The National Health Insurance Authority (NHIA) is actively combatting illegal payments, commonly referred to as “copayment,” levied on clients within the National Health Insurance Scheme (NHIS) at certain healthcare facilities.
Instances of some health service providers charging for services covered by the NHIS, identified as copayments, have been deemed illegal.
The NHIA has issued warning letters to implicated providers and is collaborating with stakeholders to eliminate this practice.
Mr. Mohammed Awudu, the NHIA District Director for Talensi and Nabdam in the Upper East Region, stated, “Some of our members have expressed concern that they still pay for some services covered by the NHIS,” says Mr Mohammed Awudu, the District Director of the NHIA in charge of Talensi and Nabdam, Upper East Region.
“…And we are working to stop those illegal payments that are happening at some of the hospitals because it is affecting our members.”
“The agreement we have with the service providers is that under the benefit package, they should give us 100 per cent of the services that we have agreed with them, and under no circumstances should they charge for any services we have contracted with them”.
According to Mr. Awudu, the NHIA has agreements with service providers stipulating that they must provide 100% of the services outlined in the benefit package without charging for any contracted services.
Mr. Awudu disclosed this during an interview with the Ghana News Agency on the sidelines of a data validation forum for research conducted by the Rural Initiative for Self-Empowerment Ghana in the Nabdam and Talensi districts.
The research aimed to evaluate the utilization of NHIS by pregnant women for Antenatal Care (ANC) services in the two districts.
Findings indicated concerns over copayments among pregnant women in both districts, along with limited knowledge of NHIS policy coverage and challenges accessing medicines under the Scheme.
While satisfaction levels varied, Mr. Awudu emphasized the NHIA’s commitment to addressing concerns and urged Ghanaians with inactive NHIS memberships to renew and encouraged those yet to register to do so to access benefits.
Additionally, Mr. Awudu highlighted the NHIA’s comprehensive sensitization efforts, targeting not only pregnant women but also service providers, midwives, and nurses, to ensure widespread understanding of NHIS policies and coverage.