The National Health Insurance Scheme (NHIS) has set up a nine-member committee to investigate co-payment at various health facilities across the country, which it describes as the biggest challenge facing the scheme.
The nationwide investigation has become necessary because the scheme has recently increased the prices of service charges and cost of medicines for service providers across the board, ranging from at least 30 per cent to about 400 per cent.
Illegal co-payment is the situation where holders of NHIS valid cards are made to pay for services and medicines covered by the scheme.
Swearing in the committee members, the Chief Executive of the Scheme, Dr Bernard Okoe-Boye, noted that preliminary investigations revealed that some facility managers claimed that they resorted to illegal-co-payments due to the fact that the tariffs were low and that the payments also delayed.
He expressed worry about the two reasons because the tariffs had been increased by 30 per cent with some receiving as high as 400 per cent while the delays in the payment of claims had been brought under control though not totally addressed.
“As of July 1, 2022, the NHIA reviewed the tariffs that we pay facilities that offer services and I am proud to say that in some cases the new prices we pay for medicines go all the way to about 400 per cent compared to the old prices,” he added.
He said with the claims, the authority had been doing very well in settling them on time, and explained that officially the claims took more than three months to settle because of the processes in reporting, verifying and other official procedures.
He said the scheme was striving hard to reduce the time, and as it evolved ways to do that the service providers must stop the behaviour of taking money from card holders.
He said the committee would be replicated in all the 16 regions as well as all the districts so that they would be able to cover the nook and cranny of the country to bring the issues up for quick attention and address.
Dr Okoe-Boye said members of the committee would not be arresting hospital management and staff for collecting the money but the expectation was to find the level of charges and get feedback from the hospitals as to why they made the charges.
The nine-member national committee is chaired by Dr Francis Asenso-Boadi. The members are Titus Sorey, Emmanuel Bukari, Daniel Adin-Darko, Albert Kwaku Ampofo, Vida Adutwumwaa Boateng, Raymond Avinu, Baba Sadique Zankawah and William Omane-Adjekum.
Dr Asenso-Boadi gave the assurance that the members would move straight into action and ensure that they worked assiduously to address the challenges for the NHIS card holders to derive the full benefits.