The free maternal care programme under the National Health Insurance Scheme has been heavily abused, a re-vetting team of clinical auditors from the head office of the National Health Insurance Authority in November last year has revealed.
The team discovered that the authority was over-billed to the tune of GH¢71,107 in claims submitted by the Tema General Hospital in respect of the free maternal care programme.”
This, it hoped, “would prevent incidents like these from happening in the future”.
The report said the Greater Accra Regional Office of the National Health Insurance Authority was alarmed by the unusually very high claims for free maternal care being submitted by the Tema General Hospital and alerted the claims division of the authority, which immediately constituted a team of clinicians. The team visited the hospital to re-vet claims relating to the hospital’s free maternal care programme, which unearthed the malpractice.
Many claims the team inspected showed clear instances of abuse and cited two as:
“Patient J.A. (full details withheld) was seen on October 10, 2009 was diagnosed as having had an assisted delivery. The claims form indicated she was given 70 units of oxytocin, 5x500ml of normal saline and 5x500ml of ringer’s lactate. The team found out that in the clinical notes, she was given 10 units of oxytocin and 2x500ml of ringer’s lactate. She also had a normal delivery.
“Patient HT(full details withheld) was seen on November 7, 2009. She was diagnosed as assisted delivery. The claims form indicated she was given 70 units of oxytocin, 5x500ml normal saline and 5x500ml of ringer’s lactate, two vials of pethidine and one vial of promethazine.
“In the clinical notes however, she was admitted in second state of labour, at 01 hours (1.00 in the night) and she delivered at 01.28a.m.
“The clinical notes showed clearly that apart from 10 units of oxytocin, no other medication was expended on this patient.”
Source: The Ghanaian Times /Ghana
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