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Auditor-General’s Findings Pre-dated My Appointment – NHIA Chief   
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Sylvester Mensah
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Chief Executive of the National Health Insurance Authority (NHIA), Sylvester Mensah, has revealed that findings in the just released Auditor-General’s report largely pre-dated his tenure as Chief Executive of the NHIA.

He said he inherited an NHIS that was fraught with a lot of inefficiencies. Mr Mensah made the comment while responding to the 2012 Auditor-General’s report which covered the 2008 and 2009 operations of the NHIS on Citi FM on Tuesday.

According to him, “the scheme under the NDC regime has seen tremendous growth in all its key performance indicators.”
The Auditor-General’s report dated 2012 covered the financial and operational accounts of all public institutions from the period 2008 to 2012. However, what was captured for the NHIS spanned the period 2008 to 2009.

Mr Mensah who until his appointment as Chief Executive was the head of public sector banking at the Intercontinental Bank (now Access Bank) disclosed that “there had never been a risk assessment of the scheme till late 2009” when he assumed office alluding to the fact that the first ever risk evaluation of the health insurance scheme was initiated by him in 2009. Risk assessment is said to be critical and routine for any insurance scheme as it consists of an objective evaluation of risks and hazards in which assumptions and uncertainties are clearly considered and presented.

According to Mr Mensah, though he was not at post in 2008 and a substantial part of 2009, he has had to respond to the Auditor-General’s report as Chief Executive. In a blow-by-blow response to the Auditor-General’s report on Citi FM, he described as “legitimate and a true reflection of what happened over the 2008/2009 period.” According to him, many of the Auditor-General’s findings were informed by a comprehensive audit of all 145 district schemes he initiated as a move to ensure transparency and accountability in the operation of the NHIS.

“It is from our internal audit report that over 90 percent of the issues you find here reflected,” he stated.

On the claim that monies were diverted into a non-existent account, he explained that the NHIA reported the matter to the police and got two of its staff prosecuted, convicted and sentenced to a total of 10 years in prison over their connivance with the then administrator of the Samatek Hospital in diverting GHC 131,409.26 paid to the facility by the NHIA. Judgement on this case was delivered four months ago.

On a point that the NHIA paid monies to some providers in 2008 even when their claims had not been vetted yet, Mr Mensah responded that though he was obviously not at the NHIA at the time, in his view and in practice, there was nothing wrong with the advance payment made to those facilities prior to the vetting of their claims.

According to the Chief Executive, the NHIA agreed to requests from some facilities at the time that some percentage of the submitted claims be paid to them while they awaited conclusion of the vetting to enable them also pay salaries of their staff.

40% of their total claims submitted was paid them while vetting continued and the rest topped up after vetting was concluded, just to enable them operate and serve NHIS subscribers.

He added that prior to his assumption of office, premiums were collected at the district level while the Authority further provided for money to pay for claims of facilities in the district. However, he said he ensured the creation of a Consolidated Premium Account (CPA) in two banks to centralize all claims collected for efficient use. He also said the review of the law from Act 650 to Act 852 in 2012 was a major achievement for the NHIA as it enabled administrators of the scheme to introduce more strategies to ensure the scheme ran efficiently.

Mr Sylvester Mensah took over from Mr Ras Boateng in July 2009 as Chief Executive of the NHIA following his appointment by the late President Mills.

Mr Mensah in the interview said a raft of efficiency gain measures have been instituted since he assumed office to ensure all identified loop holes and administrative flaws were adequately addressed. He mentioned some of these measures as the establishment of zonal Claims Processing Centres (CPS) in Kumasi, Accra, Cape Coast and Tamale to professionalize and quicken the vetting process, the introduction of the instant ID card, electronic claims processing, clinical audits and a host of others.
Source: Peacefmonline.com

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