Literature review reveals trends and causes of fraud in national health insurance, highlighting challenges faced by the JKN program.
Key Points
Fraud in Indonesia's national health insurance program leads to significant financial losses and operational inefficiencies.
Key findings indicate various actors, including participants and healthcare providers, engage in fraud like upcoding and misrepresentation.
The systematic literature review analyzed patterns and effects of fraud across several insurance studies, revealing complex challenges in addressing it.
Addressing fraud in the JKN program is complicated by cultural and legal challenges alongside the program's scale and technology integration issues.