Some health institutions have resorted to co-payment to cheat unsuspecting subscribers and managers of the National Health Insurance Scheme (NHIS).
Under the illegal practice of co-payment, the health institutions ask subscribers to go and purchase the drugs although those drugs are listed under the NHIS drugs list.
Those health institutions, however, turn around to submit the cost of the drugs to the National Health Insurance Authority (NHIA) for reimbursement as if the drugs were supplied to the patient by the facility.
The Brong Ahafo Regional Director of the NHIA, Mr Emmanuel Baah-Danquah, who disclosed this, said some Christian health institutions were the worst perpetrators of the co-payment.
He was speaking at the 2016 first quarter review meeting of the operation of the scheme in the region in Sunyani last Friday.
“The situation is worrying. If the government is paying huge sums of money to health providers, why should they adopt such practices to earn undeserved monies”, he questioned.
Mr Baah-Danquah explained that in 2015 alone, about GH¢1 billion was paid as claims submitted by health providers.
He called on subscribers of the NHIS to insist on their rights by collecting receipts on monies demanded from them whenever they receive treatment by health providers.
“They should be bold to submit such receipts to an NHIA office nearer them so that we can verify whether they were charged for services they were not supposed to pay for.”
Mr Baah-Danquah said his outfit would embark on an exercise to ensure that health providers in the region who were involved in such practices were punished.
He also expressed concern over the abnormal increase in the claims submitted by some heath providers recently.
He cited the Sampa Government Hospital as an example, explaining that their claims had jumped in one month from about GH¢150, 000 to over GH¢250, 000.
Mr Baah-Danquah said the explanation that there was an outbreak of Pneumococcal Meningitis in the area was untenable since the scheme would not allow the cost of treatment for non-subscribers to be submitted for payment as a result of the outbreak of that disease.
On the registration of subscribers, he announced that a total of 269,137 people out of an estimated 321,729, representing 84 per cent of the region’s target for the first quarter of the year, were registered.
He said 68,541 out of the number of people who registered during the period under review were pupils and students in primary, junior and senior high schools.
Source: Daily Graphic
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