BPKP Head Ardan Adiperdana in his presentation before the House of Representatives Commission IX recently stated that the payment of hospital service claims was inefficient because it used higher class fees, reaching up to Rp 819 billion.
The audit results also found a capitation fund for financing at the first-level health facility (FKTP) organized by the BPJS Health in the form of the remaining balance in the budget (Silpa) reaching up to Rp 2.5 trillion in regional governments.
Ardan said the number constituted 19.02 percent of the total capitation funds. Meanwhile, the remaining Rp 10.69 trillion or 80.98 percent were used for FKTP services and operations, such as community health centers (Puskesmas) and clinics.
BPKP said there are various problems in the use of capitation funds, such as payments that are not following the FKTP worth Rp 3.6 billion, commitment-based capitation (KBK) that is based on the FKTP performance worth Rp 46.9 billion, and referrals that do not meet the needs worth Rp 29.4 billion.
Finance Deputy Minister Mardiasmo previously stated that BPKP's findings would provide an overview of BPJS Health revenues other than the fees. “Don’t let fees go up but deficit still occurs. Don’t let it rise too high but not used,” he said.
Increase in Leave Allowances
Amid unresolved deficit problem, Sri Mulyani issued Minister of Finance Regulation (PMK) No. 112/PMK.02/2019 on Other Additional Benefits and Incentives for Members of BPJS Board of Directors and Supervisory Board.
"To improve the performance of the BPJS directors and supervisory board members, it is necessary to make changes to the Minister of Finance Regulation No. 34/PMK.02/2015,” wrote Sri Mulyani in the text of the regulation.
Based on Article 12, annual leave allowances are given once a year and twice the salary or wage. The amount of the benefit has doubled compared to the previous rule.
BPJS Watch Advocacy Coordinator Timboel Siregar said the increase in allowances is inappropriate. Based on data compiled from BPJS Health’s Annual Work and Budget Plan for 2019, the incentive for eight directors already reached Rp 32.88 billion.
If divided equally, then each director gets Rp 4.11 billion per year. “Every month, they get Rp 342.6 million,” Timboel told Katadata.co.id.
Meanwhile, the incentive for seven members of the BPJS Health supervisory board reached Rp 17.73 billion, meaning each member gets Rp 211.14 million per month.
Timboel said the Finance Minister’s reason for raising the allowances, in this case, to improve performance is very inappropriate. “Haven't they been on leave for a perfect and pleasant time?”
Moreover, with the substantial allowances so far, the performance of directors and supervisory board members remains unsatisfying. Many targets are unachievable. Fees remain high. The number of participants for this year only reached 223 million people from the goal of 254 million people.
Moreover, supervision towards hospitals in terms of the cooperation agreement is also weak. “Fees have not risen, but they try to increase the welfare of a handful of people,” Timboel said.
According to the Finance Ministry’s Communications and Information Bureau Head Nufransa Wira Sakti, the increase in leave allowances is in line with the obligations of BPJS employees who get 14 times of salary a year in the form of holiday allowances (THR) and the 13th salary.
So far, the directors and supervisory board members only get the holiday allowances. “Therefore, the adjustment of leave allowances is a substitute for the provision of the 13th salary,” Nufransa wrote in an official statement on August 13.
He also emphasized that the adjustment of the additional benefits for the directors and supervisors would not affect the management of the guarantee fund managed by BPJS Health. The other benefits are paid using BPJS operational funds, not the state budget.