KPK: Fraud In The Public Health Sector Around Rp20 Trillion

Deputy Chairman of the Corruption Eradication Commission (KPK) Alexander Marwata at an event in the Bogor area, West Java, quoted Friday, September 13, 2024 (Tsa Tsia/VOI)

JAKARTA - The Corruption Eradication Commission (KPK) said fraud or fraud in the public health sector reached Rp20 trillion.

This was conveyed by KPK Deputy Chair Alexander Marwata while attending the 2024 BPJS Health Facilities National Meeting at the Grand Sahid Jaya Hotel, Jakarta, Thursday, September 19. He said this loss was 10 percent of the budget that had been issued.

"Losses from fraud in the health sector are 10 percent of public health spending of around Rp. 20 trillion in nominal terms," Alexander said as quoted from his written statement, Friday, September 20.

"One of the cases that cause losses is manipulation or phantom billing by health facilities both central and regional in collaboration with BPJS Kesehatan," said Alexander.

As for 2024, he continued, the budget disbursed to support health facility services will reach Rp150 trillion. Thus, governance with integrity needs to be prioritized by BPJS Kesehatan so that it is right on target.

"But in fact, along with the program's journey, a number of weaknesses or fraud have still been found," he said.

Another case that Alexander also mentioned was manipulating participant data and utilizing unnecessary services to take advantages such as excessive medical action or unnecessary drug administration.

On that basis, the KPK continues to make prevention efforts through the development of an ecosystem with integrity with related parties so as to reduce the risk of fraud and corruption.

"I emphasize that eradicating corruption is not only the task of the KPK, but our task together. Everyone can't close their eyes when they know that there is fraud in the environment, report it to BPJS! I think now there is a feature like Whistle Blower System (WBS). If it can be reminded and prevented from an early age, it is better," he said.

BPJS Kesehatan merupakan gotong kerong bersama dalam rangka membuat masyarakat Indonesia sehat. Ada duean peserta, ada juga subsidi pemerintah melalui APBN dan APBD, artinya ada uang negara dan dana publik di dalamnya. Ini yang harus dikelola, ungkap Alex.

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Meanwhile, President Director of BPJS Kesehatan Ghufron Mukti conveyed the importance of synergy between parties, including government agencies, health facilities, as well as professional associations and organizations to support the sustainability and improvement of the quality of the JKN program.

He stated that 2024 is the right moment to continue the transformation of service quality, especially in expanding access to health services.

"We use this moment to appreciate health facilities that are healthy and free from corruption. In the future, BPJS Kesehatan will continue to be committed to improving access and quality of health services through various innovations," said Ghufron.

"Symplify service administration in health facilities as well as digitization of services through teleconsultation, e-SEP, online queues, and i-Care JKN," he continued.