OJK Strengthens Health Insurance Ecosystem with New Medical Advisory Board Requirement

Regulatory Framework and Implementation Timeline

The Financial Services Authority (OJK) has officially introduced OJK Regulation (POJK) No. 36/2025 concerning the Strengthening of the Health Insurance Ecosystem. This regulation was promulgated on December 22, 2025, and becomes effective three months thereafter. The new regulatory framework mandates all health insurance companies to establish a Medical Advisory Board (MAB) or Dewan Penasihat Medis (DPM).

Current Industry Status and Transition Period

Ogi Prastomiyono, OJK's Executive Head of Insurance, Pension Fund, and Guarantee Supervision, reported that some insurance companies have already implemented MAB arrangements. These implementations vary, with some establishing MAB independently while others have opted for joint schemes or collaborations with third-party providers. The regulation provides insurance companies with a one-year transition period from the date of promulgation to comply with the new requirements.

Significance and Impact on Health Insurance Sector

The introduction of this regulation marks a significant step in strengthening Indonesia's health insurance ecosystem. By mandating the establishment of MAB/DPM, OJK aims to enhance the quality and integrity of health insurance operations. This move is expected to improve risk assessment, claims processing, and overall service quality in the health insurance sector.