Article Sidebar

Submitted
25 October 2021
Published
30 December 2021
Download
PDF
Statistic
Read Counter : 2025 Download : 2915

Main Article Content

Abstract

The Minister of Health Regulation (PMK) Number 16 of 2019 concerning Fraud Prevention in the National Health Insurance Program (JKN) as a substitute for Minister of Health Regulation Number 36 of 2015 is still being evaluated and studied in its implementation. According to the mandate of PMK Number 16 of 2019, there is still the possibility of fraud in the implementation of JKN that has not been demonstrated and followed up on by the Fraud Prevention Team (TPF). Analyze PMK policy Number 16 of 2019 and investigate for other policy options so that their implementation works properly. The Bardach Criteria are used in the study to weight the alternative policy options that will be recommended next. The analysis result indicated that PMK Number 16 of 2019 is still stagnant, and optimizing the JKN TPF function is more feasible at this time, particularly that the PMK revision will require more time and be more complicated.

Keywords

fraud analisis kebijakan JKN tim pencegahan kecurangan

Article Details

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

How to Cite
Anjayani, D. (2021). Analisis Kebijakan dan Implementasi Peraturan Menteri Kesehatan Nomor 16 Tahun 2019 pada Program Jaminan Kesehatan Nasional. Jurnal Jaminan Kesehatan Nasional, 1(2), 81–94. https://doi.org/10.53756/jjkn.v1i2.37
Download Citation
Endnote/Zotero/Mendeley (RIS)
BibTeX

References

  1. Ai, J., Russomanno, J., Guigou, S., & Allan, R. (2021). A Systematic Review and Qualitative Assessment of Fraud Detection Methodologies in Health Care. North American Actuarial Journal, 0(0), 1–26. https://doi.org/10.1080/10920277.2021.1895843
  2. Bardach, E., & Patashnik, E. M. (2015). A PRACTICAL GUIDE for POLICY ANALYSIS FIFTH EDITION.
  3. Djasri, H., Rahma, P. A., & Hasri, E. T. (2016). Korupsi Dalam Pelayanan Kesehatan Di Era Jaminan Kesehatan Nasional: Kajian Besarnya Potensi Dan Sistem Pengendalian Fraud. Integritas, 2(1), 113–133.
  4. European Commission. (2013). Study on Corruption in the Healthcare Sector (Issue October). https://doi.org/10.2837/58154
  5. Gaitonde, R., Oxman, A. D., Okebukola, P. O., & Rada, G. (2016). Interventions to reduce corruption in the health sector. Cochrane Database of Systematic Reviews, 2016(8). https://doi.org/10.1002/14651858.CD008856.pub2
  6. Gee, J., & Button, M. (2015). The financial cost of fraud 2015: What data from around the world shows. PFK Littlejohn LLP and University of Portsmouth, 1–24.
  7. Hendrartini, Y. (2014). Deteksi dan Investigasi Fraud dalam Asuransi Kesehatan : Bagaimana di Indonesia ? 1–19.
  8. Hussmann, K. (2011). Addressing Corruption in the Health Sector: Securing Equitable Access to Health Care for Everyone. U4 Issue, 1, 39.
  9. Khairi, H. (2008). Konsep Dasar Kebijakan Publik. Atmospheric Environment, 42(13), 2934–2947.
  10. McGee, J., Sandridge, L., Treadway, C., Vance, K., & Coustasse, A. (2018). Strategies for Fighting Medicare Fraud. The Health Care Manager, 37(2), 147–154.
  11. Sadikin, H., & Adisasmito, W. (2016). Analisis Pengaruh Dimensi Fraud Triangle Dalam Kebijakan Pencegahan Fraud Terhadap Program Jaminan Kesehatan Nasional di RSUP Nasional Cipto Mangunkusumo. Jurnal Ekonomi Kesehatan Indonesia, 1(2), 28–34. https://doi.org/10.7454/eki.v1i2.1871
  12. Santoso, B., Hendrartini, J., Djoko Rianto, B. U., & Trisnantoro, L. (2018). System for Detection of National Healthcare Insurance Fraud Based on Computer Application. Public Health of Indonesia, 4(2), 46–56. https://doi.org/10.36685/phi.v4i2.199
  13. Simborg, D. W. (2008). Healthcare Fraud: Whose Problem is it Anyway? Journal of the American Medical Informatics Association, 15(3), 278–280. https://doi.org/10.1197/jamia.M2672
  14. Soputan, R., Tinangon, J., & Lambey, L. (2018). Analisis Resiko Kecurangan terhadap Sistem Pengelolaan Dana Kapitasi Jaminan Kesehatan Nasional Di FKTP Pemerintah Kota Bitung. Jurnal Riset Akuntansi Dan Auditing “Goodwill,” 9(2), 140–149. https://doi.org/10.35800/jjs.v9i2.26469
  15. Stowell, N. F., Schmidt, M., & Wadlinger, N. (2018). Healthcare fraud under the microscope: improving its prevention. Journal of Financial Crime, 25(4), 1039–1061. https://doi.org/10.1108/JFC-05-2017-0041
  16. Trisnantoro, L., & Hendrartini, Y. (2014). Fraud di Jaminan Kesehatan Nasional. 1–25.