Sylvester Mensah, NHIA Boss
THE UNIVERSAL Access to Health Care Campaign (UAHC) has welcomed the suspension of four health facilities by the National Health Insurance Authority (NHIA) from providing service to NHIS subscribers for making ‘fraudulent’ claims on the NHIA.
UAHC is a network of NGOs seriously crusading for the government to implement a clear plan for the removal of all user fees to make healthcare free at point of use by 2015
The facilities cited for the alleged scam include, North Western Eye Centre at Mataheko, Community Clinic also at Mataheko, Family Maternity Home at Dansoman and Adwoa Boatemaa Memorial Clinic all in Accra.
The revelation of the alleged fraud came to light following routine clinical audit inspections carried out at the health facilities.
The health facilities were alleged to have illegally taken monies from subscribers for services already covered under the NHIS, operating under poor standards and inflating claims made to the NHIA.
These, according to the NHIA, contradict existing agreements between the authority and service providers.
According to the Communications Manager of the NHIA, Selorm Adonoo, ‘The Authority finds the conduct of these facilities a breach of contract, and therefore unacceptable for them to continue providing service on account of the NHIS when they cannot adhere to basic conditions of engagement.’
The National Coordinator of UAHC, Sidua Hor, noted that ‘for some time now, a number of NHIS clients have had several challenges in accessing healthcare services and these experiences are in the form of illegal co-payments, stockouts and denial of some basic but essential services such as x-rays and scanning.’
The NGO said it is willing to work with the NHIA to monitor NHIS accredited facilities across the country to ensure that NHIS clients get the best of care.
The organisation is also calling on the NHIA to speed up payment due all its accredited health facilities.
This, according to the UAHC, is in response to the ongoing suspension of the supply of medicines on credit to all health facilities under NHIS since August 1, 2014.
According to Ghana’s Chamber of Pharmacy, the suspension signifies possible medicine shortage in the affected health facilities and patients may bear the burden of paying for medicines covered under the NHIS.
Meanwhile, UAHC has described government’s 100-day contingency plan to fight cholera as a knee-jerk approach. The Campaign believes that the fight against cholera is not about instituting a 100-day contingency plan but rather a systemic issue that has to be dealt with by addressing environmental fundamentals of poor sanitation, poor water supply and bad drainage.
BY Jamila Akweley Okertchiri
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