BPJS Kesehatan Finds Cheating Of JKN Program Reaching IDR866 Billion

President Director of BPJS Kesehatan Ghufron Mukti (right) and Inspector General of the Indonesian Ministry of Health Murti Utami (left) / DOK ANTARA

JAKARTA - The Health Social Security Administration (BPJS) found allegations of fraud or fraud in health care facilities affiliated with the National Health Insurance Program (JKN) with a value of Rp866 billion this year. "In total, it's only Rp866 billion this year, so it's quite large," said BPJS Health President Director Ghufron Mukti on the sidelines of the awarding ceremony for the Anti-Corruption and Control of the JKN Program Gratification in Jakarta, Thursday, December 7. Ghufron explained that the fraud consisted of various modes. Such as accessive use or use for unnecessary things and phantom billing or false claims without any action or fraudulent patients. To overcome this, he revealed, BPJS Kesehatan implemented a number of sanctions such as warnings and strengthening the anti-fraud ecosystem from within to prevent this from happening. "We are also building a system, so we are not just looking for victims. We are working with various parties, including the Ministry of Health (Kemenkes), hospitals, and associations, to build and improve the system so that it can be more effective and efficient," he said. For this reason, Ghufron said that currently BPJS Kesehatan is strengthening the anti-fraud ecosystem in various ways, one of which is by forming 1,947 JKN Anti-Corruption Teams spread throughout Indonesia. On the same occasion, the Inspector General (Irjen) of the Indonesian Ministry of Health, Murti Utami, explained that his party would continue to improve prevention. One of them, through a database or database that records the track records of all health and medical personnel to prevent fraud individually.

In addition, he revealed that the policy of limiting and termination of employment between hospitals proven to have committed fraud with BPJS Kesehatan could also be considered if it had been repeatedly warned. "That is also if we have warned repeatedly and repeatedly. So we are not sporadic, we have to go through various considerations because we also want to serve the community," he said.