卡瓦贡地区总医院医疗针灸专科服务国家健康保险方案的法律实施情况

Edi Suhaimi, Joni Emirzon
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摘要

2015年1月,BPJS终止了医疗针灸的医疗服务覆盖,理由是医疗针灸包括2013年第12号总统令第25 (j)条所载的传统医疗服务。此前,根据2009年第138号和第12号卫生部长和内政部长的联合条例,医疗针灸服务由PT. Askes提供保障。本研究采用实证法律方法,并回顾与健康保险相关的法律法规。结果:针刺服务有2条规定,即由非医务人员进行传统针灸和由医务人员(针灸专科医生或全科医生加)进行医学针灸。根据2013年第12号总统条例的第四次修订,即关于第47条第(1)款b3和b4点的2018年第82号总统令,由针灸专家在医院提供的医疗针灸服务包括:根据医学适应症进行检查和诊断、治疗和非手术专科医疗。也符合先前的条例,即2014年卫生部长关于医疗针灸服务保障的第28号条例。结论:基于“专科法贬损一般法”的原则,该规范可作为医院实施医学针灸服务JKN的依据。
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Law Implementation Of The National Health Insurance Program (JKN) For Medical Acupunture Specialist Services In Kayuagung Regional General Hospital
Termination of health service coverage for medical acupuncture by BPJS in January 2015 on the grounds that medical acupuncture includes traditional health services contained in Presidential Decree number 12 of 2013 article 25 (j). Previously, medical acupuncture services had been guaranteed by PT. Askes based onjoint regulation of the Minister of Health and Minister of Home Affairs number 138 and 12 of 2009.This study uses an empirical legal approach and a review of laws and regulations related to health insurance. Results: There are 2 regulations for acupuncture services, namely traditional acupuncture performed by nonmedical personnel, and medical acupuncture performed by medical personnel (acupuncture specialists or general practitioners plus). Medical acupuncture services in hospitals performed by acupuncture specialists are medical services which include: examination and diagnosis, treatment and non-surgical specialist medical treatment according to medical indications, as contained in the fourth revision of Presidential Regulation number 12 of 2013 namely Ppresidential decree number 82 of 2018 on article 47 paragraph (1) points b3 and b4. Also in line with the previous regulation, namely Regulation of the Minister of Health number 28 of 2014 concerning guarantees for medical acupuncture services. Conclusion: Based on the principle of Lex specialis derogate legi generalis, the Perpres can be the basis for implementing JKN for medical acupuncture services in hospitals..
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