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The National Health Insurance Authority (NHIA) has advised its service providers against engaging in cash-and-carry and co-payment practices in the event of a delay on the part of the service to reimburse them.

The Acting Brong Ahafo Regional Director of the NHIA, Mr Aminu Yakubu, who gave the advice at the opening of a two-day regional review meeting of the authority in Sunyani, conceded that, “There had been some occasional delays in reimbursing providers, but that should not under any circumstance serve as the basis for cash-and-carry and co-payment at the provider sites.”

Challenges

Mr Yakubu said district offices in the region had to engage some service providers over issues of co-payment since the practice largely affected the confidence of subscribers with its attendant negative effect on membership drive.

He expressed concern about the lack of understanding of the application of the NHIA tariff regime and medicine list by some service providers, and explained that the situation sometimes created undue cost to the scheme and also resulted in a situation where some providers suffered huge clinical audit deductions due to non-compliance with tariff structure.

Membership drive

According to Mr Yakubu, the region achieved a total active membership registration of 1,216,276 being 48 per cent of the region’s population in 2015, which included 941,049 registered under the Biometric Registration System (BMS).

In addition, a total of 171,624 poor people were registered out of the target of 291,863, he said, adding: “Our mandate to target and capture the various categories of the vulnerable groups such as orphans, the physically challenged, prison inmates and the mentally challenged, as well as LEAP beneficiaries, remains unshaken.”

Payment of claims

With regard to claims, Mr Yakubu disclosed that the NHIA paid a total of GH¢66,361,336 to its service providers during the period spanning July 2014 and April 2015, while GH¢13,195,011.54 was paid to all providers in the region in May and June 2015.

“The NHIA is committed to ensuring that the continuous claims burden on the scheme is arrested in order to sustain the scheme, and such reforms as the BMS registration, provider and authentication, and capitation roll out, are expected to deliver on the sustainability drive,” he said.

The Brong Ahafo Regional Co-ordinator of the NHIA for the Ghana Health Service, Mr George Asare-Tabi, called for measures to ensure that service providers understood the implementation of the medical list among other issues about the scheme.

He called for the prompt payment of the claims to the service providers since the delay was suffocating their operations.