Revealed: Why BNI is probing ex-NHIA boss

General News of Friday, 1 January 2016


Sylvester Mensah NhisSylvester Mensah, ex-NHIA boss

Investigations by have revealed that there have been intensified interactions between the National Health Insurance Authority and the Bureau of National Investigations (BNI) within the past few weeks leading to NHIA’s former boss Sylvester Mensah being invited.

A credible source within the NHIA told that various NHIA directors and managers have been invited by the BNI to brief the security agency on their roles, targets and work processes.

The source told that the recent attention of the state investigative agency on the NHIA will deepen the culture of transparency and probity run by the Authority.

According to the source, the NHIA is open and has cooperated well with the BNI so far and will continue to do so.

Some healthcare providers too have been visited and their books looked at in respect of how claims from the provider end are processed before they are submitted to the NHIA for vetting.

The source who spoke to said “the NHIA has a mandate to run the NHIS by providing financial risk protection against the cost of basic healthcare for all residents in Ghana. In doing so, its work is subject to the work of other state institutions such as the auditor general and investigative bodies.

“And anytime that comes we fully cooperate as we are currently doing. The ongoing process, the NHIA believes will only produce an outcome that will improve the operations of the scheme.”

According to sources, some of the areas of interest to the BNI include;

1. The Accreditation/credentialing process: What processes a health facility goes through to become a service provider of the NHIA.

2. Provider tariffs: How tariffs for providers are calculated and what tariffs apply to the various provider levels under the NHIS.

3. Claims: How claims are vetted/processed. What ingredients go into claims vetting and how monies are paid to providers after claims vetting, operation of the NHIS Claims Processing Centres etc

4. 11 year journey of the NHIS, its achievements, challenges and way forward.

5. Membership and financial management.

Mr. Mensah is being held at the headquarters of the Bureau of National Investigations (BNI) in Accra in connection with the above as the immediate past boss.

A confidant of the ex-NHIA boss told that the former MP of La Dadekotopon reported himself to the national investigative body on New Year Day after seven heavily armed officials from the facility invaded his residence on New Year’s Eve ostensibly to arrest him.