STATE NEWS
REPUBLIC OF INDONESIA
| No. 1400, 2013 | HEALTH MINISTRY. National Health Care. Service. Staging. Retraction. |
INDONESIA ' S HEALTH MINISTER REGULATION
No. 71 YEAR 2013
ABOUT
HEALTH CARE SERVICES ON NATIONAL HEALTH GUARANTEE
WITH THE GRACE OF THE ALMIGHTY GOD
HEALTH MINISTER OF THE REPUBLIC OF INDONESIA,
Weighing: that to carry out the provisions of Article 21 paragraph (7), Section 22 of the paragraph (1) letter c, Article 26 of the paragraph (2), Section 29 of the paragraph (6), Section 31, Section 34 of the paragraph (4), Section 36 of the paragraph (5), Section 37 of the paragraph (3), and Article 44 of the Presidential Regulation No. 12 of 2013 about the Health Guarantee, need to establish the Minister of Health ' s Regulation on Health Care On National Health Guarantee;
Remembering: 1. Act Number 29 of 2004 on the Practice of Medicine (Indonesian Republic of Indonesia 2004 Number 116, Additional Gazette of the Republic of Indonesia Number 4431);
2. Law Number 40 Year 2004 on National Social Security System (Sheet Country Indonesia Year 2004 Number 150, Additional Gazette Republic Indonesia Number 4456);
3. Law No. 36 Year 2009 on Health (State Sheet of the Republic of Indonesia Year 2009 Number 144, Additional Sheet of State of Indonesia Republic No. 5063);
4. Law No. 44 Year 2009 concerning Hospital (Sheet State Republic Of Indonesia 2009 Number 153, Additional Gazette Republic of Indonesia Number 5072);
5. Law No. 24 Year 2011 on Social Security Organizing Agency (Sheet Country Indonesia Year 2011 Number 116, Additional Sheet Republic Of Indonesia Number 5256);
6. Government Regulation No. 51 Year 2009 on Kefarmasian Works (Sheet State Republic Indonesia Year 2009 Number 124, Additional Sheet Of State Republic Of Indonesia Number 5044);
7. Government Regulation Number 101 of 2012 on Recipient Of Health Guarantee Assistance (State Sheet Of The Republic Of Indonesia Year 2012 Number 264, Additional Gazette Of The Republic Of Indonesia Number 5372);
8. Presidential Regulation Number 12 Year 2013 on Health Guarantee (State Sheet of the Republic of Indonesia Year 2013 Number 29);
9. Health Minister Regulation Number HK.02.02/Menkes/148/I/2010 on Permission and Hosting Practice of Nurses as amended with the Regulation of Minister of Health Number 17 Year 2013 (State News of the Republic of Indonesia 2013 Number 473);
10.Regulation of Health Minister Number 1464 /Menkes/Per/Per/Per/X/2010 on Permission and Hosting of the Bidan Practice (State News of the Republic of Indonesia 2010 Number 501);
11.3 Health Minister Regulation No. 2052/Menkes/Per/X/2011 on the Permission of the Practice and Implementation of the Practice of Medicine (State News of the Republic of Indonesia of 2011 Number 671);
DECIDED:
Establish: Health minister ' s regulations on health care on national health guarantees.
BAB I
UMUM CONDITIONS
Section 1
In Regulation of the Minister this is referred to:
1. Health Guarantee is a guarantee of health protection so that participants benefit health care benefits and protection in meeting the basic health needs given to each person who has paid his dues or dues paid for by the government.
2. The subsequent Health Social Security Organizing Agency (BPJS Health) is a legal entity that is set up to host a Health Security program.
3. Participants are each person, including a foreigner who works the most short 6 (six) months in Indonesia, who has paid dues.
4. Benefits are a social security faedah which is the rights of the Participants and/or members of his family.
5. Health facilities are health care facilities used to host individual health care efforts, either the promotion, preventive, curative or rehabilitative performed by the Government, the Local Government, and/or Society.
6. First-level Health Service is a non-specialistic (primary) individual health care service including outpatient and outpatient services.
7. The First Street Rawat is a non-specialistic individual health care service that is exercised at first-degree health facilities for the purposes of observation, diagnosis, treatment, and/or other health services.
8. First-degree Rawat Inap is a non-specialistic individual health service and is exercised at first-degree health facilities for the purposes of observation, treatment, diagnosis, treatment, and/or other medical services, where the participant and/or his family members are hospitalized at least 1 (one) days.
9. Advanced Advanced Health Service is an individual or sub-specific sub-specific health care effort that includes advanced outpatient, advanced hospitalization, and hospitalization in the care room. Special.
10. Medical Emergency Health Service is a health care ministry that must be provided immediately to prevent death, severity, and/or disability in accordance with the ability of a health facility.
11. Health tools are instruments, aparatus, machines, and/or implants that do not contain medications that are used to prevent, diagnose, cure and relieve disease, care for the sick as well as restore health to humans and/or forming structure and repairing body functions.
12. The National Formularium is a list of drugs compiled by the national committee set by the Minister of Health, based on cutting-edge scientific evidence, is safe, and at an affordable price that is provided and used as a reference. the use of drugs in the national health guarantee.
13. The system of persuasion is the host of health care that governs the abundance of duties and responsibility of the health ministry in reciprocity both vertically and horizontally.
14. The Minister is the minister who organizes government affairs in the field of health.
BAB II
HEALTH CARE ORGANIZER
Section 2
(1) The organizers of the health service include all Health Facilities in cooperation with BPJS Health of the first-degree Health Facility and advanced referral Health Facility.
(2) The first level Health Facility as referred to in paragraph (1) may be:
a. puskesmas or equivalent;
B. doctor practice;
c. dentists practice;
D. previewed or equivalent preview clinic; and
e. The Class D Pratama Hospital or the equivalent.
(3) The advanced referral Health Facility as referred to in paragraph (1) is:
a. Primary or equivalent clinic;
B. public hospitals; and
c. Special hospital.
Section 3
(1) The first level Health Facility in cooperation with BPJS Health should host a comprehensive health service.
(2) Comprehensive health care as referred to in paragraph (1) the promotional, preventive, curative health care, rehabilitation, monastic services, and Medical Emergency Health Services, including the support services included. Simple laboratory examination and pharmacist service in accordance with the provisions of the laws.
(3) In the event of a comprehensive health service as referred to in paragraph (1), for Health Facilities which do not have the means of support to build a network with a means of support.
(4) In the case of a support service other than the support service as referred to in paragraph (2), it can be obtained by reference to another support facility.
BAB III
HEALTH FACILITIES COOPERATION WITH BPJS HEALTH
The Kesatu section
General
Section 4
(1) The Health Facility as referred to in Article 2 conducts cooperation with BPJS Health.
(2) The Health Facility with BPJS Healthcare as referred to in paragraph (1) is conducted through a cooperation agreement.
(3) The health facility ' s cooperation agreement with BPJS Health is carried out between the leadership or the owner of the Health Facility authorized with BPJS Health.
(4) The cooperation agreement as referred to in paragraph (3) applies at least 1 (one) years and may be extended back to a mutual agreement.
Section 5
(1) To be able to perform cooperation with BPJS Health, the Health Facility as referred to in Article 2 must meet the requirements.
(2) In addition to the provision must meet the requirements as referred to in paragraph (1), the BPJS Health in doing cooperation with the Health Facility should also consider the adequates between the number of Health Facilities with the number of Participants must be served.
The Second Part
Requirements, Selection and Kredensialing
Section 6
(1) The requirement to be fulfilled as referred to in Article 5 of the paragraph (1), for the first-level Health Facility consists of:
a. for a doctor ' s practice or a dentist should have:
1. Ijin Practice Letter;
2. Tax (NPWP) Subject Number (NPWP);
3. cooperation agreements with labs, pharmacies, and other networks; and
4. A letter of statement of willingness to comply with the provisions related to the National Health Guarantee.
B. for Puskesmas or an equivalent must have:
1. Operational Permissions;
2. Letter of Ijin Practice (SIP) for dentists/dentists, Letter Ijin Practice Apoteker (SIPA) for the Apoteker, and the Ijin Practice Letter (SIP/SIK) for other health personnel;
3. The cooperation agreement with the network, if required; and
4. A letter of statement of willingness to comply with the provisions related to the National Health Guarantee.
c. for the Pratama Clinic or the equivalent must have:
1. Operational Permissions;
2. Letter Ijin Practice (SIP) for dentists/dentists and Ijin Work Letters or Work Ijin Letters (SIP/SIK) for other health care;
3. Letter of Ijin Practice Apoteker (SIPA) for the Apoteker in terms of the clinic hosting a pharmacist ministry;
4. Tax (NPWP) Subject Number (NPWP);
5. The cooperation agreement with the network, if required; and
6. A statement of willingness to comply with the provisions related to the National Health Guarantee.
D. for Pratama Class D Hospital or the equivalent must have:
1. Operational Permissions;
2. Letter Ijin Practice (SIP) of the practised health care;
3. Tax (NPWP) Subject Number (NPWP);
4. The cooperation agreement with the network, if required; and
5. A letter of statement of willingness to comply with the provisions related to the National Health Guarantee.
(2) In addition to the requirements as referred to in paragraph (1), the first-level Health Facility should also have been accredited.
Section 7
The requirements to be fulfilled as referred to in Section 5 of the paragraph (1), for the advanced referral Health Facility consist of:
a. for primary or equivalent clinics should have:
1. Operational Permissions;
2. Letter Ijin Practice (SIP) of the practised health care;
3. Tax (NPWP) Subject Number (NPWP);
4. cooperation agreement with laboratory, radiology, and other networks if required; and
5. A letter of statement of willingness to comply with the provisions related to the National Health Guarantee.
B. for the hospital must have:
1. Operational Permissions;
2. Hospital Class Penetration Letter;
3. Letter Ijin Practice (SIP) of the practised health care;
4. Tax (NPWP) Subject Number (NPWP);
5. The cooperation agreement with the network, if required;
6. Accreditation certificate; and
7. A letter of statement of willingness to comply with the provisions related to the National Health Guarantee.
Section 8
(1) In the event of a sub-district there is no doctor based on the designation of Head of the District Health Services/Local City, BPJS Health may cooperate with the practice of midwife and/or nurse practice to provide Health Care Level First in accordance with the authority defined in the laws.
(2) In order of granting obstetric services in a given region, BPJS Health can work together with the practice of midwife.
(3) The requirements for the practice of bidan and/or nurse practices as referred to in paragraph (1) and paragraph (2) are composed of:
a. Practice License (SIP);
B. Tax (NPWP):
c. cooperation agreement with the physician or the culling of its tormentor; and
D. a statement of willingness to comply with the provisions associated with the National Health Guarantee.
Section 9
(1) In setting a Health Facility option, BPJS Health performs selection and credensialing by using the technical criteria that includes:
a. human resources;
B. completeness of the means and infrastructure;
c. scope of service; and
D. service commitment.
(2) Technical Criteria as referred to in paragraph (1) is used for the assignment of cooperation with BPJS Health, type and breadth of service, capitation quantity, and number of Participants who can be served.
(3) BPJS Health in establishing technical criteria as referred to paragraph (1) guidelines on the Regulation of Ministers.
Section 10
(1) The extension of cooperation between Health Facilities with BPJS Healthcare after recreational use.
(2) Recredensialing as referred to in paragraph (1) is carried out using the technical criteria as referred to in Article 9 of the paragraph (1) and the performance assessment agreed together.
(3) Recredensialing as referred to in paragraph (2) the slowest (three) months prior to the end of the work agreement is over.
Section 11
(1) The health facility may file objections to the credensialing and recreational results implemented by BPJS Health to the county/city health service.
(2) In following up the objections submitted by the Health Facility as referred to in paragraph (1), the Head of the District Health Service/City can form a settlement team objecting.
(3) The team as referred to in verse (2) consists of a health service element and a health facility association.
The Third Part
Rights and Liability
Section 12
(1) The cooperation agreement between Health Facilities and BPJS Health contains the rights and obligations of both parties.
(2) The least Health Care Facility is made up of:
a. obtaining information about the disservice, service procedure, payment and cooperation process with BPJS Health; and
B. receive a claim payment for the services provided to the Participants of the slowest 15 (fifteen) working days since the claim document is fully accepted.
(3) The most Health Facility Oblicity consists of:
a. provide health care to Participant in accordance with applicable terms; and
B. provide a service report on time and the type that has been agreed upon.
(4) The least comprised of the BPJS Health rights consists of:
a. create or stop working contracts with the Health Facility; and
B. received a service report on time and the type has been agreed upon.
(5) The least liability of BPJS Health consists of:
a. provide information to the Health Facility with regard to its participation, service procedure, payment and cooperation process with BPJS Health; and
B. Make a claim payment to a Health Facility for the slowest 15 (fifteen) working days since the claim document is fully accepted.
(6) Further provisions regarding rights and obligations are governed by BPJS Healthcare.
BAB IV
HEALTH SERVICES FOR PARTICIPANTS
The Kesatu section
General
Section 13
(1) Each participant is entitled to a health care that includes promotional, preventive, curative, and rehabilitative services including drug services and consumable medical materials in accordance with the necessary medical needs.
(2) The health care services for Participants guaranteed by BPJS Health consist of:
a. First Level Health Services;
B. Advanced Level Referral Health Service, consisting of:
1. Second-level health (specialistic) health care; and
2. Third-level health services (subspecialistic);
c. Other health services set by the Minister.
The Second Part
Health Care Proceed
Section 14
(1) Health care for Participants is carried out as per the medical needs of the first-degree Health Facility.
(2) The First Level Health Service for Participants is hosted by the first-level Health Facility where the Participant is registered.
(3) In certain circumstances, the provisions referred to in paragraph (2) do not apply to the Participant:
a. located outside of the first-level Health Facility area of the registered Participant; or
B. In a state of medical emergency.
(4) Participants as referred to in paragraph (2) may select the first level Health Facility in addition to the Health Facility where the participant is first listed after a term of 3 (three) months or more.
Section 15
(1) In the case of the Participant requires Advanced Level Health Services on medical indications, the first-level Health Facility must refer to the nearest advanced referral Health Facility in accordance with the Regulated System. the provisions of the laws.
(2) A second level health service can only be provided for referrals from the First Level Health Service.
(3) Third-degree health care can only be provided for referrals from second or first degree health services.
(4) The provisions referred to in paragraph (2) and verse (3) are excluded from the state of emergency, disaster, the specificity of patient health problems, geographical considerations, and consideration of the availability of the facility.
(5) The order of the referral is implemented in accordance with the provisions of the laws.
The Third Part
First Level Health Service
Section 16
The First Level Health Service is a non-specialistic health service that includes:
a. service administration;
B. Promotional and preventive services;
C. examination, treatment, and medical consultation;
D. non-specialistic medical actions, both operative and non operative;
e. Drug and medical services are used;
f. Blood transfusion according to medical needs;
G. preview of the preview level laboratory diagnostic support; and
h. First-degree hospitalization in accordance with medical indications.
Section 17
(1) The First Level Health Service as referred to in Section 16 for medical services includes:
a. a tunnable medical case in the First Level Health Service;
B. medical cases requiring initial handling prior to referrals;
c. Medical case backheader;
D. examination, treatment, and first-degree dental health care measures;
e. examination of pregnant mothers, nifas, breastfeeding mothers, babies and child toddlers by midwives or doctors; and
f. Basic medik rehabilitation.
(2) The health care services as referred to in paragraph (1) are performed in accordance with the clinical guidelines.
(3) The clinical guidelines of health care as referred to in paragraph (2) are set forth by the Minister.
Section 18
First-Level Outpatient Service in accordance with medical indications as referred to in Article 16 of the letter h includes:
a. Outpatient at the treatment/treatment of cases that can be completed completely in the First Level Health Service;
B. The help of a perm copy is not a high risk;
c. Help with childbirth with complication and/or pervaginal purification for the PONED Puskesmas;
D. neonatal help with complications; and
e. Blood transfusion services according to the competence of the Health Facility and/or medical needs.
Section 19
(1) The Drug and National Program Health Tools that have been borne by the Government and/or the Local Government, not borne by BPJS Healthcare.
(2) The Drug and Health Tool as referred to in paragraph (1) includes:
a. basic contraceptive tool;
B. vaccine for basic immunization; and
c. Government program drug.
The Fourth Part
Advanced Level Referral Health Service
Section 20
(1) Advanced Level Advanced Health Services include:
a. service administration;
B. examination, treatment and specialistic consultations by specialist physicians and subspecialists;
c. Specialistic medical actions both surgical and non surgical according to medical indications;
D. Drug and medical services are used to use;
e. advanced diagnostic support services in accordance with medical indications;
f. medical rehabilitation;
G. blood service;
h. clinic forensic medicine ministry;
i. a body service in a patient who died at the Health Facility;
J. non intensive stay treatment; and
No, Intensive care in intensive care.
(2) The service administration as referred to in paragraph (1) of the letter a consists of the cost of patient registration and other administrative costs that occur during the patient ' s care or health care process.
(3) Examination, treatment, and specialistic consultation by specialist physicians and subspecialists as referred to in paragraph (1) letter b including the ministry of emergency.
(4) The type of medical medical ministry of the clinic as referred to in paragraph (1) the letter h includes the creation of the visum et repertum or medik letter based on the examination of the life of the living and forensic psychiatry.
(5) The body service in the patient who died at the Health Facility as referred to in paragraph (1) of the letter i was limited to only the death of the post-hospitalization at the Health Facility in cooperation with BPJS where the patient was treated. It's a dead body and doesn't include a coffin.
Section 21
(1) Participants who want a higher level of care than in their right, may improve their right by following additional health insurance, or pay their own the difference between the costs guaranteed by BPJS Health at the cost of the required Paid for the improvement of treatment classes.
(2) Excluded from the provisions as referred to in paragraph (1), for the Warranted Health Assistance Recipients are not allowed to choose a higher class of its rights.
Section 22
(1) In terms of inpatient space being the right of the Attendees, Participants can be treated in a one-tier nursing class.
(2) The BPJS Health pays the Participant ' s care class in its right in the state as it is referred to in paragraph (1).
(3) If the class of care in accordance with the participant's rights is available, then the Participant is placed in the care class who becomes the participant's right.
(4) A higher level of treatment as referred to in paragraph (1) at most (3) days.
(5) In the event of a treatment as referred to in paragraph (4) more than 3 (three) days, the difference of such charges becomes the responsibility of the Health Facility in question or based on the consent of the patient referred to the Health Facility which equivalent.
The Fifth Part
Drug Services, Health Tools, and Habis Medical Materials Use
Section 23
(1) Participants have the right to receive drug services, Health Tools, and disposable medical materials needed according to medical indications.
(2) Drug Services, Health Tools, and used medical materials as referred to in paragraph (1) may be provided on outpatient and/or hospitable health services at first-level Health Facilities and Referral Health Facility Advanced level.
(3) Drug Services, Health Tools, and the used medical materials provided to Participants guideline on the list of drugs, health tools, and consumable medical materials prescribed by the Minister.
(4) The list of medicines, Health Tools, and medical materials consumes as referred to in paragraph (3) is poured in the National Formularium and the Compendium of Health Tools.
(5) The addition and/or reduction of drug lists, Health Tools, and medical materials are used in the National Formularium and the Compendium of Health Tools are prescribed by the Minister of Health.
Section 24
(1) Drug Service, Health Tools, and the use of advanced medical materials on advanced referral Health Facilities are among the components paid in the Indonesian Case Based Groups (INA-CBG ' s) package.
(2) In terms of the medication required according to medical indications at the advanced referral Health Facility not listed in the National Formularium, it can be used other drugs based on the approval of the Medik Committee and the head/director of the hospital.
Section 25
(1) BPJS Health guarantees the drug needs of the return program through Apotek or the first level Health Facility pharmacy depo that works closely with BPJS Health.
(2) The drug as referred to in paragraph (1) is paid BPJS Health beyond the cost of the capitation.
(3) Further provisions concerning the drug service procedures of the reverse program are set up with the BPJS Healthcare Regulation.
Section 26
(1) The Health Tools Service is already included in the Indonesian Case Based Groups (INA-CBG ' s) package.
(2) The Health Facility and its jenets are required to provide the Health Tools required by Participant in accordance with medical indications.
(3) In the event of a dispute over medical indications between Participants, the Health Facility, and BPJS Health, were completed by the clinical considerations council set up by the Minister.
Section 27
(1) The non-entry Health Tool in the Indonesian Case Based Groups (INA-CBG ' s) package is paid for by its own claim.
(2) The non-entry Health Tool in the Indonesian Case Based Groups (INA-CBG ' s) package is set forth by the Minister.
(3) In a special condition for patient safety, the non-entry Health Tool in the Indonesian Case Based Groups (INA-CBG ' s) package as referred to in paragraph (2) can be set by the clinical considerations board with BPJS Health.
(4) Further provisions on Health Tools procedures that are not included in the Indonesian Case Based Groups (INA-CBG ' s) package are set up with the BPJS Healthcare Regulation.
The Sixth Part
Health Skrining Service
Section 28
(1) The health screening ministry is given in person and selectively.
(2) Health screening services as referred to in paragraph (1) are intended to detect the risk of disease and prevent further impacts from the risk of certain diseases, including:
a. diabetes mellitus type 2;
B. hypertension;
c. cervical cancer;
D. breast cancer; and
e. Another disease prescribed by the Minister.
(3) Health screening services as referred to in paragraph (2) letters a and letter b begin with the analysis of the health history, which is performed at least 1 (one) years.
(4) In the case of the identified participant having a risk based on the health history as referred to in verse (3), the enforcement is conducted through a certain diagnostic support check.
(5) Participants who have been diagnosed with a particular disease based on diagnostic enforcement as referred to in verse (4) are given treatment according to medical indications.
(6) The health screening service as referred to in paragraph (2) the letter c up to the letter e is performed according to medical indications.
The Seventh Part
Ambulance Service
Section 29
(1) Ammoon Service is the transportation service of a referral patient with certain conditions between the Health Facility accompanied by an effort or activities maintaining the stability of the patient's condition for the safety of the patient's safety.
(2) Amlunar services are only guaranteed when referrals are performed at the Health Facility in cooperation with BPJS or on the emergency case of the Health Facility that does not cooperate with BPJS Health with the life-saving purpose of patient life.
(3) The terms regarding the requirements and manners of the ambulance service are established with the BPJS Healthcare Regulation.
The Eighth Part
The Compensation
Section 30
(1) In terms of an unavailable area of Health Facility eligible to meet the medical needs of a number of Participants, BPJS Health is required to provide compensation.
(2) The determination of the area is not yet available a Health Facility which is eligible to meet the medical needs of a number of Participants is set forth by the local health service at the consideration of the BPJS Health and the Health Facilities Association.
(3) Compensation as referred to in paragraph (1) is given in form:
a. cash replacement;
B. health care delivery; and
c. The provision of a specific Health Facility.
(4) Compensation in the form of cash reimbursing as referred to in paragraph (3) of the letter a replacement of the health care costs provided by the Health Facility which does not cooperate with BPJS Health.
(5) The replacement of the reimbursed health care charge as referred to in paragraph (4) is equated with the fare of the Health Facility in the nearby region with regard to health care and the type of service given.
(6) Compensation in the form of health care delivery and the provision of a specific Health Facility as referred to in paragraph (3) the letter b and the letter c may cooperate with the health service, the health profession organization, and/or association Health facilities.
(7) Further provisions of the compensation criteria are set out with the BPJS Health Regulation.
The Ninth Part
Further Settings
Section 31
The provisions of procedure and health care work for the Participants as set forth in the Attachment are an inseparable part of the Regulation of this Minister.
BAB V
HEALTH CARE PAYMENT SYSTEM
Section 32
(1) BPJS Health makes payments to the Health Facility which provides services to Participant.
(2) The payment of the BPJS Healthcare to the Health Facility as referred to in paragraph (1) is determined by agreement between the BPJS Health with the association of healthcare facilities in the area of the Health Facility be as well as referring to the tariff standards set by the Minister.
(3) The association of healthcare facilities as referred to in paragraph (2) for the first-degree Health Facility and the advanced level referral Health Facility is set with the Minister ' s Decision.
(4) The agreement between BPJS Health with the health facilities association as referred to in paragraph (3) is conducted between BPJS Health with representative health facilities associations in each province.
(5) In the event the quantity of payment as referred to in paragraph (2) is not agreed upon by the association of health facilities and BPJS Healthcare then the quantity of payment on the Health Guarantee program corresponds to the rate set by the Minister.
BAB VI
QUALITY CONTROL AND COST CONTROL
Section 33
(1) In order to guarantee quality control and cost, the Minister authorized to do:
a. health technology assessment (health technology assessment);
B. clinical advisory (clinical advisory);
c. standard rate calculation;
D. monitoring and evaluation of the hosting of health assurance services.
(2) Monitoring and evaluation as referred to in paragraph (1) letter d intended for health care which provides health care to the first level Health Facility, the advanced level referral Health Facility has been appropriate the authority and standards of the medical services set forth by the Minister.
Section 34
(1) Health technology assessment as referred to in Article 33 of the paragraph (1) letter a performed in order to develop technological use in the holding of health assurance for increased quality and efficiency expenses and the addition of health assurance benefits.
(2) The health technology assessment as referred to in paragraph (1) is conducted under the proposal of the association of healthcare facilities, the health profession organization, and BPJS Health.
(3) The health technology assessment as referred to in verse (1) is carried out by the Team Health Technology Assessment (HTA) set up by the Minister.
(4) Team Health Technology Assessment (HTA) as referred to in paragraph (3) is responsible for performing assessments on health care categorized in new technologies, new methods, new drugs, special expertise, and other health services with High cost.
(5) The Health Technology Assessment (HTA) team provides a recommendation to the Minister regarding the viability of health care as referred to in paragraph (4) to be included as a guaranteed health service.
(6) The health care guaranteed as referred to in paragraph (5) is set by the Minister.
Section 35
(1) The clinical advisory (clinical advisory) as referred to in Article 33 of the paragraph (1) letter b is intended for the health care provided to an effective patient and as needed.
(2) The clinical advisory (clinical advisory) as referred to in verse (2) is given by a Team that is created by the Minister, which consists of an element of the organization of profession and academic medicine.
(3) The team referred to in paragraph (3) is responsible for providing recommendations relating to the medical technical problems of the health ministry.
Section 36
Quality control and cost control at the Health Facility level are performed by the Health and BPJS Health Facility.
Section 37
The holding of quality control and cost by the Health Facility as referred to in Article 36 is done through:
a. health care settings in running the practice of the profession in accordance with competency;
B. the utilization of medical reviews and audits;
c. ethics coaching and the discipline of the profession to the health workforce; and/or
D. The monitoring and evaluation of drug use, Health Tools, and medical materials are used in regular health care which is implemented through the utilization of the health information system.
Section 38
(1) Hosting of quality control and control by BPJS Health as referred to in Article 36 is done through:
a. The fulfillment of the Health Facility quality standards;
B. standard fulfillment of the health care process; and
c. monitoring of the Attendees ' health release.
(2) In order to host quality control and cost control as referred to in paragraph (1), BPJS Health forms a degree of quality control and cost control team composed of elements of the profession organization, academia, and clinical experts.
(3) The quality control and cost control team as referred to in paragraph (2) may perform:
a. the socialization of the health care authority in running the practice of the profession by competence;
B. the utilization of medical reviews and audits; and/or
c. ethics coaching and the discipline of the profession to the health workforce.
(4) In certain cases, the quality control and cost control team referred to in paragraph (2) may request information on identity, diagnosis, history of illness, examination history and the history of the Participant's treatment in the form of a copy/photocopy Medical to the Health Facility as needed.
(1) The health facility is required to make a regularly-provided health care report every month to the BPJS Health.
(2) The BPJS Health is required to implement the Utilization Review periodically and continuously and provide the feedback of Utilization Review to the Health Facility.
(3) BPJS Health reports the results of Utilization Review to the Minister and DJSN.
(4) The provisions of the reporting mechanism and Utilization Review as referred to in paragraph (2) and paragraph (3) are defined with the BPJS Healthcare Regulation.
(1) At the time the Ministerial Regulation is in effect, the entire TNI/Polri-owned first-level Health Facility is declared a preview clinic.
(2) The Health Facility as referred to in paragraph (1) must conform to the licensing of the pratama clinic within the term 2 (two) years since the Regulation of the Minister came into effect.
(2) The first level health facility as referred to in paragraph (1) the letter a must conform to the provisions in this Ministerial Regulation in the term of 5 (five) years since the Regulation of the Minister came into effect.
(3) The hospital as referred to in paragraph (1) letter b must conform to the provisions in the Regulation of this Minister in the term 3 (three) years since the Regulation of the Minister came into effect.
At the time of the Ordinance of the Minister, the Regulation of the Minister of Health No. 416 /Menkes// /II/2011 on the Tarif of Health Services for the Participant of PT Askes (Persero) (State News of the Republic of Indonesia 2011 Number 117) as amended. with the Regulation of Health Minister Number 029 of 2012 (the State News of the Republic of Indonesia 2012 Number), revoked and declared not valid.
The Minister's Rule came into force on 1 January 2014.
In order for everyone to know it, order the invitational of the Minister's Regulation with its placement in the News of the Republic of Indonesia.
