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Tamale Metro NHIS Manager exposes accredited hospitals charging NHIS clients illegal fees

The management of the Tamale Metropolitan Health Insurance Authority (NHIA) led by its manager Mr. Abdul-Ganiyu Ahmed, has exposed some accredited health facilities within the Tamale metropolis for charging illegal fees, also known as co-payment.

The health facilities including Tamale Central Hospital, SDA Hospital, One Heart Health center, Kabsad Hospital, Tamale West Hospital, among others. 

This was revealed at the stakeholder’s engagement including accredited health service providers under the National Health Insurance Scheme (NHIS) over the growing trend of out-of-pocket payments demanded from members of the scheme on Tuesday October 31, 2023.

According to the leadership of the NHIA such practice was outright violation of the law which governed the scheme, and the contractual agreement between the authority and credentialed health providers.

In his power point presentation on monitoring findings on illegal payment at providers site, the Tamale Metropolitan Manager of NHIS, Mr. Abdul Ganiu Ahmed, said their monitoring had revealed that, clients of Ghana’s NHIS seeking health care at the above mentioned health facilities continue make out-of-pocket payments for consultation and drugs that are covered by the scheme.

He said all efforts to curb this menace at these facilities proved futile, hence the exposure. 

“We have been monitoring the activities of the facilities. So far we have monitored all the facilities, and the responses are that, there is a lot of illegality happening at the various health facilities. So, when we started it, we call them to our office and had a discussion and they signed agreement for not to sin anymore. But what we have realize is that , it has even increase, when this things is happening people begin to lose confidence on the scheme. So the purpose of these engagement is to expose them, because we use to dialogue with them not to sin, but we have realize that they are not cooperating”, he narrates.  

He further warned that “One Heart Health Centre, SDA Hospital, Tamale Central Hospital, Kabsad Health Center, Tamale West Hospital and others have institutionalized illegal payment. You see it on their receipts top up cause recovering that is what they are doing. So that is what we are telling the facilities to stop with immediate effect before the law catch up with them”.

“So far it is only one or two drugs that we realized that they are not covered by NHIS like Ivy paracetamol, tramadol injection, Nugel-O. That is the only legality that they have done ro our knowledge, ” he stressed. 

He said the practice had made the general public lose confidence and trust in the scheme, adding the practice had also culminated in the decline in membership enrolment and retention of the scheme. 

Mr. Abdul Ganiu also stated that, another worrying observation was that some accredited healthcare facilities were detaining NHIS members over such illegal payments. “We shall be on them until all these things stop”, he promise. 

Speaking to on the sideline of the meeting, the northern regional deputy director in charge of the Claims Processing Centres (CPC), of the national health insurance authority (NHIA) Mr. Issack Akonde, said the CPC would consider the findings when the above mention facilities submitted their claims. 

The national health insurance authority in the Tamale Metropolis on Tuesday October 31, 2023, engaged stakeholders, especially accredited health service providers, traditional leaders, city authority, security agency, the clergy and the media, to brainstorm the way forward before any action could be taken.

Story By: Alhassan Yakubu ||Ghana.

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