National Health Insurance Authority (NHIA) payment to National Health Insurance Scheme (NHIS) service providers is in over six months arrears, DAILY GUIDE has learnt.
NHIS service providers have, therefore, dismissed comments by President John Mahama that government was up-to-date with payment to the NHIA.
President Mahama, speaking on Radio BAR in the Brong Ahafo Region during his ‘Accounting To The People’ tour last Thursday, mentioned that government was up-to-date with its payment to the NHIA, thereby denying claims NHIS payments were in arrears since July 2015.
President Mahama said, “Government is supposed to owe the health insurance one-quarter. You need to calculate how much is due them, and, so, you need a quarter to be able to calculate how much is due them before you pay. But now every month, government is releasing what is estimated to be due to the National Health Insurance Scheme. Then, at the end of the quarter, they calculate to see if there is a shortfall or there is an overpayment. If there is an overpayment, it is deducted from the next quarter, and, so, government is up-to-date.”
Officials of the NHIA were tight-lipped when DAILY GUIDE contacted them about the debt profile of the authority.
Per President Mahama’s calculation, the NHIA should have received funds for the settlement of arrears of service providers till January 2016. The NHIA reimburses claims filed by service providers within 90 days of submission, thus, all things being equal and going by the statement of the president, the NHIA owes service providers February to April 2016 claims.
However, NHIA owes service providers nine months arrears from August 2015 to April 2016.
NHIS service providers say the last payment received from the scheme managers was for the month of July and it was paid about three weeks ago, raising the question of whether the president was misinformed or had not been was not provided with the full facts about the release of funds to the NHIA.
President of the Health Insurance Providers Association of Ghana (HIAPAG), Frank Toblu, toldDAILY GUIDE that the NHIA owed the association more than five months arrears although he could not give the figures of the exact amount.
Cash & Carry
Dr Issac Morrison, president of the Society of Private Medical and Dental Practitioners, also confirmed payment of July 2015 arrears by the NHIA, adding that members of the society were yet to receive reimbursement from the NHIA for services they provided to subscribers since August 2015.
Dr Morrison said most of the facilities were reverting to cash-and-carry because of the undue delay in reimbursing them for services they had provided.
He said it was very difficult to understand why the NHIA with so much pressure to settle service providers would receive funds and not pay their clients.
A private service provider who is being affected by the delay in reimbursement said he cannot pay his workers’ social security contribution and income taxes, a situation which has led to the state institutions dragging him to court.
President Mahama in the said interview denied claims that the NHIS was collapsing, noting that a committee had been set up to restructure the scheme, a move he said would make it more efficient.
“I have set up a committee to restructure the National Health Insurance Scheme. When it was started, a study was done that showed that if we do not find new sources of income for the National Health Insurance Scheme, it will collapse. … I think it was 2009. … Since then, we have not found new sources of financing, but the health insurance is still lingering on,” he added.
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