To restore public trust in the National Health Insurance Scheme (NHIS), Ghana’s Ministry of Health has warned health service providers not to charge patients for services that are already covered by the program.
Kwaku Agyeman-Manu, the sector minister, said that co-payment, a separate fee charged by service providers for conditions covered by the scheme, had become a big problem for the scheme. He asked service providers, especially the Ghana Health Service (GHS), to help fix the problem.
“Co-payments have been banned” the minister said.
The President hates to see poor patients being charged out of pockets for healthcare services,” he said.
“Maternal services such as deliveries are supposed to be free, but some facilities are charging patients as high as a GH¢1,000 for the service, and that is unacceptable.
When it happens that way, to the end-user it will look as if the scheme is not working,” he added.
The sector minister stated, in an interview with the Daily Graphic in Accra, that co-payments prevented access, and the ministry was working to end the illegality through meaningful engagements.
“Fortunately, the government has, in recent times, been doing well with timely payments. We have been doing frequent monthly payments in bits to ensure service providers get monies frequently. The arrears gap have been bridged over time”.
Service providers are owed around four or five months as compared to the circumstance that endured a few years back when they were owed a year and over.
“Therefore, service providers have no reason to accept co-payments. The act amounts to extortion, and that is illegal,” he said.
The minister stated that the NHIS was still working and continued to offer unrestricted access to healthcare.
He added that the scheme had not fallen apart and that the government would continue to invest in it.
Mr Agyeman-Manu asked administrators of the Ghana Health Service (GHS), who comprise around 70% of medical care supplier organizations under the service, to fight the canker that could make the NHIS unattractive.
“From the end-users’ point of view, it looks like the scheme is not working as a result of the extortions.
He stated,
This statement is not meant to insinuate that health insurance is not working, but is an admonition to the managers of the Ghana Health Service to help end this criminality by every means possible,” he said.
The minister stated that the government was making investments to strengthen the program, particularly to implement universal health coverage, a policy that aims to eliminate barriers to healthcare access.
“With huge investments and efforts being made, there is no way I would, in any way, suggest that the scheme is ineffective as being speculated,” he said.
In January this year, the Chief Executive Officer (CEO) of the National Health Insurance Authority (NHIA), Dr Bernard Okoe-Boye, cautioned facilities against co-payment arrangement or risk losing their accreditation.
“I am announcing confidently that very soon the accreditation of health facilities which additionally charge active NHIS patients with impunity will be revoked.
“The NHIA annually injects GH¢120 million into the health sector, an average of GH¢1.5 million is paid to each health facility every month across the nation.
“So we are pumping so much into the health sector on a monthly basis, and, therefore, we demand that patients who visit the hospitals should be taken care of and not be made to pay for services covered by the NHIS,” he said.
Admitting that there were often delays in the payment of claims, Dr Okoe Boye, however, attributed the delay in the payment of claims partly to the fact that “some of the tariffs are high and unrealistic.”
In order to prevent service providers and suppliers on the health insurance scheme from losing money or refusing to provide services, the MoH and the National Health Insurance Authority (NHIA) increased the prices of medicines and services paid to them in February of this year.
He stated that the reviews were conducted in accordance with Act 852 of the National Health Insurance Act of 2012, explaining that they were required to improve service delivery for subscribers and provide providers with value for their money in order to prevent certain gaps in access to the scheme’s medications and services.
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