Amended Gov’t Regulation Gives Bigger Rooms for Recipients of National Heatlh Insurance Program

In an effort to provide health services for recipients of the national health insurance program, President Joko ‘Jokowi’ Widodo on 7 October 2015 signed a Government Regulation Number 76 of 2015 on the Amendment to the Government Regulation Number 101 of 2012 on Contribution Assistance Recipients (PBI) of the National Health Insurance Program.

One of the highlights of the Government Regulation is Article 11 on the change in data of Contribution Assistance Recipients (PBI) of the National Health Insurance Program. Previously, it was regulated that the change can be done by:

1. Eliminating data  of the underprivileged people who no longer meet the criteria;
2. Adding data of underprivileged people to be listed as Contribution Assistance Recipients (PBI) of the National Health Insurance Program after they meet the criteria as underprivileged people.

In this Government Regulation, it is stated that the change of the data as intended by the Government Regulation shall be done by:

a. eliminating;

b. replacing; or

c. adding

Eliminating the Contribution Assistance Recipients (PBI) of the National Health Insurance Program as intended by the Government Regulation shall be done if the recipients:

a. no longer meet the criteria as underprivileged people;

b. passes away; or

c. registered more than once.

“Elimination of Contribution Assistance Recipients (PBI) of the national health insurance program registered more than once as intended shall be done to get a single data,” according to article 11 paragraph (4) Government Regulation No. 76 of 2015. In the meantime, replacement shall be done with the provisions as follows:

a. there are underprivileged people who have not been registered as Contribution Assistance Recipients (PBI) of the National Health Insurance Program.;

b. there is elimination of data of Contribution Assistance Recipients (PBI) of the National Health I nsurance Program; and

 c. has not exceeded the national number of  Contribution Assistance Recipients (PBI) of th e National hHealth Insurance Program.

Adding the number of recipients shall be done if:

a. there are underprivileged people who have not been listed in the data of Contribution Assistance Recipients (PBI) of the national health insurance program; and

b. exceeds the national number of Contribution Assistance Recipients (PBI) of the National Health Insurance Program.

“Replacing and adding as intended by this Government Regulation may be from underprivileged people, namely:

a.   workers who has been laid off and has not worked after more than 6 (six) months;

b    victims of natural disasters;

c.   workers who have entered pension period;

d.   family members of a worker who passes away;

e. babies born from a mother of family who is registered as Contribution Assistance Recipients (PBI) of the National Health Insurance Program;

f.   inmates at penitentiaries; and/or

g. those who have social problems,” according to Article 11 paragraph of the Government Regulation.

Change of data of Contribution Assistance Recipients (PBI) of the National Health Insurance Program as intended by this Government Regulation shall be verified and validated by Minister of Social Affairs.

 In the event change in data of Contribution Assistance Recipients (PBI) of the National Health Insurance Program as intended by the Government Regulation does not cause the national number of Contribution Assistance Recipients (PBI) of the National Health Insurance Program exceed, according to this Government Regulation, the Minister shall stipulate the change of data of Contribution Assistance Recipients (PBI) of the National Health Insurance Program.

However, in the event that change in data of Contribution Assistance Recipients (PBI) of the National Health Insurance Program as intended by this Government Regulation as intended by this Government Regulation causes the national number of Contribution Assistance Recipients (PBI) of the National Health Insurance Program exceed, the Minister shall stipulated the change in data of Contribution Assistance Recipients (PBI) of the National Health Insurance Program after coordinating with ministers overseeing financial affairs and other related ministers or heads of institutions.

“Change in the data of Contribution Assistance Recipients (PBI) of the National Health Insurance program as intended by this Government Regulation shall be done every 6 (six) months at the latest,” according to Article 11A paragraph (4) of the Government Regulation.

The Government Regulation also states that babies born by a biological mother registered as Contribution Assistance Recipients (PBI) of the National Health Insurance Program shall be automatically declared as Contribution Assistance Recipients (PBI) of the National Health Insurance Program.

When this Government Regulation begins to take effect, the number of Contribution Assistance Recipients (PBI) of the National Health Insurance Program in 2015 shall be stipulated by the Minister based on the 2014 integrated data base that has been verified and validated, after coordination with ministers overseeing financial affairs as well as related ministers and/or heads of institutions.

“This Government Regulation begins to take effect on the date it is promulgated,” according to this Government Regulation, which was promulgated by Minister of Justice and Human Rights Yasonna H. Laoly on 7 October 2015. (Pusdatin/ES) (MEP/YM-Naster)