号の措置が採られたときは、当該減額された一部負担金）の支払を受けるべきものとし、保険医療機関又は保険薬局が善良な管理者と同一の注意をもってその支払を受けることに努めたにもかかわらず、なお療養の給付を受けた者が当該一部負担金の全部又は一部を支払わないときは、保険者は、当該保険医療機関又は保険薬局の請求に基づき、この法律の規定による徴収金の例によりこれを処分することができる。

(2)A medical institution providing services covered by health insurance or a pharmacy providing services covered by health insurance is to receive the co-payment referred to in the preceding paragraph (if the reduction referred to in Article 75-2, paragraph (1), item (i) is made, the co-payment after the reduction) and, when a person who received the relevant benefit for medical treatment fails to make all or part of the co-payment despite the efforts of the medical institution or pharmacy to receive the payment with the same level of care as the due care of a prudent manager, the insurer may impose a disposition on the person pursuant to the same rules as those for the money to be collected pursuant to the provisions of this Act, at the request of the medical institution or pharmacy.

第七十五条前条第一項の規定により一部負担金を支払う場合においては、同項の一部負担金の額に五円未満の端数があるときは、これを切り捨て、五円以上十円未満の端数があるときは、これを十円に切り上げるものとする。

Article 75When co-payment is made pursuant to the provisions of paragraph (1) of the preceding Article, if the amount of co-payment referred to in the same paragraph is a figure with less than five, it is to be rounded down to the nearest ten yen, whereas if it is a figure with at least five yen but less than ten yen, it is to be rounded up to the nearest ten yen.

第七十五条の二保険者は、災害その他の厚生労働省令で定める特別の事情がある被保険者であって、保険医療機関又は保険薬局に第七十四条第一項の規定による一部負担金を支払うことが困難であると認められるものに対し、次の措置を採ることができる。

Article 75-2(1)An insurer may take any of the following measures with respect to an insured person who is in a disaster or other special circumstances specified by Order of the Ministry of Health, Labour and Welfare and regarding whom it is found difficult to make co-payment to a medical institution providing services covered by health insurance or pharmacy providing services covered by health insurance pursuant to the provisions of Article 74, paragraph (1):

２前項の措置を受けた被保険者は、第七十四条第一項の規定にかかわらず、前項第一号の措置を受けた被保険者にあってはその減額された一部負担金を保険医療機関又は保険薬局に支払うをもって足り、同項第二号又は第三号の措置を受けた被保険者にあっては一部負担金を保険医療機関又は保険薬局に支払うことを要しない。

(2)Notwithstanding the provisions of Article 74, paragraph (1), if the measure referred to in item (i) of the preceding paragraph has been taken with respect to an insured person, it is sufficient for the person to pay the amount of co-payment so reduced to the relevant medical institution or pharmacy providing services covered by health insurance, and if the measure referred to in item (ii) or (iii) has been taken with respect to an insured person, the person is not required to make co-payment to the relevant medical institution providing services covered by health insurance or pharmacy providing services covered by health insurance.

３前条の規定は、前項の場合における一部負担金の支払について準用する。

(3)The provisions of the preceding Article apply mutatis mutandis to co-payment in the case referred to in the preceding paragraph.

第七十六条保険者は、療養の給付に関する費用を保険医療機関又は保険薬局に支払うものとし、保険医療機関又は保険薬局が療養の給付に関し保険者に請求することができる費用の額は、療養の給付に要する費用の額から、当該療養の給付に関し被保険者が当該保険医療機関又は保険薬局に対して支払わなければならない一部負担金に相当する額を控除した額とする。

Article 76(1)Insurers is to pay expenses related to benefits for medical treatment to medical institutions providing services covered by health insurance and pharmacies providing services covered by health insurance. The amount of expenses which a medical institution providing services covered by health insurance or pharmacy providing services covered by health insurance may claim to an insurer in relation to benefits for medical treatment is calculated by deducting the amount of co-payment payable to the medical institution providing services covered by health insurance or pharmacy providing services covered by health insurance by the insured person in relation to the benefits for medical treatment from the amount of expenses incurred in providing the benefits for medical treatment.

２前項の療養の給付に要する費用の額は、厚生労働大臣が定めるところにより、算定するものとする。

(2)The amount of expenses for benefits for medical treatment referred to in the preceding paragraph is to be calculated as specified by the Minister of Health, Labour and Welfare.

３保険者は、厚生労働大臣の認可を受けて、保険医療機関又は保険薬局との契約により、当該保険医療機関又は保険薬局において行われる療養の給付に関する第一項の療養の給付に要する費用の額につき、前項の規定により算定される額の範囲内において、別段の定めをすることができる。

(3)An insurer may, with the authorization of the Minister of Health, Labour and Welfare, specify otherwise in a contract with a medical institution providing services covered by health insurance or pharmacy providing services covered by health insurance with respect to the amount of expenses incurred in providing the benefits for medical treatment referred to in paragraph (1) to be provided at the medical institution providing services covered by health insurance or pharmacy providing services covered by health insurance within the range of the amount calculated pursuant to the provisions of the preceding paragraph.

４保険者は、保険医療機関又は保険薬局から療養の給付に関する費用の請求があったときは、第七十条第一項及び第七十二条第一項の厚生労働省令並びに前二項の定めに照らして審査の上、支払うものとする。

(4)When receiving a claim for expenses incurred in providing medical services from a medical institution providing services covered by health insurance or pharmacy providing services covered by health insurance, the insurer is to make payment after conducting an examination in light of the provisions of Order of the Ministry of Health, Labour and Welfare referred to in Article 70, paragraph (1) and Article 72, paragraph (1) and the provisions of the preceding two paragraphs.

５保険者は、前項の規定による審査及び支払に関する事務を社会保険診療報酬支払基金法（昭和二十三年法律第百二十九号）による社会保険診療報酬支払基金（以下「基金」という。）又は国民健康保険法第四十五条第五項に規定する国民健康保険団体連合会（以下「国保連合会」という。）に委託することができる。

(5)An insurer may delegate affairs concerning the examination and payment pursuant to the provisions of the preceding paragraph to the Social Insurance Medical Fee Payment Fund (hereinafter referred to as the "Social Insurance Fund") established pursuant to the Social Insurance Medical Fee Payment Fund Act (Act No. 129 of 1948) or a federation of national health insurance associations (hereinafter referred to as an "NHI federation") prescribed in Article 45, paragraph (5) of the National Health Insurance Act.

６前各項に定めるもののほか、保険医療機関又は保険薬局の療養の給付に関する費用の請求に関して必要な事項は、厚生労働省令で定める。

(6)Beyond what is provided for in the preceding paragraphs, necessary matters concerning claims for expenses incurred in providing medical services at a medical institution providing services covered by health insurance or pharmacy providing services covered by health insurance are specified by Order of the Ministry of Health, Labour and Welfare.

第七十七条厚生労働大臣は、前条第二項の定めのうち薬剤に関する定めその他厚生労働大臣の定めを適正なものとするため、必要な調査を行うことができる。

Article 77The Minister of Health, Labour and Welfare may conduct a necessary survey to ensure the appropriateness of the provisions for chemicals among the provisions of paragraph (2) of the preceding Article and other provisions specified by the Minister of Health, Labour and Welfare.

第七十八条厚生労働大臣は、療養の給付に関して必要があると認めるときは、保険医療機関若しくは保険薬局若しくは保険医療機関若しくは保険薬局の開設者若しくは管理者、保険医、保険薬剤師その他の従業者であった者（以下この項において「開設者であった者等」という。）に対し報告若しくは診療録その他の帳簿書類の提出若しくは提示を命じ、保険医療機関若しくは保険薬局の開設者若しくは管理者、保険医、保険薬剤師その他の従業者（開設者であった者等を含む。）に対し出頭を求め、又は当該職員に関係者に対して質問させ、若しくは保険医療機関若しくは保険薬局について設備若しくは診療録、帳簿書類その他の物件を検査させることができる。

Article 78(1)When the Minister of Health, Labour and Welfare finds it necessary in relation to benefits for medical treatment, the minister or governor may order a medical institution providing services covered by health insurance or pharmacy providing services covered by health insurance, or a person who was an establisher or manager, physician who provided health insurance treatment, pharmacist who filled health insurance prescriptions, or another employee of a medical institution providing services covered by health insurance or pharmacy providing services covered by health insurance (hereinafter referred to as "former establisher, etc." in this paragraph) to make a report or submit or present medical records or other books and other documents, may request an establisher, manager, physician providing health insurance treatment, pharmacist filling health insurance prescriptions or another employee of a medical institution or pharmacy providing services covered by health insurance (including former establishers, etc.) to appear, or may have an official question persons involved or inspect any equipment or medical records, record books and documents or other objects of the medical institution or pharmacy providing services covered by health insurance.

２第七条の三十八第二項及び第七十三条第二項の規定は前項の規定による質問又は検査について、第七条の三十八第三項の規定は前項の規定による権限について準用する。

(2)The provisions of Article 7-38, paragraph (2) and Article 73, paragraph (2) apply mutatis mutandis to questions or inspections pursuant to the provisions of the preceding paragraph, and the provisions of Article 7-38, paragraph (3) apply mutatis mutandis to the authority granted pursuant to the provisions of the preceding paragraph.

第七十九条保険医療機関又は保険薬局は、一月以上の予告期間を設けて、その指定を辞退することができる。

Article 79(1)A medical institution providing services covered by health insurance or pharmacy providing services covered by health insurance may decline its designation by giving notice not less than one month in advance.

２保険医又は保険薬剤師は、一月以上の予告期間を設けて、その登録の抹消を求めることができる。

(2)A physician providing health insurance treatment or pharmacist filling health insurance prescriptions may request deregistration by giving notice not less than one month in advance.

第八十条厚生労働大臣は、次の各号のいずれかに該当する場合においては、当該保険医療機関又は保険薬局に係る第六十三条第三項第一号の指定を取り消すことができる。

Article 80The Minister of Health, Labour and Welfare may rescind the designation referred to in Article 63, paragraph (3), item (i) pertaining to a medical institution providing services covered by health insurance or pharmacy providing services covered by health insurance if the medical institution or pharmacy falls under any of the following items:

第八十一条厚生労働大臣は、次の各号のいずれかに該当する場合においては、当該保険医又は保険薬剤師に係る第六十四条の登録を取り消すことができる。

Article 81The Minister of Health, Labour and Welfare may cancel the registration pertaining to a physician providing health insurance treatment or pharmacist filling health insurance prescriptions under Article 64 who falls under any of the following items:

第八十二条厚生労働大臣は、第七十条第一項（第八十五条第九項、第八十五条の二第五項、第八十六条第四項、第百十条第七項及び第百四十九条において準用する場合を含む。）若しくは第三項若しくは第七十二条第一項（第八十五条第九項、第八十五条の二第五項、第八十六条第四項、第百十条第七項及び第百四十九条において準用する場合を含む。）の厚生労働省令を定めようとするとき、又は第六十三条第二項第三号若しくは第五号若しくは第七十六条第二項（これらの規定を第百四十九条において準用する場合を含む。）の定めをしようとするときは、中央社会保険医療協議会に諮問するものとする。ただし、第六十三条第二項第三号の定めのうち高度の医療技術に係るものについては、この限りでない。

Article 82(1)When intending to issue Order of the Ministry of Health, Labour and Welfare referred to in Article 70, paragraph (1) (including when applied mutatis mutandis to Article 85, paragraph (9), Article 85-2, paragraph (5), Article 86, paragraph (4), Article 110, paragraph (7), and Article 149) or paragraph (3), or Article 72, paragraph (1) (including when applied mutatis mutandis to Article 85, paragraph (9), Article 85-2, paragraph (5), Article 86, paragraph (4), Article 110, paragraph (7), and Article 149), or intending to specify matters prescribed in Article 63, paragraph (2), item (iii) or (v), or Article 76, paragraph (2) (including when these provisions are applied mutatis mutandis in Article 149), the Minister of Health, Labour and Welfare is to consult with the Central Social Insurance Medical Council; provided, however, that this does not apply to Orders of matters pertaining to advanced medical care techniques among the provisions of Article 63, paragraph (2), item (iii).

２厚生労働大臣は、保険医療機関若しくは保険薬局に係る第六十三条第三項第一号の指定を行おうとするとき、若しくはその指定を取り消そうとするとき、又は保険医若しくは保険薬剤師に係る第六十四条の登録を取り消そうとするときは、政令で定めるところにより、地方社会保険医療協議会に諮問するものとする。

(2)When intending to make or rescind a designation referred to in Article 63, paragraph (3), item (i) pertaining to a medical institution providing services covered by health insurance or pharmacy providing services covered by health insurance, or to rescind a registration referred to in Article 64 pertaining to a physician providing health insurance covered treatment or pharmacist filling health insurance prescriptions, the Minister of Health, Labour and Welfare is to consult with the relevant Local Social Medical Insurance Council as specified by Cabinet Order.

第八十三条厚生労働大臣は、保険医療機関に係る第六十三条第三項第一号の指定をしないこととするとき、若しくはその申請に係る病床の全部若しくは一部を除いて指定（指定の変更を含む。）を行おうとするとき、若しくは保険薬局に係る同号の指定をしないこととするとき、又は保険医若しくは保険薬剤師に係る第六十四条の登録をしないこととするときは、当該医療機関若しくは薬局の開設者又は当該保険医若しくは保険薬剤師に対し、弁明の機会を与えなければならない。この場合においては、あらかじめ、書面で、弁明をすべき日時、場所及びその事由を通知しなければならない。

Article 83When the Minister of Health, Labour and Welfare determines not to make a designation referred to in Article 63, paragraph (3), item (i) pertaining to a medical institution providing services covered by health insurance, determines to make a designation excluding all or some of the beds pertaining to that medical institution's application (including an alternation of such a designation), or determines not to make a designation referred to in the same item pertaining to a pharmacy providing services covered by health insurance, or a registration referred to in Article 64 pertaining to a physician providing health insurance treatment or pharmacist filling health insurance prescriptions, the Minister must grant the establisher of the medical institution or pharmacy, or the physician or pharmacist, an opportunity to hear an explanation.In this case, the Minister must give notification of the date, time, and place for the explanation and the circumstances thereof in writing, in advance.

第八十四条第六十三条第三項第二号及び第三号に掲げる病院若しくは診療所又は薬局において行われる療養の給付及び健康保険の診療又は調剤に関する準則については、第七十条第一項及び第七十二条第一項の厚生労働省令の例による。

Article 84(1)Rules on benefits for medical treatment, and on medical care and prescription services covered by health insurance and provided by hospitals, clinics, and pharmacies listed in Article 63, paragraph (3), items (ii) and (iii) are governed by Order of the Ministry of Health, Labour and Welfare referred to in Article 70, paragraph (1) and Article 72, paragraph (1).

２第六十三条第三項第二号に掲げる病院若しくは診療所又は薬局から療養の給付を受ける者は、その給付を受ける際、第七十四条の規定の例により算定した額を、一部負担金として当該病院若しくは診療所又は薬局に支払わなければならない。ただし、保険者が健康保険組合である場合においては、規約で定めるところにより、当該一部負担金を減額し、又はその支払を要しないものとすることができる。

(2)A person who receives benefits for medical care from a hospital, clinic, or pharmacy listed in Article 63, paragraph (3), item (ii) must pay the amount calculated pursuant to the provisions of Article 74 as co-payment to the hospital, clinic, or pharmacy upon receiving the benefits; provided, however, that if the insurer is a health insurance society, the amount of the co-payment may be decreased or payment thereof may not be required, pursuant to the insurer's constitution.

３健康保険組合は、規約で定めるところにより、第六十三条第三項第三号に掲げる病院若しくは診療所又は薬局から療養の給付を受ける者に、第七十四条の規定の例により算定した額の範囲内において一部負担金を支払わせることができる。

(3)A health insurance society may, pursuant to its constitution, have a person who receives benefits for medical treatment from a hospital, clinic, or pharmacy listed in Article 63, paragraph (3), item (iii) pay the amount of co-payment within the extent of the amount calculated pursuant to the provisions of Article 74.

第八十五条被保険者（特定長期入院被保険者を除く。以下この条において同じ。）が、厚生労働省令で定めるところにより、第六十三条第三項各号に掲げる病院又は診療所のうち自己の選定するものから同条第一項第五号に掲げる療養の給付と併せて受けた食事療養に要した費用について、入院時食事療養費を支給する。

Article 85(1)Dietary treatment expenses for inpatients are paid to an insured person (excluding insured persons undergoing special long-term hospitalization; the same applies hereinafter in this article) for expenses required for dietary treatment that the person received along with benefits for medical treatment listed in Article 63, paragraph (1), item (v) from a hospital or clinic that the person selected from those listed in the items of Article 63, paragraph (3), pursuant to Order of the Ministry of Health, Labour and Welfare.

２入院時食事療養費の額は、当該食事療養につき食事療養に要する平均的な費用の額を勘案して厚生労働大臣が定める基準により算定した費用の額（その額が現に当該食事療養に要した費用の額を超えるときは、当該現に食事療養に要した費用の額）から、平均的な家計における食費の状況及び特定介護保険施設等（介護保険法第五十一条の三第一項に規定する特定介護保険施設等をいう。）における食事の提供に要する平均的な費用の額を勘案して厚生労働大臣が定める額（所得の状況その他の事情をしん酌して厚生労働省令で定める者については、別に定める額。以下「食事療養標準負担額」という。）を控除した額とする。

(2)The amount of dietary treatment expenses for inpatients is the amount obtained by deducting the amount specified by the Minister of Health, Labor and Welfare taking into consideration the status of food expenses for an average household budget and the average amount of expenses required to provide meals at a specified facility for insured long-term care (meaning the specified facilities for insured long-term care prescribed in Article 51-3, paragraph (1) of the Long-Term Care Insurance Act) from the amount calculated based on standards specified by the Minister of Health, Labour and Welfare taking into account the average amount of expenses required for the dietary treatment (if the calculated amount exceeds the amount of expenses actually incurred in the dietary treatment, the amount of expenses actually incurred in the dietary treatment) (for a person specified by Order of Health, Labor and Welfare in consideration of income status and other circumstances, a separately determined amount; hereinafter referred to as "standard co-payment for dietary treatment").

３厚生労働大臣は、前項の基準を定めようとするときは、中央社会保険医療協議会に諮問するものとする。

(3)When intending to specify the standards referred to in the preceding paragraph, the Minister of Health, Labour, and Welfare is to consult with the Central Social Insurance Medical Council.

４厚生労働大臣は、食事療養標準負担額を定めた後に勘案又はしん酌すべき事項に係る事情が著しく変動したときは、速やかにその額を改定しなければならない。

(4)If the circumstances to be taken into consideration have changed significantly since the Minister of Health, Labour, and Welfare determines the amount of standard co-payment for dietary treatment, the Minister must promptly revise the amount.

５被保険者が第六十三条第三項第一号又は第二号に掲げる病院又は診療所から食事療養を受けたときは、保険者は、その被保険者が当該病院又は診療所に支払うべき食事療養に要した費用について、入院時食事療養費として被保険者に対し支給すべき額の限度において、被保険者に代わり、当該病院又は診療所に支払うことができる。

(5)When an insured person has received dietary treatment at or from a hospital or clinic listed in Article 63, paragraph (3), item (i) or (ii), the insurer may, on behalf of the insured person, pay to the hospital or clinic the expenses incurred for the dietary treatment payable by the insured person to the hospital or clinic within the limit of the amount payable to the insured person as expenses for dietary treatment for inpatients.

６前項の規定による支払があったときは、被保険者に対し入院時食事療養費の支給があったものとみなす。

(6)When a payment pursuant to the provisions of the preceding paragraph is paid, it is deemed that the relevant dietary treatment expenses for inpatients are paid to the insured person.

７被保険者が第六十三条第三項第三号に掲げる病院又は診療所から食事療養を受けた場合において、保険者がその被保険者の支払うべき食事療養に要した費用のうち入院時食事療養費として被保険者に支給すべき額に相当する額の支払を免除したときは、入院時食事療養費の支給があったものとみなす。

(7)When an insured person receives dietary treatment from a hospital or clinic listed in Article 63, paragraph (3), item (iii), if the insurer exempts the insured person from payment of an amount equivalent to the amount to be paid as dietary treatment expenses for inpatients among the expenses required for dietary treatment to be paid by the insured person, it is deemed that dietary treatment expenses for inpatients are paid to the insured person.

８第六十三条第三項各号に掲げる病院又は診療所は、食事療養に要した費用につき、その支払を受ける際、当該支払をした被保険者に対し、厚生労働省令で定めるところにより、領収証を交付しなければならない。

(8)Upon acceptance of a payment of expenses incurred for dietary treatment, the hospital or clinic listed in the items of Article 63, paragraph (3) must issue a receipt therefor to the relevant insured person who makes the payment, pursuant to Ordinance of the Ministry of Health, Labour and Welfare.

９第六十四条、第七十条第一項、第七十二条第一項、第七十三条、第七十六条第三項から第六項まで、第七十八条及び前条第一項の規定は、第六十三条第三項各号に掲げる病院又は診療所から受けた食事療養及びこれに伴う入院時食事療養費の支給について準用する。

(9)The provisions of Article 64, Article 70, paragraph (1), Article 72, paragraph (1), Article 73, Article 76, paragraphs (3) through (6), Article 78, and paragraph (1) of the preceding Article apply mutatis mutandis to payment of dietary treatment received at or from a hospital or clinic listed in the items of Article 63, paragraph (3) and dietary treatment expenses for inpatients associated with that dietary treatment.

第八十五条の二特定長期入院被保険者が、厚生労働省令で定めるところにより、第六十三条第三項各号に掲げる病院又は診療所のうち自己の選定するものから同条第一項第五号に掲げる療養の給付と併せて受けた生活療養に要した費用について、入院時生活療養費を支給する。

Article 85-2(1)Living support expenses for inpatients are paid to an insured person undergoing special long-term hospitalization for expenses required for living support that the person received along with benefits for medical treatment listed in Article 63, paragraph (1), item (v) from a hospital or clinic that the person selected from those listed in the items of Article 63, paragraph (3) pursuant to Order of the Ministry of Health, Labour and Welfare.

２入院時生活療養費の額は、当該生活療養につき生活療養に要する平均的な費用の額を勘案して厚生労働大臣が定める基準により算定した費用の額（その額が現に当該生活療養に要した費用の額を超えるときは、当該現に生活療養に要した費用の額）から、平均的な家計における食費及び光熱水費の状況並びに病院及び診療所における生活療養に要する費用について介護保険法第五十一条の三第二項第一号に規定する食費の基準費用額及び同項第二号に規定する居住費の基準費用額に相当する費用の額を勘案して厚生労働大臣が定める額（所得の状況、病状の程度、治療の内容その他の事情をしん酌して厚生労働省令で定める者については、別に定める額。以下「生活療養標準負担額」という。）を控除した額とする。

(2)The amount of living support expenses for inpatients is the amount obtained by deducting the amount specified by the Minister of Health, Labor and Welfare taking into consideration an amount equivalent to the amount of base cost for meal expenses prescribed in Article 51-3, paragraph (2), item (i) of the Long-Term Care Insurance Act and the amount of base cost for residence expenses prescribed in item (ii) of the same paragraph with regard to the status of food expenses for an average household budget and fuel, lighting and water charges as well as expenses required for living support at hospitals and clinics from the amount calculated based on standards specified by the Minister of Health, Labour and Welfare taking into account the average amount of expenses required for the living support (when the calculated amount exceeds the amount of expenses actually incurred in the living support, the amount of expenses actually incurred in the living support) (for a person specified by Order of the Ministry of Health, Labor and Welfare in consideration of income status, extent of symptoms, contents of medical treatment, and other circumstances, a separately determined amount; hereinafter referred to as "standard co-payment for living support").

３厚生労働大臣は、前項の基準を定めようとするときは、中央社会保険医療協議会に諮問するものとする。

(3)When intending to specify the standards referred to in the preceding paragraph, the Minister of Health, Labour, and Welfare is to consult with the Central Social Insurance Medical Council.

４厚生労働大臣は、生活療養標準負担額を定めた後に勘案又はしん酌すべき事項に係る事情が著しく変動したときは、速やかにその額を改定しなければならない。

(4)If the circumstances to be taken into consideration have changed significantly since the Minister of Health, Labour, and Welfare determined the amount of standard co-payment for living support, the minister must promptly revise the amount.

５第六十四条、第七十条第一項、第七十二条第一項、第七十三条、第七十六条第三項から第六項まで、第七十八条、第八十四条第一項及び前条第五項から第八項までの規定は、第六十三条第三項各号に掲げる病院又は診療所から受けた生活療養及びこれに伴う入院時生活療養費の支給について準用する。

(5)The provisions of Article 64, Article 70, paragraph (1), Article 72, paragraph (1), Article 73, Article 76, paragraphs (3) through (6), Article 78, Article 84, paragraph (1), and paragraphs (5) through (8) of the preceding Article apply mutatis mutandis to payment of living support received at or from a hospital or clinic listed in the items of Article 63, paragraph (3) and living support expenses for inpatients associated with the living support.

第八十六条被保険者が、厚生労働省令で定めるところにより、第六十三条第三項各号に掲げる病院若しくは診療所又は薬局（以下「保険医療機関等」と総称する。）のうち自己の選定するものから、評価療養、患者申出療養又は選定療養を受けたときは、その療養に要した費用について、保険外併用療養費を支給する。

Article 86(1)When an insured person receives evaluation treatment, patient-requested treatment, or selective treatment pursuant to Order of the Ministry of Health, Labour and Welfare from a hospital, clinic, or pharmacy (hereinafter collectively referred to as s "medical institution providing services covered by health insurance") that the insured person selected from those listed in the items of Article 63, paragraph (3), medical expenses combined with treatment outside insurance coverage are paid for expenses required for the received treatment.

２保険外併用療養費の額は、第一号に掲げる額（当該療養に食事療養が含まれるときは当該額及び第二号に掲げる額の合算額、当該療養に生活療養が含まれるときは当該額及び第三号に掲げる額の合算額）とする。

(2)The amount of medical expenses combined with treatment outside insurance coverage is the amount listed in item (i) below (the aggregate of that amount and the amount listed in item (ii) if the medical treatment includes dietary treatment, or the aggregate of that amount and the amount listed in item (iii) if the medical treatment includes living support):

３厚生労働大臣は、前項第一号の定めをしようとするときは、中央社会保険医療協議会に諮問するものとする。

(3)When intending to specify the matters as prescribed in item (i), the Minister of Health, Labour, and Welfare is to consult with the Central Social Insurance Medical Council.

４第六十四条、第七十条第一項、第七十二条第一項、第七十三条、第七十六条第三項から第六項まで、第七十七条、第七十八条、第八十四条第一項及び第八十五条第五項から第八項までの規定は、保険医療機関等から受けた評価療養、患者申出療養及び選定療養並びにこれらに伴う保険外併用療養費の支給について準用する。

(4)The provisions of Article 64, Article 70, paragraph (1), Article 72, paragraph (1), Article 73, Article 76, paragraphs (3) through (6), Article 77, Article 78, Article 84, paragraph (1), Article 85, paragraphs (5) through (8) apply mutatis mutandis to the payment of evaluation treatment, patient-requested treatment, and selective treatment received at or from a medical institution providing services covered by health insurance, as well as medical expenses combined with treatment outside insurance coverage associated with the received treatment.

５第七十五条の規定は、前項の規定により準用する第八十五条第五項の場合において第二項の規定により算定した費用の額（その額が現に療養に要した費用の額を超えるときは、当該現に療養に要した費用の額）から当該療養に要した費用について保険外併用療養費として支給される額に相当する額を控除した額の支払について準用する。

(5)The provisions of Article 75 apply mutatis mutandis to payment of the amount calculated by deducting the amount payable as medical expenses combined with treatment outside insurance coverage with respect to expenses incurred in the relevant medical treatment from the amount of expenses calculated pursuant to the provisions of paragraph (2) in the case referred to in Article 85, paragraph (5) as applied mutatis mutandis pursuant to the preceding paragraph (when the amount exceeds the amount of expenses actually incurred in the medical treatment, the amount of expenses actually incurred in the medical treatment).

第八十七条保険者は、療養の給付若しくは入院時食事療養費、入院時生活療養費若しくは保険外併用療養費の支給（以下この項において「療養の給付等」という。）を行うことが困難であると認めるとき、又は被保険者が保険医療機関等以外の病院、診療所、薬局その他の者から診療、薬剤の支給若しくは手当を受けた場合において、保険者がやむを得ないものと認めるときは、療養の給付等に代えて、療養費を支給することができる。

Article 87(1)When an insurer finds it difficult to pay benefits for medical treatment, expenses for dietary treatment for inpatients, living support expenses for inpatients, or medical expenses combined with treatment outside insurance coverage (hereinafter referred to as "benefits for medical treatment" in this paragraph) or finds it unavoidable in cases where an insured person has received any medical care, medication or treatment at or from a hospital, clinic, pharmacy or any other person other than a medical institution providing services covered by health insurance, it may pay medical expenses in lieu of benefits for medical treatment.

２療養費の額は、当該療養（食事療養及び生活療養を除く。）について算定した費用の額から、その額に第七十四条第一項各号に掲げる場合の区分に応じ、同項各号に定める割合を乗じて得た額を控除した額及び当該食事療養又は生活療養について算定した費用の額から食事療養標準負担額又は生活療養標準負担額を控除した額を基準として、保険者が定める。

(2)The amount of medical expenses is determined by the insurer based on: (a) the amount calculated by deducting, from the amount calculated for the medical treatment (excluding dietary treatment and living support), the amount calculated by multiplying the amount by the applicable ratio specified in the items of Article 74, paragraph (1) in accordance with the classifications listed in the items of the same paragraph; and (b) the amount calculated by deducting, from the amount of expenses calculated for the dietary treatment or living support, the amount of standard co-payment for dietary treatment or standard co-payment for living support, respectively.

３前項の費用の額の算定については、療養の給付を受けるべき場合においては第七十六条第二項の費用の額の算定、入院時食事療養費の支給を受けるべき場合においては第八十五条第二項の費用の額の算定、入院時生活療養費の支給を受けるべき場合においては第八十五条の二第二項の費用の額の算定、保険外併用療養費の支給を受けるべき場合においては前条第二項の費用の額の算定の例による。ただし、その額は、現に療養に要した費用の額を超えることができない。

(3)The amount of expenses referred to in the preceding paragraph is calculated as the amount referred to in Article 76, paragraph (2) when a benefit for medical treatment is to be received, the amount referred to in Article 52, paragraph (2) when expenses for dietary treatment for inpatients are to be received, the amount referred to in Article 85-2, paragraph (2) when expenses for living support for inpatients are to be received, and the amount referred to in paragraph (2) of the preceding Article when medical expenses combined with treatment outside insurance coverage are to be received;however, the amount must not exceed the amount of expenses actually required for medical treatment.

第八十八条被保険者が、厚生労働大臣が指定する者（以下「指定訪問看護事業者」という。）から当該指定に係る訪問看護事業（疾病又は負傷により、居宅において継続して療養を受ける状態にある者（主治の医師がその治療の必要の程度につき厚生労働省令で定める基準に適合していると認めたものに限る。）に対し、その者の居宅において看護師その他厚生労働省令で定める者が行う療養上の世話又は必要な診療の補助（保険医療機関等又は介護保険法第八条第二十八項に規定する介護老人保健施設によるものを除く。以下「訪問看護」という。）を行う事業をいう。）を行う事業所により行われる訪問看護（以下「指定訪問看護」という。）を受けたときは、その指定訪問看護に要した費用について、訪問看護療養費を支給する。

Article 88(1)When an insured person receives home-nursing services (services to provide medical care or necessary assistance (excluding those provided by a medical institution providing services covered by health insurance or long-term care health facilities prescribed in Article 8, paragraph (28) of the Long-Term Care Insurance Act; hereinafter referred to as "home-nursing") for medical treatment by a nurse or other person specified by Order of the Ministry of Health, Labor and Welfare to a person who needs to continue to receive medical treatment at the person's home due to sickness or injury (limited to those who are found by an attending physician to be a person requiring medical treatment to an extent that conforms to standards as specified by Order of the Ministry of Health, Labour, and Welfare)) from a provider designated by the Minister of Health, Labor and Welfare (hereinafter referred to as "designated home-nursing provider") at a place of business providing home-nursing services to which the designation pertains (hereinafter referred to as "designated home nursing"), the expenses required for designated home-nursing services are paid to the insured person.

２前項の訪問看護療養費は、厚生労働省令で定めるところにより、保険者が必要と認める場合に限り、支給するものとする。

(2)The medical expenses for home-nursing referred to in the preceding paragraph are paid only if the insurer finds it necessary pursuant to Order of the Ministry of Health, Labour and Welfare.

３指定訪問看護を受けようとする者は、厚生労働省令で定めるところにより、自己の選定する指定訪問看護事業者から受けるものとする。

(3)A person who intends to receive designated home-nursing services is to receive the services from a designated home-nursing provider personally selected by the person pursuant to Order of the Ministry of Health, Labour and Welfare.

４訪問看護療養費の額は、当該指定訪問看護につき指定訪問看護に要する平均的な費用の額を勘案して厚生労働大臣が定めるところにより算定した費用の額から、その額に第七十四条第一項各号に掲げる場合の区分に応じ、同項各号に定める割合を乗じて得た額（療養の給付に係る同項の一部負担金について第七十五条の二第一項各号の措置が採られるべきときは、当該措置が採られたものとした場合の額）を控除した額とする。

(4)The amount of expenses for home nursing is calculated by deducting, from the amount specified by the Minister of Health, Labour and Welfare for the home nursing taking into account the average expenses required for home-nursing, the amount obtained by multiplying the specified amount by the applicable ratio specified in an item of Article 74, paragraph (1) (if any of the measures listed in the items of Article 75, paragraph (1) need to be taken with respect to the co-payment referred to in the same paragraph for benefits for medical treatment, the amount calculated as if the relevant measures were taken), in accordance with the classifications listed in the items of the same paragraph.

５厚生労働大臣は、前項の定めをしようとするときは、中央社会保険医療協議会に諮問するものとする。

(5)When intending to specify the matters referred to in the preceding paragraph, the Minister of Health, Labour, and Welfare is to consult with the Central Social Insurance Medical Council.

６被保険者が指定訪問看護事業者から指定訪問看護を受けたときは、保険者は、その被保険者が当該指定訪問看護事業者に支払うべき当該指定訪問看護に要した費用について、訪問看護療養費として被保険者に対し支給すべき額の限度において、被保険者に代わり、当該指定訪問看護事業者に支払うことができる。

(6)When an insured person has received designated home-nursing from a designated home-nursing provider, the insurer may, on behalf of the relevant insured person, pay to the designated home-nursing provider expenses incurred in the designated home-nursing payable by the insured person to the designated home-nursing provider, within the limit of the amount payable to the insured person as medical expenses for home-nursing.

７前項の規定による支払があったときは、被保険者に対し訪問看護療養費の支給があったものとみなす。

(7)When a payment pursuant to the provisions of the preceding paragraph is made, it is deemed that medical expenses for home-nursing are paid to the insured person.

８第七十五条の規定は、第六項の場合において第四項の規定により算定した費用の額から当該指定訪問看護に要した費用について訪問看護療養費として支給される額に相当する額を控除した額の支払について準用する。

(8)The provisions of Article 75 apply mutatis mutandis to the payment of the amount calculated by deducting, from the amount of expenses calculated pursuant to the provisions of paragraph (4) in the case referred to in paragraph (6), the amount payable as medical expenses for home-nursing with respect to expenses incurred in the relevant designated home-nursing.

９指定訪問看護事業者は、指定訪問看護に要した費用につき、その支払を受ける際、当該支払をした被保険者に対し、厚生労働省令で定めるところにより、領収証を交付しなければならない。

(9)Upon acceptance of the payment of expenses incurred in designated home-nursing, the designated home-nursing provider must issue a receipt therefor to the insured person who made the payment, pursuant to Order of the Ministry of Health, Labour and Welfare.

１０保険者は、指定訪問看護事業者から訪問看護療養費の請求があったときは、第四項の定め及び第九十二条第二項に規定する指定訪問看護の事業の運営に関する基準（指定訪問看護の取扱いに関する部分に限る。）に照らして審査の上、支払うものとする。

(10)When requested to pay medical expenses for home-nursing expenses by a designated home-nursing provider, an insurer is to conduct an examination in light of the matters prescribed in paragraph (4) and standards for operations in home-nursing prescribed in Article 92, paragraph (2) (limited to the part regarding the handling of designated home-nursing).

１１保険者は、前項の規定による審査及び支払に関する事務を基金又は国保連合会に委託することができる。

(11)An insurer may delegate an examination and payment affairs pursuant to the provisions of the preceding paragraph to the Social Insurance Fund or an NHI federation.

１２指定訪問看護は、第六十三条第一項各号に掲げる療養に含まれないものとする。

(12)No designated home-nursing is to be included in any of the types of medical treatment listed in the items of Article 63, paragraph (1).

１３前各項に定めるもののほか、指定訪問看護事業者の訪問看護療養費の請求に関して必要な事項は、厚生労働省令で定める。

(13)Beyond what is provided for in the provisions of the preceding paragraphs, necessary matters concerning requests for medical expenses for home-nursing by a designated home-nursing provider are specified by Order of the Ministry of Health, Labour and Welfare.

第八十九条前条第一項の指定は、厚生労働省令で定めるところにより、訪問看護事業を行う者の申請により、訪問看護事業を行う事業所（以下「訪問看護事業所」という。）ごとに行う。

Article 89(1)The designation referred to in paragraph (1) of the preceding Article is determined pursuant to Order of the Ministry of Health, Labour, and Welfare, upon application by a person that operates a home-nursing business, for each place of business that operates home-nursing business (hereinafter referred to as "home-nursing provider office").

２指定訪問看護事業者以外の訪問看護事業を行う者について、介護保険法第四十一条第一項本文の規定による指定居宅サービス事業者（訪問看護事業を行う者のうち、厚生労働省令で定める基準に該当するものに限る。次項において同じ。）の指定、同法第四十二条の二第一項本文の規定による指定地域密着型サービス事業者（訪問看護事業を行う者のうち、厚生労働省令で定める基準に該当するものに限る。次項において同じ。）の指定又は同法第五十三条第一項本文の規定による指定介護予防サービス事業者（訪問看護事業を行う者のうち、厚生労働省令で定める基準に該当するものに限る。次項において同じ。）の指定があったときは、その指定の際、当該訪問看護事業を行う者について、前条第一項の指定があったものとみなす。ただし、当該訪問看護事業を行う者が、厚生労働省令で定めるところにより、別段の申出をしたときは、この限りでない。

(2)With respect to a provider of home-nursing services other than a designated home-nursing provider, when a designation of an in-home service provider pursuant to the main clause of Article 41, paragraph (1) of the Long-Term Care Insurance Act (limited to a provider of home-nursing services which meets the standards specified by Order of the Ministry of Health, Labor and Welfare; the same applies in the following paragraph), a designation of a community-based service provider pursuant to the provisions of the main clause of Article 42-2, paragraph (1) of the same Act (limited to a provider of home-nursing services which satisfies the standards specified by Order of the Ministry of Health, Labor and Welfare; the same applies in the following paragraph), or a designation of a provider of services to prevent long-term care pursuant to the provisions of the main clause of Article 53, paragraph (1) of the same Act (limited to a provider of home-nursing services which meets the standards specified by Order of the Ministry of Health, Labor and Welfare; the same applies in the following paragraph) has been made, the designation referred to in paragraph (1) of the preceding Article is deemed to have been made for the relevant provider of home-nursing services; provided, however, that this does not apply if the provider of home-nursing services gives a different notification pursuant to Order of the Ministry of Health, Labour, and Welfare.

３介護保険法第七十条の二第一項の規定による指定居宅サービス事業者の指定の失効若しくは同法第七十七条第一項若しくは第百十五条の三十五第六項の規定による指定居宅サービス事業者の指定の取消し若しくは効力の停止、同法第七十八条の十（同法第七十八条の十七の規定により読み替えて適用される場合を含む。）の規定による指定地域密着型サービス事業者の指定の取消し若しくは効力の停止若しくは同法第七十八条の十二において準用する同法第七十条の二第一項若しくは同法第七十八条の十五第一項若しくは第三項（同条第五項において準用する場合を含む。）の規定による指定地域密着型サービス事業者の指定の失効又は同法第百十五条の九第一項若しくは第百十五条の三十五第六項の規定による指定介護予防サービス事業者の指定の取消し若しくは効力の停止若しくは同法第百十五条の十一において準用する同法第七十条の二第一項の規定による指定介護予防サービス事業者の指定の失効は、前項本文の規定により受けたものとみなされた前条第一項の指定の効力に影響を及ぼさないものとする。

(3)An expiration of the designation of a designated in-home service provider pursuant to the provisions of Article 70-2, paragraph (1) of the Long-Term Care Insurance Act or a rescission or suspension of validity of the designation of a designated in-home service provider pursuant to Article 77, paragraph (1) or Article 115-35, paragraph (6) of the same Act, a rescission or suspension of validity of the designation of a designated community-based service provider referred to in Article 78-10 of the same Act (including when applied by replacing terms pursuant to the provisions of Article 78-17 of the same Act), expiration of the designation of a designated community-based service provider referred to in Article 70-2, paragraph (1) of the same Act or Article 78-15, paragraph (1) or (3) of the same Act as applied mutatis mutandis to Article 78-12 of the same Act (including when applied mutatis mutandis to paragraph (5) of the same Act), rescission or expiration of the designation of a designated provider of services to prevent long-term care pursuant to Article 115-9, paragraph (1) of the same Act or Article 115-35, paragraph (6), or expiration of the designation of a designated provider of services to prevent long-term care service pursuant to Article 70-2, paragraph (1) of the same Act as applied mutatis mutandis to Article 115-11 of the same Act does not have any effect on the validity of a designation referred to in paragraph (1) of the preceding Article which is deemed to have been made pursuant to the provision of the main clause of the preceding paragraph.

４厚生労働大臣は、第一項の申請があった場合において、次の各号のいずれかに該当するときは、前条第一項の指定をしてはならない。

(4)When an application referred to in paragraph (1) corresponds to any of the following items, the Minister of Health, Labour and Welfare must not make a designation referred to in the main clause of paragraph (1) of the preceding Article:

第九十条指定訪問看護事業者は、第九十二条第二項に規定する指定訪問看護の事業の運営に関する基準に従い、訪問看護を受ける者の心身の状況等に応じて自ら適切な指定訪問看護を提供するものとする。

Article 90(1)A home-nursing provider is to provide appropriate designated home-nursing itself according to the physical and mental conditions of the person receiving home-nursing, in accordance with the standards for operations in home-nursing prescribed in Article 92, paragraph (2).

２指定訪問看護事業者は、前項（第百十一条第三項及び第百四十九条において準用する場合を含む。）の規定によるほか、この法律以外の医療保険各法による被保険者及び被扶養者の指定訪問看護並びに高齢者の医療の確保に関する法律による被保険者の指定訪問看護を提供するものとする。

(2)Beyond what is provided for in the provisions of the preceding paragraph (including when applied mutatis mutandis to Article 111, paragraph (3) and Article 149), a home-nursing provider is to provide insured persons and their dependents with designated home-nursing under medical insurance laws other than this act as well as the Act on Assurance of Medical Care for Elderly People.

第九十一条指定訪問看護事業者及び当該指定に係る訪問看護事業所の看護師その他の従業者は、指定訪問看護に関し、厚生労働大臣の指導を受けなければならない。

Article 91A designated home-nursing provider, and the nurses and other employees at the home-nursing provider's office to which the designation pertains must receive guidance from the Minister of Health, Labour and Welfare concerning designated home-nursing.

第九十二条指定訪問看護事業者は、当該指定に係る訪問看護事業所ごとに、厚生労働省令で定める基準に従い厚生労働省令で定める員数の看護師その他の従業者を有しなければならない。

Article 92(1)A designated home-nursing provider must employ the number of employees, including nurses, specified by Order of the Ministry of Health, Labour, and Welfare in accordance with standards specified by Order of the Ministry of Health, Labour, and Welfare, at each home-nursing provider office to which the designation pertains.

２前項に規定するもののほか、指定訪問看護の事業の運営に関する基準は、厚生労働大臣が定める。

(2)Beyond what is provided for in the preceding paragraph, standards for operations of a designated home-nursing business are provided for by the Minister of Health, Labour, and Welfare.

３厚生労働大臣は、前項に規定する指定訪問看護の事業の運営に関する基準（指定訪問看護の取扱いに関する部分に限る。）を定めようとするときは、中央社会保険医療協議会に諮問するものとする。

(3)When specifying matters concerning the standards for operations of a designated home-nursing business prescribed in the preceding paragraph (limited to the part concerning the handling of designated home-nursing), the Minister of Health, Labour, and Welfare is to hear the opinions of the Central Social Insurance Medical Council.

第九十三条指定訪問看護事業者は、当該指定に係る訪問看護事業所の名称及び所在地その他厚生労働省令で定める事項に変更があったとき、又は当該指定訪問看護の事業を廃止し、休止し、若しくは再開したときは、厚生労働省令で定めるところにより、十日以内に、その旨を厚生労働大臣に届け出なければならない。

Article 93When the name or location of a home-nursing provider office to which the designation of a designated home-nursing provider pertains or other matters specified by Order of the Ministry of Health, Labour and Welfare are changed, or when the home-nursing business is abolished, suspended, or recommenced, the designated home-nursing provider must provide notification of the change to the Minister of Health, Labour and Welfare within ten days pursuant to Order of the Ministry of Health, Labour and Welfare.

第九十四条厚生労働大臣は、訪問看護療養費の支給に関して必要があると認めるときは、指定訪問看護事業者又は指定訪問看護事業者であった者若しくは当該指定に係る訪問看護事業所の看護師その他の従業者であった者（以下この項において「指定訪問看護事業者であった者等」という。）に対し報告若しくは帳簿書類の提出若しくは提示を命じ、指定訪問看護事業者若しくは当該指定に係る訪問看護事業所の看護師その他の従業者（指定訪問看護事業者であった者等を含む。）に対し出頭を求め、又は当該職員に関係者に対して質問させ、若しくは当該指定訪問看護事業者の当該指定に係る訪問看護事業所について帳簿書類その他の物件を検査させることができる。

Article 94(1)If the Minister of Health, Labour and Welfare finds it necessary in relation to the payment of medical expenses for home-nursing, the Minister may order a designated home-nursing provider or an entity which was a designated home-nursing provider, or a person who was a nurse or other employee at the home-nursing provider office to which the designation pertains (hereinafter referred to as a "former designated home-nursing business, etc." in this paragraph) to make a report, or submit or present the books and other documents, may request a designated home-nursing provider, or a nurse or other employee at the home-nursing provider office to which the designation pertains (including a former designated home-nursing businesses, etc.) to appear, or may have the ministry's official question the persons involved, or inspect the books and other documents or other articles of the designated home-nursing provider at the home-nursing provider office to which the designation pertains.

２第七条の三十八第二項の規定は前項の規定による質問又は検査について、同条第三項の規定は前項の規定による権限について準用する。

(2)The provisions of Article 7-38, paragraph (2) apply mutatis mutandis to questions or inspections pursuant to the provisions of the preceding paragraph, and the provisions of paragraph (3) of the same Article apply mutatis mutandis to the authority pursuant to the provisions of the preceding paragraph.

第九十五条厚生労働大臣は、次の各号のいずれかに該当する場合においては、当該指定訪問看護事業者に係る第八十八条第一項の指定を取り消すことができる。

Article 95The Minister of Health, Labour and Welfare may rescind the designation referred to in Article 88, paragraph (1) pertaining to a designated home-nursing provider that falls under any of the following items:

第九十六条厚生労働大臣は、次に掲げる場合には、その旨を公示しなければならない。

Article 96The Minister of Health, Labour and Welfare must make public notice of the cases listed below in those cases:

第九十七条被保険者が療養の給付（保険外併用療養費に係る療養を含む。）を受けるため、病院又は診療所に移送されたときは、移送費として、厚生労働省令で定めるところにより算定した金額を支給する。

Article 97(1)When an insured person has been transported to a hospital or clinic in order to receive medical treatment (including medical treatment covered by medical expenses combined with treatment outside insurance coverage), the insurer pays, as transport expenses, an amount calculated pursuant to Order of the Ministry of Health, Labour and Welfare to the insured person.

２前項の移送費は、厚生労働省令で定めるところにより、保険者が必要であると認める場合に限り、支給するものとする。

(2)The transport expenses referred to in the preceding paragraph are to be paid only if the insurer finds it necessary pursuant to Order of Ministry of Health, Labour and Welfare.

第九十八条被保険者が資格を喪失し、かつ、日雇特例被保険者又はその被扶養者となった場合において、その資格を喪失した際に療養の給付、入院時食事療養費に係る療養、入院時生活療養費に係る療養、保険外併用療養費に係る療養、療養費に係る療養若しくは訪問看護療養費に係る療養又は介護保険法の規定による居宅介護サービス費に係る指定居宅サービス（同法第四十一条第一項に規定する指定居宅サービスをいう。第百二十九条第二項第二号において同じ。）、特例居宅介護サービス費に係る居宅サービス（同法第八条第一項に規定する居宅サービスをいう。同号及び第百三十五条第一項において同じ。）若しくはこれに相当するサービス、地域密着型介護サービス費に係る指定地域密着型サービス（同法第四十二条の二第一項に規定する指定地域密着型サービスをいう。同号において同じ。）、特例地域密着型介護サービス費に係る地域密着型サービス（同法第八条第十四項に規定する地域密着型サービスをいう。同号及び第百三十五条第一項において同じ。）若しくはこれに相当するサービス、施設介護サービス費に係る指定施設サービス等（同法第四十八条第一項に規定する指定施設サービス等をいう。同号において同じ。）、特例施設介護サービス費に係る施設サービス（同法第八条第二十六項に規定する施設サービスをいう。同号及び第百三十五条第一項において同じ。）、介護予防サービス費に係る指定介護予防サービス（同法第五十三条第一項に規定する指定介護予防サービスをいう。同号において同じ。）若しくは特例介護予防サービス費に係る介護予防サービス（同法第八条の二第一項に規定する介護予防サービスをいう。同号及び第百三十五条第一項において同じ。）若しくはこれに相当するサービスのうち、療養に相当するものを受けているときは、当該疾病又は負傷及びこれにより発した疾病につき、当該保険者から療養の給付又は入院時食事療養費、入院時生活療養費、保険外併用療養費、療養費、訪問看護療養費若しくは移送費の支給を受けることができる。

Article 98(1)If an insured person has lost eligibility and become a specially-insured day laborer or a dependent thereof, and, at the time of loss of the eligibility, the person receives a benefit for medical treatment equivalent to medical treatment covered by expenses for dietary treatment for inpatients, medical treatment covered by expenses for living support for inpatients, medical treatment covered by expenses for medical treatment combined with treatment outside insurance coverage, medical treatment covered by medical expenses, or medical treatment covered by medical expenses for home-nursing, or equivalent to a designated in-home service covered by expenses for in-home long-term care service pursuant to the provisions of the Long-Term Care Insurance Act (meaning designated in-home service prescribed in Article 41, paragraph (1) of the same Act; the same applies in Article 129, paragraph (2), item (ii)),or an in-home service covered by an exceptional allowance for in-home long-term care service (meaning in-home service prescribed in Article 8, paragraph (1) of the same Act; the same applies in Article 129, paragraph (2), item (ii) and Article 135, paragraph (1)), a service equivalent thereto, a designated community-based service covered by expenses for community-based long-term care service (meaning designated community-based service prescribed in Article 42-2, paragraph (1) of the same Act; the same applies in Article 129, paragraph (2), item (ii)), a community-based service covered by an exceptional allowance for community-based long-term care service (meaning community-based service prescribed in Article 8, paragraph (14) of the same Act; the same applies in Article 129, paragraph (2), item (ii) and Article 135, paragraph (1)), a service equivalent thereto, a designated facility service, etc. covered by expenses for long-term care facility service (meaning designated facility service, etc. prescribed in Article 48, paragraph (1) of the same Act; the same applies in Article 129, paragraph (2), item (ii)), a facility service covered by an exceptional allowance for long-term care facility service (meaning facility service prescribed in Article 8, paragraph (26) of the same Act; the same applies in Article 129, paragraph (2), item (ii) and Article 135, paragraph (1)), a designated service to prevent long-term care covered by expenses for service to prevent long-term care (meaning designated service to prevent long-term care prescribed in Article 53, paragraph (1) of the same Act; the same applies in Article 129, paragraph (2), item (ii)), a service to prevent long-term care covered by exceptional allowance for service to prevent long-term care (meaning service to prevent long-term care prescribed in Article 8-2, paragraph (1) of the same Act; the same applies in Article 129, paragraph (2), item (ii) and Article 135, paragraph (1)), or a service equivalent thereto, pursuant to the provisions of the same Act, then the person may receive from the relevant insurer benefits for medical treatment, expenses for dietary treatment for inpatients, expenses for living support for inpatients, medical expenses combined with treatment outside insurance coverage, medical expenses, medical expenses for home-nursing, or transport expenses with respect to the relevant illness or injury, and any illness arising therefrom.

２前項の規定による療養の給付又は入院時食事療養費、入院時生活療養費、保険外併用療養費、療養費、訪問看護療養費若しくは移送費の支給は、次の各号のいずれかに該当するに至ったときは、行わない。

(2)Benefits for medical treatment, or expenses for dietary treatment for inpatients, expenses for living support for inpatients, medical expenses combined with treatment outside insurance coverage, medical expenses, medical expenses for home-nursing, or transportation expenses pursuant to the provisions of the preceding paragraph are not paid when any of the events listed in the following items has occurred:

３第一項の規定による療養の給付又は入院時食事療養費、入院時生活療養費、保険外併用療養費、療養費、訪問看護療養費若しくは移送費の支給は、当該疾病又は負傷について、次章の規定により特別療養費（第百四十五条第六項において準用する第百三十二条の規定により支給される療養費を含む。）又は移送費若しくは家族移送費の支給を受けることができる間は、行わない。

(3)Benefits for medical treatment, or expenses for dietary treatment for inpatients, expenses for living support for inpatients, medical expenses combined with treatment outside insurance coverage, medical expenses, medical expenses for home-nursing, or transport expenses pursuant to the provisions of paragraph (1) are not paid during the period in which the relevant person is eligible for payment of special medical expenses (including medical expenses paid pursuant to the provisions of Article 132 as applied mutatis mutandis to Article 145, paragraph (6)), transport expenses, or dependent's transport expenses pursuant to the provisions of the next chapter with respect to the relevant illness or injury.

４第一項の規定による療養の給付又は入院時食事療養費、入院時生活療養費、保険外併用療養費、療養費若しくは訪問看護療養費の支給は、当該疾病又は負傷について、介護保険法の規定によりそれぞれの給付に相当する給付を受けることができる場合には、行わない。

(4)Benefits for medical treatment, or expenses for dietary treatment for inpatients, expenses for living support for inpatients, medical expenses combined with treatment outside insurance coverage, medical expenses, or medical expenses for home-nursing pursuant to the provisions of paragraph (1) are not paid if the relevant person is eligible for any benefit corresponding to one of the above benefits pursuant to the provisions of the Long-Term Care Insurance Act with respect to the relevant illness or injury.

第九十九条被保険者（任意継続被保険者を除く。第百二条第一項において同じ。）が療養のため労務に服することができないときは、その労務に服することができなくなった日から起算して三日を経過した日から労務に服することができない期間、傷病手当金を支給する。

Article 99(1)When an insured person (excluding an insured person with optional and continued coverage; the same applies in Article 102, paragraph (1)) is unable to engage in labor due to medical treatment, the injury and sickness allowance is paid for the period during which the person is unable to engage in work, starting from the day on which three days elapsed after the day on which the person becomes unable to engage in work.

２傷病手当金の額は、一日につき、傷病手当金の支給を始める日の属する月以前の直近の継続した十二月間の各月の標準報酬月額（被保険者が現に属する保険者等により定められたものに限る。以下この項において同じ。）を平均した額の三十分の一に相当する額（その額に、五円未満の端数があるときは、これを切り捨て、五円以上十円未満の端数があるときは、これを十円に切り上げるものとする。）の三分の二に相当する金額（その金額に、五十銭未満の端数があるときは、これを切り捨て、五十銭以上一円未満の端数があるときは、これを一円に切り上げるものとする。）とする。ただし、同日の属する月以前の直近の継続した期間において標準報酬月額が定められている月が十二月に満たない場合にあっては、次の各号に掲げる額のうちいずれか少ない額の三分の二に相当する金額（その金額に、五十銭未満の端数があるときは、これを切り捨て、五十銭以上一円未満の端数があるときは、これを一円に切り上げるものとする。）とする。

(2)The amount of injury and sickness allowance per day is an amount equivalent to two-thirds of the amount equivalent to 1/30th of the average standard monthly remuneration amount (limited to the amount specified by the relevant insured person's insurer; the same applies hereinafter in this paragraph) of each month in the most recent 12 consecutive months before the month in which the payment of injury and sickness allowance starts (if the 1/30 amount is a figure with less than five yen in the ones place, it is to be rounded down, and if it is a figure with at least five yen but less than ten yen in the ones place, it is to be rounded up to the nearest ten yen; if the two-thirds amount is a figure with less than 0.5 yen in the ones place, it is rounded down, and if it is a figure with at least 0.5 yen but less than one yen in the ones place, it is to be rounded up to the nearest one yen); provided, however, that if the number of consecutive months for which the average standard monthly remuneration amount is determined is less than 12, an amount equivalent to two-thirds of an amount equivalent to smaller of the amounts listed in the following items (if the amount is a figure with less than 0.5 yen in the one place, it is to be rounded down, and if it is a figure with at least 0.5 yen but less than one yen in the ones place, it is to be rounded up to the nearest one yen).

３前項に規定するもののほか、傷病手当金の額の算定に関して必要な事項は、厚生労働省令で定める。

(3)Beyond what is provided for in the preceding paragraph, necessary matters concerning calculation of the amount of injury and sickness allowance are specified by Order of the Ministry of Health, Labour, and Welfare.

４傷病手当金の支給期間は、同一の疾病又は負傷及びこれにより発した疾病に関しては、その支給を始めた日から起算して一年六月を超えないものとする。

(4)The payment period for injury and sickness allowance is not to exceed one year and six months from the day on which the payment starts, with regard to the same sickness and injury as well as any sickness and injury caused thereby.

第百条被保険者が死亡したときは、その者により生計を維持していた者であって、埋葬を行うものに対し、埋葬料として、政令で定める金額を支給する。

Article 100(1)In the case of the death of an insured person, an amount specified by Cabinet Order is paid as burial charges to the person whose livelihood depends on the income of the insured person and who arranged the burial.

２前項の規定により埋葬料の支給を受けるべき者がない場合においては、埋葬を行った者に対し、同項の金額の範囲内においてその埋葬に要した費用に相当する金額を支給する。

(2)If there is no one to receive burial charges pursuant to the provisions of the preceding paragraph, an amount equivalent to the expenses required for the burial within the range of the amount in the same paragraph is paid to the person who arranged the burial.

第百一条被保険者が出産したときは、出産育児一時金として、政令で定める金額を支給する。

Article 101When an insured person gives birth, the amount specified by Cabinet Order is paid as a lump-sum allowance for childbirth and childcare.

第百二条被保険者が出産したときは、出産の日（出産の日が出産の予定日後であるときは、出産の予定日）以前四十二日（多胎妊娠の場合においては、九十八日）から出産の日後五十六日までの間において労務に服さなかった期間、出産手当金を支給する。

Article 102(1)When an insured person gives birth, childbirth allowance is paid in the period during which the person does not engage in work, including 42 days (98 days in the case of multiple fetuses) preceding the day of childbirth (the scheduled date of childbirth if the day of childbirth is after the scheduled date of childbirth) and 56 days following the day of childbirth.

２第九十九条第二項及び第三項の規定は、出産手当金の支給について準用する。

(2)The provisions of Article 99, paragraphs (2) and (3) apply mutatis mutandis to the payment of childbirth allowance.

第百三条出産手当金を支給する場合（第百八条第三項又は第四項に該当するときを除く。）においては、その期間、傷病手当金は、支給しない。ただし、その受けることができる出産手当金の額（同条第二項ただし書の場合においては、同項ただし書に規定する報酬の額と同項ただし書の規定により算定される出産手当金の額との合算額）が、第九十九条第二項の規定により算定される額より少ないときは、その差額を支給する。

Article 103(1)Injury and sickness allowance is not paid during the period in which childbirth allowance is paid (excluding cases falling under Article 108, paragraph (3) or (4)); provided, however, that if the amount of childbirth allowance to be received (in the case of the proviso to paragraph (2) of the same Article, the total sum of the amount of remuneration prescribed in the proviso and the amount of childbirth allowance calculated pursuant to the proviso) is less than the amount calculated pursuant to the provisions of Article 99, paragraph (2), the difference between those amounts is paid.

２出産手当金を支給すべき場合において傷病手当金が支払われたときは、その支払われた傷病手当金（前項ただし書の規定により支払われたものを除く。）は、出産手当金の内払とみなす。

(2)If injury and sickness allowance is paid when childbirth allowance is to be paid, the injury and sickness allowance (excluding an allowance paid pursuant to the proviso to the preceding paragraph) is deemed as part payment of childbirth allowance.

第百四条被保険者の資格を喪失した日（任意継続被保険者の資格を喪失した者にあっては、その資格を取得した日）の前日まで引き続き一年以上被保険者（任意継続被保険者又は共済組合の組合員である被保険者を除く。）であった者（第百六条において「一年以上被保険者であった者」という。）であって、その資格を喪失した際に傷病手当金又は出産手当金の支給を受けているものは、被保険者として受けることができるはずであった期間、継続して同一の保険者からその給付を受けることができる。

Article 104A person who continued to have been an insured person for one year or more until the day preceding the day of loss of eligibility (in case of an insured person with optional and continued coverage, by the day of acquisition of eligibility) as an insured person (excluding insured persons with optional and continued coverage who are members of a mutual aid association) (referred to as a "person who was insured for one year or more" in Article 106) and who received payment of injury and sickness allowance or childbirth allowance at the time of loss of the eligibility may continue to receive the benefits from the same insurer for the period in which the person was eligible for the payment as an insured person.

第百五条前条の規定により保険給付を受ける者が死亡したとき、同条の規定により保険給付を受けていた者がその給付を受けなくなった日後三月以内に死亡したとき、又はその他の被保険者であった者が被保険者の資格を喪失した日後三月以内に死亡したときは、被保険者であった者により生計を維持していた者であって、埋葬を行うものは、その被保険者の最後の保険者から埋葬料の支給を受けることができる。

Article 105(1)When a person receiving insurance benefits pursuant to the provisions of the preceding Article dies, a person who had been receiving insurance benefits pursuant to the provisions of the same Article dies within three days after the day of loss of the benefits, or a person who was an insured person dies within three days after the day of loss of a eligibility as an insured person, a person whose livelihood depends on the income of the insured person and who arranges the burial may receive burial charges from the last insurer of the insured person.

２第百条の規定は、前項の規定により埋葬料の支給を受けるべき者がない場合及び同項の埋葬料の金額について準用する。

(2)The provisions of Article 100 apply mutatis mutandis to a case in which no one is eligible to receive burial charges pursuant to the provisions of the preceding paragraph and to the amount of burial charges referred to in the same paragraph.

第百六条一年以上被保険者であった者が被保険者の資格を喪失した日後六月以内に出産したときは、被保険者として受けることができるはずであった出産育児一時金の支給を最後の保険者から受けることができる。

Article 106A person who was an insured person for one year or more and gives birth within six months after the date of loss of the eligibility as an insured person may be paid the lump-sum allowance for childbirth and childcare that should have been received as an insured person from the person's last insurer.

第百七条前三条の規定にかかわらず、被保険者であった者が船員保険の被保険者となったときは、保険給付は、行わない。

Article 107Notwithstanding the provisions of the preceding three Articles, when a person who was an insured person becomes an insured person covered by Seamen's Insurance, insurance benefits are not paid.

第百八条疾病にかかり、又は負傷した場合において報酬の全部又は一部を受けることができる者に対しては、これを受けることができる期間は、傷病手当金を支給しない。ただし、その受けることができる報酬の額が、第九十九条第二項の規定により算定される額より少ないとき（第百三条第一項又は第三項若しくは第四項に該当するときを除く。）は、その差額を支給する。

Article 108(1)Injury and sickness allowance is not paid to a person who may receive all or part of the person's remuneration in case of sickness or injury during the period in which the person may receive the remuneration; provided, however, that if the amount of the remuneration to be received is less than the amount calculated pursuant to the provisions of Article 99, paragraph (2) (excluding the cases falling under Article 103, paragraph (1) or , paragraph (3) or (4)), the difference between those amounts is paid.

２出産した場合において報酬の全部又は一部を受けることができる者に対しては、これを受けることができる期間は、出産手当金を支給しない。ただし、その受けることができる報酬の額が、出産手当金の額より少ないときは、その差額を支給する。

(2)Childbirth allowance is not paid to a person who may receive all or part of the person's remuneration in case of childbirth during the period in which the person may receive the remuneration; provided, however, that if the amount of the remuneration to be received is less than the amount of childbirth allowance, the difference between those amounts is paid.

３傷病手当金の支給を受けるべき者が、同一の疾病又は負傷及びこれにより発した疾病につき厚生年金保険法による障害厚生年金の支給を受けることができるときは、傷病手当金は、支給しない。ただし、その受けることができる障害厚生年金の額（当該障害厚生年金と同一の支給事由に基づき国民年金法による障害基礎年金の支給を受けることができるときは、当該障害厚生年金の額と当該障害基礎年金の額との合算額）につき厚生労働省令で定めるところにより算定した額（以下この項において「障害年金の額」という。）が、第九十九条第二項の規定により算定される額より少ないときは、当該額と次の各号に掲げる場合の区分に応じて当該各号に定める額との差額を支給する。

(3)Injury and sickness allowance is not paid when the person to receive injury and sickness allowance is eligible for a disability welfare pension pursuant to the Employee's Pension Insurance Act due to the same sickness and injury, and diseases caused thereby; provided, however, that if the amount of the disability welfare pension to be received (when it is possible to receive the disability basic pension pursuant to the National Pension Act based on the same payment reason as that for the disability welfare pension, the total sum of the amount of the disability welfare pension and the amount of the disability basic pension) calculated pursuant to Order of the Ministry of Health, Labour and Welfare (hereinafter referred to as the "amount of disability pension" in this paragraph) is less than the amount calculated pursuant to the provisions of Article 99, paragraph (2), the difference between the calculated amount and an amount specified in accordance with the classification of each of the following items is paid:

４傷病手当金の支給を受けるべき者が、同一の疾病又は負傷及びこれにより発した疾病につき厚生年金保険法による障害手当金の支給を受けることができるときは、当該障害手当金の支給を受けることとなった日からその者がその日以後に傷病手当金の支給を受けるとする場合の第九十九条第二項の規定により算定される額の合計額が当該障害手当金の額に達するに至る日までの間、傷病手当金は、支給しない。ただし、当該合計額が当該障害手当金の額に達するに至った日において当該合計額が当該障害手当金の額を超える場合において、報酬の全部若しくは一部又は出産手当金の支給を受けることができるときその他の政令で定めるときは、当該合計額と当該障害手当金の額との差額その他の政令で定める差額については、この限りでない。

(4)When a person who is to receive injury and sickness allowance is eligible for disability allowance pursuant to the Employee's Pension Insurance Act due to the same sickness and injury, and diseases caused thereby, injury and sickness allowance is not paid during the period from day on which the person starts receiving the disability allowance until the day on which the total sum of the amounts calculated pursuant to the provisions of Article 99, paragraph (2) in the case where the person is to receive payment of injury and sickness allowance after that day reaches the amount of the disability allowance; provided, however, this does not apply to the difference between that total amount and the disability allowance or another difference specified by Cabinet Order if the person is entitled to all or some of remuneration or eligible for childbirth allowance, or in other cases specified by Cabinet Order on the day when the total amount reaches or exceeds the amount of the disability allowance.

５傷病手当金の支給を受けるべき者（第百四条の規定により受けるべき者であって、政令で定める要件に該当するものに限る。）が、国民年金法又は厚生年金保険法による老齢を支給事由とする年金たる給付その他の老齢又は退職を支給事由とする年金である給付であって政令で定めるもの（以下この項及び次項において「老齢退職年金給付」という。）の支給を受けることができるときは、傷病手当金は、支給しない。ただし、その受けることができる老齢退職年金給付の額（当該老齢退職年金給付が二以上あるときは、当該二以上の老齢退職年金給付の額の合算額）につき厚生労働省令で定めるところにより算定した額が、傷病手当金の額より少ないときは、その差額を支給する。

(5)When a person who is to receive injury and sickness allowance (limited to a person who is to receive it pursuant to the provisions of Article 104 and who meets the requirements specified by Cabinet Order) is eligible for payment of pension benefits specified by Cabinet Order pursuant to the National Pension Act or the Employee's Pension Insurance Act with aging or retirement as the grounds for payment (hereinafter referred to as "superannuation benefits" in this paragraph and the following paragraph), injury and sickness allowance is not paid; provided, however, that if the amount of the superannuation benefits (if there are two or more superannuation benefits, the total sum of the benefits) calculated pursuant to Order of the Ministry of Health, Labour and Welfare is less than the amount of injury and sickness allowance, the difference between those amounts is paid.

６保険者は、前三項の規定により傷病手当金の支給を行うにつき必要があると認めるときは、老齢退職年金給付の支払をする者（次項において「年金保険者」という。）に対し、第二項の障害厚生年金若しくは障害基礎年金、第三項の障害手当金又は前項の老齢退職年金給付の支給状況につき、必要な資料の提供を求めることができる。

(6)When finding it necessary for the payment of injury and sickness allowance pursuant to the provisions of the preceding three paragraphs, an insurer may request those who pay superannuation benefits (referred to as "pension insurers" in the next paragraph) to provide necessary materials about the status of payment of disability welfare pension or disability basic pension referred to in paragraph (2), disability allowance referred to in paragraph (3), or superannuation benefits referred to in the preceding paragraph.

７年金保険者（厚生労働大臣を除く。）は、厚生労働大臣の同意を得て、前項の規定による資料の提供の事務を厚生労働大臣に委託して行わせることができる。

(7)Pension insurers (except for the Minister of Health, Labour and Welfare), with the consent of the Minister of Health, Labour and Welfare, may delegate affairs related to the provision of documents pursuant to the provisions of the preceding paragraph to the Minister of Health, Labour and Welfare.

第百九条前条第一項から第四項までに規定する者が、疾病にかかり、負傷し、又は出産した場合において、その受けることができるはずであった報酬の全部又は一部につき、その全額を受けることができなかったときは傷病手当金又は出産手当金の全額、その一部を受けることができなかった場合においてその受けた額が傷病手当金又は出産手当金の額より少ないときはその額と傷病手当金又は出産手当金との差額を支給する。ただし、同条第一項ただし書、第二項ただし書、第三項ただし書又は第四項ただし書の規定により傷病手当金又は出産手当金の一部を受けたときは、その額を支給額から控除する。

Article 109(1)When a person prescribed in any of paragraphs (1) through (4) of the preceding Article becomes sick or injured, or gives birth, with respect to all of part of the remuneration to which the person is entitled, the entire amount of injury and sickness allowance or childbirth allowance is paid if the person is unable to receive all of the remuneration, and the difference between the amount of remuneration received and the amount of injury and sickness allowance or childbirth allowance is paid if the person is unable to receive part of the remuneration and the received amount is less than the amount of injury and sickness allowance or childbirth allowance; provided, however, that if a part of injury and sickness allowance or childbirth allowance is received pursuant to the provisions of the proviso to paragraph (1), paragraph (2), paragraph (3) or paragraph (4) of the preceding article, an amount equivalent to the allowance is deducted from the amount to be paid.

２前項の規定により保険者が支給した金額は、事業主から徴収する。

(2)The amount paid by the insurer pursuant to the provisions of the preceding paragraph is collected from the employer.