What’s wrong with JKN patients being sent home to hospital in a condition not fit to go home, notes Timboel Siregar BPJS Watch
29 June 2023
ZERO FRAUD AT HOSPITAL
By: Timboel Siregar, BPJS Watch Coordinator
News about JKN patients whose treatment is limited by being sent home to the hospital in a condition that is not fit to go home continues to be an issue that is directly experienced by the JKN participant population.
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This is a form of fraud committed by RS.
I once received a report of a JKN patient who was sent home to a hospital in an unconscious condition. Had been treated for a day at home in the absence of doctors and medical equipment.
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The patient was finally admitted to the hospital again but after 8 hours of treatment, his life was not saved.
In addition, there are several other frauds that are also often experienced by JKN patients, for example, being told to buy their own medicine on the grounds that the medicine at the pharmacy is empty, being told to pay for medical equipment for a medical procedure, being told to buy their own blood, and so on.
This has continued to happen, which has been carried out by hospital staff, since the start of JKN operations until today.
It seems that the hospital personnel who committed this fraud took advantage of the doctor’s authority subjectively to limit treatment at the hospital by sending them home in a condition that was not fit to go home.
The motive is simple: take advantage. Usually the act of repatriating a patient who is not yet fit to go home will be followed by a request to the patient for further treatment, so that a new INA-CBGs fee will appear.
Hospitals as BPJS Health partners in serving JKN patients with BPJS Health insurance, are required to comply with the provisions of our positive law and the cooperation agreement signed by the Hospital and BPJS Health.
Of course, these frauds have violated various provisions of our positive law and cooperation agreements.