In a decisive move to uphold the core principles of the National Health Insurance Scheme (NHIS), the National Health Insurance Authority (NHIA) has announced stringent measures against facilities engaging in payment demands from NHIS members.
Following widespread complaints regarding unwarranted payments for services covered under the Benefit Package, the NHIA has emphasized its commitment to preventing out-of-pocket expenses at the point of service delivery. Such demands not only undermine the fundamental tenets of the scheme but also diminish public trust, thereby impeding efforts towards achieving Universal Health Coverage.
Despite recent appeals and a nationwide ban on payment demands issued by the Ministry of Health, reports from NHIA monitoring officers have revealed persistent non-compliance by some facilities.
In response, the NHIA intends to enforce Clause 15 of its contract with credentialed providers, which mandates the prompt return of any payments made by subscribers for services covered under the agreement. Furthermore, the NHIA reserves the right to deduct the refunded amount from any payments due to the provider from the NHIA.
All deductions will be based on verifiable complaints from NHIS members and will contribute to refunding aggrieved members, safeguarding them from excessive health expenditures.
Dr. Bernard Okoe Boye, CEO of NHIA, affirmed the authority’s unwavering commitment to protecting NHIS members’ rights and ensuring equitable access to healthcare services for all.
Read the statement below:
