The National Health Insurance Scheme (NHIS), which describes co-payment at various medical facilities around the nation as its largest concern, has established a nine-member committee to look into the issue.
The scheme has lately increased the prices of service fees and the cost of medicines for service providers countrywide, ranging from at least 30% to over 400%, necessitating the national probe.
When holders of active NHIS cards are required to make payments for services and medications that are covered by the program, this is known as an illegal co-payment.
Preliminary
Dr. Bernard Okoe-Boye, the scheme’s chief executive, who administered the oath of office to the committee members, said that preliminary investigations had shown that some facility managers had stated they had turned to unlawful co-payments since the rates were low and the payments were slow.
He voiced concern about the two factors because the tariffs had grown by 30%, with some receiving as much as 400%, and the claims payment delays had been curbed but not completely resolved.
I’m glad to tell that in some situations, the new costs we pay for medicines go all the way up to roughly 400% compared to the old ones, he continued. “As of July 1, 2022, the NHIA evaluated the tariffs that we pay facilities that supply services.
He claimed that the authority had been doing a great job of resolving claims in a timely manner and went on to explain that, in reality, it took more than three months to pay claims due to the processes involved in reporting, verifying, and other official procedures.
According to him, the program was working hard to cut down on the amount of time, and when it found new ways to do so, the service providers had to stop asking cardholders for money.
Miniature
In order to reach every corner of the nation and bring the issues up for prompt consideration and resolution, he said the committee would be reproduced in all 16 regions and in all the districts.
Members of the committee, according to Dr. Okoe-Boye, would not detain hospital administrators or employees for taking the money; rather, they expected to determine the level of charges and seek hospital input on why they levied them.
Francis Asenso-Boadi, a doctor, is the chairman of the nine-person national committee. The group’s members are Baba Sadique Zankawah, Raymond Avinu, Vida Adutwumwaa Boateng, Albert Kwaku Ampofo, Titus Sorey, Emmanuel Bukari, Daniel Adin-Darko, and William Omane-Adjekum.
