The Legal Obligation To Revise The Internal Regulations Of A Hospital In Accordance With Minister Of Health Regulation Number 6/2026*

The Government of Indonesia has enacted a Regulation of the Minister of Health of the Republic of Indonesia Number 6 of 2026 concerning Hospitals (“MoH Regulation 6/2026”). Systematically, this regulation comprises 15 (fifteen) chapters and establishes technical-operational guidelines for hospitals operated by the Central Government, Regional Governments, or the private sector. MoH Regulation 6/2026 was formulated using an “Omnibus Bill” approach; it revokes and declares void more than 21 (twenty-one) existing legal regulations, including Decree of the Minister of Health Number 772/MENKES/SK/VI/2002 concerning Guidelines for Hospital Internal Regulations (MoH Decree 772/2002) and Regulation of the Minister of Health Number 10 of 2014 concerning Hospital Supervisory Boards (MoH Regulation 10/2014).

 

The regulation became effective upon its promulgation on June 12, 2026, requiring hospitals to make necessary adjustments—including compliance measures—within a maximum period of 2 (two) years from its effective date. From a practical standpoint, MoH Regulation 6/2026 facilitates ease of use by consolidating various provisions related to the health sector. However, closer examination reveals that the regulation contains legal provisions involving cross-cutting issues that are interconnected with other legal policies.

 

Therefore, this client notice outlines the key provisions of MoH Regulation 6/2026 that we consider most significant, specifically hospital licensing and investment, hospital internal regulations, options regarding hospital supervisory boards, reporting of hospital violations, and the types and imposition of sanctions on hospitals.

 

What has Changed

• Regulations on Hospital Group Licensing and Investment
  
  Private entities may establish hospitals, subject to legal obligations regarding the fulfillment of licensing requirements. Hospitals established in the country may be classified as either Domestic Investment (PMDN) or Foreign Investment (PMA) entities. A PMDN hospital must be classified as providing “Basic” (Dasar) services and possess a minimum of 50 inpatient beds, whereas a PMA hospital must be classified as providing “Comprehensive” (Paripurna) services and possess a minimum of either 50 or 200 inpatient beds. Exceptions regarding service classification and the number of inpatient beds apply to PMA hospitals established through Hospital Group investments intended to support hospital service requirements.

• Hospital Internal Regulations (Hospital Bylaws) as a Legal Obligation
  
  The policy set forth in MoH Regulation 6/2026 stipulates that Hospital Internal Regulations (hospital bylaws) comprise two components: hospital organizational regulations (corporate bylaws) and regulations governing the hospital’s medical staff and healthcare personnel (medical staff bylaws). These regulations serve as guidelines for hospital governance and clinical governance, ensuring operations are conducted effectively, transparently, and accountably.
  
  Furthermore, the establishment of hospital organizational regulations (corporate bylaws) constitutes a legal obligation for the hospital to define, at a minimum, the hospital’s identity, the relationship with the hospital owner (or their representative), and the hospital’s organizational structure. This structure must include—at the very least—elements of leadership, medical services, nursing, medical and non-medical support, administration, and operations. Meanwhile, the Hospital Supervisory Board is designated as an independent, non-structural unit accountable to the hospital owner; its working procedures are governed by the hospital’s internal regulations, distinct from the medical staff bylaws. Furthermore, establishing bylaws for medical and healthcare staff is a legal obligation for hospitals under the policy set forth in MoH Regulation 6/2026. Consequently, the validity of technical-operational policies implemented by various organizational units can be substantiated by referencing the hospital’s internal regulations.

• Policy Options Regarding the Hospital Supervisory Board for Hospital Owners and/or Leadership
  
  Establishing an independent Supervisory Board is a policy option available to hospital owners and/or leadership under MoH Regulation 6/2026. Nevertheless, owners and/or leadership may consider the objective of the hospital’s organizational structure—namely, achieving the hospital’s vision and mission through sound organizational and clinical governance. In this context, the decision to adopt an independent Supervisory Board based on checks-and-balances principles is an integral aspect of formulating hospital bylaws.
  
  One method for selecting members of the independent Supervisory Board—comprising representatives from the hospital owners, experts, and the Ministry of Health, and consisting of a maximum of 5 (five) members, including the chairperson. Members of the Supervisory Board are appointed by the hospital owner.

• Sources of Reports on Hospital Violations and Types of Sanctions
  
  Under the policy set forth in MoH Regulation 6/2026, the reporting of hospital violations falls into three categories: formal complaints, reports in electronic or print media, and the results of monitoring and evaluation. Formal complaints may be submitted by individuals, the public, and/or institutions, agencies, or organizations; such complaints must be made in writing and include a description of the incident, the identity of the complainant, the name and address of the party complained against, the act alleged to constitute a violation of hospital obligations, the time of the incident, and the grounds for the complaint (supported by facts, data, or indications).
  
  Furthermore, administrative sanctions apply to hospitals that violate their legal obligations. These sanctions are tiered, ranging from verbal warnings and written warnings to administrative fines, the revocation of accreditation status, and the revocation of the hospital’s business license. However, in cases where a hospital violation results in consequences such as patient death, disability, or permanent organ damage, sanctions are imposed without following the tiered structure.

 

Implications and Mitigation

The policy set forth in MoH Regulation 6/2026 directly impacts hospitals by imposing legal obligations; consequently, a key practical question arises: what legal rights do hospitals possess alongside these obligations?

• Updating the 2025 KBLI and Monitoring Ministry of Health Policies for Foreign-Invested (PMA) Hospitals
  
  Updating the 2025 KBLI (Indonesian Standard Industrial Classification) is a legal obligation for hospitals. Typically, the KBLI update necessitates amendments to the corporate deeds of hospitals that are incorporated as legal entities. Furthermore, foreign-invested (PMA) hospital groups need to monitor Ministry of Health policies regarding investment, ideally with the assistance of legal consultants possessing expertise in investment law.
  
  

• Absence and/or Incompleteness of Hospital Internal Regulations (Hospital Bylaws) as a Basis for Sanctions
  
  Updating hospital internal regulations (hospital bylaws) in accordance with MoH Regulation 6/2026 requires a comprehensive mapping against applicable legal provisions, as these regulations cannot be interpreted solely within the framework of health law. Beyond health regulations, there are developments in other areas of law—such as national criminal law—that involve cross-cutting issues relevant to hospital operations.
  
  For instance, the obligation to provide legal assistance to all hospital personnel—including drivers and security staff—must be incorporated into the medical staff bylaws. Meanwhile, issues regarding hospital ownership as a legal entity are subject to legislation governing limited liability companies and are addressed in the hospital’s organizational regulations (corporate bylaws).
  
  

• Supervisory Board Arrangements to Enhance Hospital Governance (Good Corporate Governance) and Good Clinical Governance
  
  Hospital owners and/or leadership may consider incorporating Supervisory Board membership and operational procedures into the hospital bylaws. Doing so strengthens both corporate and clinical governance, thereby boosting confidence among the public, investors, and regulatory authorities.
  
  However, there is a risk of the Supervisory Board becoming merely nominal; since appointments are controlled by the hospital owner, the essential principle of checks and balances may not be effectively realized. Furthermore, in the event of a violation, the absence of a Supervisory Board complicates the task of substantiating governance practices, while a board dominated by members affiliated with the owner undermines the oversight function itself.
  
  

• Three Channels for Public Reporting: Expanded Sanction Risks and a Dual-Standard Sanction System
  
  Exposure to three distinct channels for public reporting increases the risk of sanctions—and the likelihood of rapid enforcement, sometimes occurring before the hospital has the opportunity to respond, particularly regarding reports in digital media. Additionally, the sanction system—which typically follows a tiered approach ranging from verbal warnings to license revocation—may bypass this progression in cases involving patient death or permanent disability/damage; such a situation leaves hospitals unable to implement gradual improvements and exposes them to the immediate risk of license revocation.
  
  

Next Steps for Hospital Legal Compliance

Given that hospitals are legally required to comply with the policy set forth in the MoH Regulation 6/2026, the following points warrant consideration:

• A competitive disparity may arise between Domestic Investment (PMDN) hospitals and Foreign Investment (PMA) hospitals due to differing investment thresholds; furthermore, exemption provisions for hospital groups could encourage multi-entity or holding-company investment structures, potentially risking delays or stagnation in the licensing process for hospital businesses.
• Conduct a legal audit performed by a certified legal auditor and draft the Hospital Internal Regulations—specifically the Hospital Organizational Regulations and the Regulations for Medical Staff and Healthcare Professionals. Ensure these two sets of regulations are distinct yet cross-referenced, and establish a formal ratification mechanism so they may serve as the valid basis for technical-operational regulations issued by the hospital’s structural units.
• Ensure the hospital regulations specify expert criteria and supervisory board selection procedures, along with working procedures and documentation practices, to enhance credibility with the public and regulators.
• Hospitals may establish a complaint-handling team as part of their risk management framework, formulate patient safety policies, and train their internal legal teams—supported by external legal counsel (advocates)—to assess the formal validity of complaints.