STATE NEWS
REPUBLIC OF INDONESIA
| No. 509 2014 | KEMENHAN. Out of the way. BPJS. Ministry. |
RULES OF DEFENSE MINISTER OF THE REPUBLIC OF INDONESIA
Number 15 YEAR 2014
ABOUT
HEALTH CARE SERVICES OUTSIDE OF THE DEPENDENTS
THE SOCIAL SECURITY ORGANIZER AGENCY
WITH THE GRACE OF THE ALMIGHTY GOD
DEFENSE MINISTER OF THE REPUBLIC OF INDONESIA,
Weigh: a. that the health assurance benefits set in Presidential Regulation No. 12 of 2013 on Health Guarantee provide promotional, preventive, curative or rehabilitative health services organized by the Warranty Organizing Agency Social;
B. That the health insurance that is not guaranteed by the Social Security Organizing Board needs to be granted to the members of the TNI, the Kemhan civil servant and his family to benefit the health care and protection of the company. health basic needs;
c. that under consideration as referred to in letter a and letter b, need to establish the Defense Minister 's Regulation on Health Services outside the Social Security Organizing Agency' s Dependents;
Remembering: 1. Law No. 40 of the Year 2004 on National Social Security System (Indonesian Republic of Indonesia Year 2004 Number 150, Additional Gazette of the Republic of Indonesia No. 4456);
2. Law No. 24 Year 2011 on Social Security Organizing Agency (Sheet Of State RepublikIndonesia Year 2011 Number 116, Additional LembaranNegara Republik Indonesia Number 5256);
3. Presidential Regulation Number 12 Year 2013 on Health Guarantee (State Sheet of the Republic of Indonesia Year 2013 Number 29);
DECIDED:
Establish: DEFENSE MINISTER REGULATION ON HEALTH CARE OUTSIDE OF THE ORGANIZING BODY OF SOCIAL SECURITY ORGANIZERS.
BAB I
UMUM CONDITIONS
Section 1
In Regulation of the Minister this is referred to:
1. The subsequent Health Social Security Organizing Agency (BPJS Health) is a legal entity that is set up to organize a social security program.
2. Health Services outside the BPJS Dependents are the benefits of medical and non-medical services for members of the Indonesian National Army, Kemhan Civil Servants and his family that are not guaranteed by BPJS Health in accordance with the Presidential Regulation No. 12 Years 2013 on Health Guarantee.
3. The next Ministry of Defence called Kemhan is the executor of government functions in the field of state defense.
4. Indonesian National Armed Forces (Indonesian National Armed Forces) which are abbreviated to the Indonesian National Armed Forces (Indonesian National Armed Forces) are the tools of the country responsible for defending, protecting, and maintaining
5. Indonesian Health is all activities in the field of health implemented with the aim of maintaining and improving the physical and mental health of soldiers to always be ready to carry out the task.
6. Indonesian soldiers who were later called Members of the TNI were the personnel/soldiers of the state equipment in the field of defence who performed their duties in a matra under the leadership of the Chief of Staff of the Army or a joint under the leadership of the Commander in Chief.
7. Kemhan civil civil servant who is next called PNS Kemhan is a civil servant who works in the Kemhan and TNI neighborhoods.
8. Family is a wife or husband and son of a member of the TNI and PNS Kemhan.
BAB II
HEALTH CARE
Section 2
Members of the TNI, PNS Kemhan and members of his family get health care as referred to in Presidential Regulation No. 12 of 2013 on Health Guarantee.
Section 3
(1) Health services guaranteed by BPJS Health to TNI members, PNS Kemhan and family members are individual health services, covering promotional, preventive, curative, and rehabilitative services including drug services and materials Medical use is in accordance with the necessary medical needs.
(2) The Health Service as referred to in paragraph (1) consists of medical benefits and nonmedical benefits.
Section 4
Health care which is not guaranteed by BPJS Health to TNI members, PNS Kemhan and his family members if:
a. Health care services performed without going through the procedure;
B. Health care services are conducted at healthcare facilities that do not cooperate with BPJS Health, except for emergency cases;
c. Health services to the disease or injury due to a working accident or working relationship;
D. Health care services conducted abroad;
e. health service for aesthetic purposes;
f. services to overcome infertility;
G. services flatten the tooth (orthodonsion);
h. health/disease disorders due to drug and/or alcohol dependence;
i. health care disorder intentionally hurting oneself, or as a result of a self-harm hobby;
J. Complementary, alternative and traditional treatments, including acupuncture, shin she, chiropractic, which have not been declared effective based on health technology assessment (health technology assessment);
No, treatment and medical actions categorized as experiments (experiments);
I. Contraceptive devices, cosmetics, baby food, and milk;
m.household health provisions;
N. Health services due to disaster during emergency response times, external events/wabah; and
O. other service costs that no link to the health guarantee benefits are given.
Section 5
Health care which is not guaranteed by BPJS as referred to in Article 4 can be provided in terms of:
a. Health services for the emergency case as referred to in Section 4 of the letter b may immediately obtain services in any cooperative health facility or not cooperating with BPJS Healthcare;
B. the health care service of the disease or injury due to a working accident or working relationship as referred to in Article 4 of the letter c is not guaranteed by BPJS Health but is guaranteed by the employment accident guarantee program by BPJS Employment;
c. Health services for aesthetic purposes are not guaranteed by BPJS Health as referred to in Article 4 of the letter e not guaranteed except to restore health function according to medical indications; and
D. Baby food and milk that are not guaranteed by BPJS Health as referred to in Section 4 of the l except for the treatment of poor nutrition in accordance with medical indications.
Section 6
(1) The benefits of non-medical services as referred to in Article 3 of the paragraph (2) to the Indonesian High Officer or PNS Kemhan with an equal group and the Family deserve the benefit of accommodation of a VIP class of nursing classes in the environment The Kemhan and TNI hospitals are in accordance with the laws.
(2) The benefits of VIP nursing class accommodations for Higher Officers and PNS Kemhan with an equal group and Family as referred to in verse (1) are governed by the respective hospitals in the Kemhan and TNI environments.
BAB III
HEALTH CARE ORGANIZER
Section 7
(1) Kemhan health facility and the TNI organizes a health care guarantee cooperation with BPJS Health.
(2) The Kemhan and Indonesian Health Care Facility which organizes health care cooperation with BPJS Health as referred to in paragraph (1), must meet the requirements in accordance with the applicable provisions.
Section 8
(1) The Kemhan and Indonesian Health Facility as referred to in Article 7 of the paragraph (2) includes:
a. Acting Level I Health Services (PPK I);
B. Acting Level II Health Service (PPK II); and
C. Acting Level III Health Service (PPK III).
(2) PPK I as referred to in paragraph (1) the letter a, includes the Relief Hospital (Rumkitban), Policlinics, Medical Hall, Health Hall and the minimum Health Section have a general doctor in the Kemhan and TNI environments.
(3) PPK II as referred to in paragraph (1) the letter b includes a hospital in the Kemhan and Indonesian environments that have a specialist doctor.
(4) PPK III as referred to in paragraph (1) the letter c includes a hospital in the Kemhan and Indonesian environments that have a sub-specialist physician.
Section 9
The Kemhan and TNI health facilities that become PPK as referred to in Article 8 of the paragraph (1) are referral paths according to the level of health care capability.
BAB IV
SUPERVISION AND CONTROL
Section 10
(1) Member of the Indonesian Armed Forces, PNS Kemhan and his family are being treated at a health facility outside the Kemhan health facility and the TNI must report to his unit.
(2) Reporting as referred to in paragraph (1) to obtain the person's health status information for the health of the reported unit health data to the upper unit.
Section 11
The Kemhan and TNI health units can request the medical data of the TNI Member, PNS Kemhan and his family members who are treated with healthcare facilities outside of Kemhan and TNI, in accordance with the applicable provisions.
Section 12
(1) The supervision of health care for TNI members, PNS Kemhan and his Family include:
a. health care policy oversight;
B. supervision of health care implementation; and
c. supervision of the medical data of the TNI members, PNS Kemhan and his family of drugs outside the Kemhan and TNI health facilities.
(2) The health insurance in the Kemhan and the Indonesian environment carrying out the supervision of health care for the members of the TNI, PNS Kemhan and his Family as referred to in paragraph (1) consists of:
a. Director General of Defense Forces Kemhan carries out the supervision of health care policy;
B. Head of the Indonesian National Health Center carries out the supervision of the health care implementation; and
C. The head of the Ministry of Health carries out the supervision of the medical data of the TNI members, PNS Kemhan and his family of drugs outside the Kemhan and TNI health facilities.
Section 13
The health care management of the TNI members, the PNS Kemhan and his family are carried out by each working unit in the Kemhan and TNI environments.
BAB VI
CLOSING PROVISIONS
Section 14
The rules of the Ministry are effective on the date of the promulgations.
In order for everyone to know, ordered the invitational of the Minister's Ordinance with its placement in the News of the Republic of Indonesia.
Set in Jakarta
on 8 april 2014
DEFENSE MINISTER
REPUBLIC OF INDONESIA,
"PURNOMO YUSGIANTORO"
Promulgated in Jakarta
on April 17, 2014
MINISTER OF LAW AND HUMAN RIGHTS
REPUBLIC OF INDONESIA
AMIR SYAMSUDIN
