RACHMATULLAH, FIRMAN (2024) TINDAKAN PEMERINTAH DALAM PENCEGAHAN DUGAAN KECURANGAN (FRAUD) PEMINDAHAN DATA KEPESERTAAN PROGRAM JAMINAN KESEHATAN DI KABUPATEN LEBAK. Master thesis, UNIVERSITAS SULTAN AGENG TIRTAYASA.
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Abstract
Health Insurance is a guarantee that participants obtain health care benefits and protection in meeting basic health needs provided to every person who has paid contributions or whose contributions are paid by the government. The existence of fraud (Fraud) in the implementation of Public Health Insurance can be interpreted as an unlawful act committed by people from within and/or outside the organization, with the intention of obtaining personal or group benefits which directly harm other parties, One form of fraud that is detrimental to the community is the transfer of membership data without the knowledge or wishes of the community as participants in the National Health Insurance program. This research aims to analyze government actions in preventing fraudulent transfer of participant data as well as the effectiveness and efficiency of procedural data transfer for National Health Insurance program participants in the Lebak Regency area. The research method used is empirical juridical carried out to obtain clarity and understanding of research problems based on existing reality. The data collection technique involves collecting and reviewing existing regulations, followed by conducting in-depth interviews with office holders who are directly related to the data protection policy for National Health Insurance Program participants. The results of this research show that fraud prevention measures have been taken, but the weak implementation of sanctions according to existing regulations has not had a deterrent effect on the perpetrators. To be more effective and efficient in protecting participation data, support from all elements of society and the injured party is needed to report it so that individuals who commit fraud can immediately be given warnings and sanctions and preventive measures can be taken to prevent repeat cases. The results of this research show that fraud prevention measures have been taken, but the weak implementation of sanctions according to existing regulations has not had a deterrent effect on the perpetrators. To be more effective and efficient in protecting participation data, support from all elements of society and the injured party is needed to report so that individuals who commit fraud can immediately be given warnings and sanctions and preventive measures can be taken to prevent repeat cases It is hoped that this research can evaluate and determine risk mitigation efforts for factors that can influence the occurrence of fraud and as additional literature that can be used by Regional Governments to prevent fraud.
| Item Type: | Thesis (Master) | |||||||||
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| Additional Information: | Jaminan Kesehatan adalah jaminan agar peserta memperoleh manfaat pemeliharaan kesehatan dan perlindungan dalam memenuhi kebutuhan dasar kesehatan yang diberikan kepada setiap orang yang telah membayar iuran atau iurannya dibayar oleh pemerintah‟Adanya kecurangan (Fraud) dalam pelaksanaan Jaminan Kesehatan Masyarakat dapat diartikan sebagai suatu perbuatan melawan hukum yang dilakukan oleh orang-orang dari dalam dan atau luar organisasi, dengan maksud untuk mendapatkan keuntungan pribadi dan atau kelompoknya yang secara langsung merugikan pihak lain, Salah satu bentuk kecurangan yang merugikan masyarakat adalah pemindahan data kepesertaan yang tidak sepengetahuan dan sesuai keinginan masyarakat sebagai peserta program Jaminan Kesehatan Nasional. Penelitian ini bertujuan untuk menganalisis Tindakan pemerintah dalam pencegahan dugaan kecurangan pemindahan data peserta serta efektifi dan efisiensi prosedural pemindahan data kepesertaan program Jaminan Kesehatan Nasional di wilayah Kabupaten Lebak. Metode Penelitian digunakan adalah yuridis empiris dilakukan untuk memperoleh kejelasan dan pemahaman dari permasalahan penelitian berdasarkan realitas yang ada. Adapun tehniik pengumpulan data dengan mengumpulkan serta mengkaji peraturan yang ada dilanjutkan dengan melakukan wawancara mendalam (depth interview) kepada pemangku jabatan yang berkaitan langsung dengan kebijakan perlindungan data kepesertaan Program Jaminan Kesehatan Nasional. Adapun hasil penelitian ini menunjukkan bahwa Tindakan pencegahan dugaan kecurangan (fraud) sudah dilakukan namun lemahnya penerapan sanksi sesuai peraturan yang ada belum menjadikan efek jera pelakunya. Untuk lebih efektif dan efiesiensi dalam perlindungan data keepesertaan diperlukan dukungan dari semua unsur masyarakat serta pihak yang dirugikan untuk melaporkan agar oknum yang berbuat kecurangan (fraud) dapat segera diberikan peringatan dan sanksi serta dapat dilakukan upaya pencegahan agar tidak terjadi kasus yang berulang . Penelitian ini diharapkan dapat mengevaluasi dan menentukan upaya mitigasi risiko terhadap faktor-faktor yang dapat mempengaruhi keterjadian fraud dan sebagai literatur tambahan yang dapat digunakan oleh Pemerintah Daerah untuk mencegah terjadinya fraud. | |||||||||
| Uncontrolled Keywords: | fraud, health insurance, government action kecurangan (fraud), jaminan kesehatan, Tindakan Pemerintah | |||||||||
| Subjects: | K Law > K Law (General) | |||||||||
| Divisions: | 01-Fakultas Hukum 08 Pascasarjana > 74101-Magister Ilmu Hukum |
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| Depositing User: | Perpustakaan Pusat | |||||||||
| Date Deposited: | 21 Nov 2025 09:31 | |||||||||
| Last Modified: | 21 Nov 2025 09:31 | |||||||||
| URI: | http://eprints.untirta.ac.id/id/eprint/56241 |
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