The National Health Insurance Scheme (NHIS) has issued a warning of potential suspension to certain credentialed health facilities found engaging in illegal charges to subscribers.
The caution comes in response to numerous complaints from NHIS members regarding unauthorized fees for services, investigations, and medicines covered by the scheme.
NHIS stated that such practices violate Section 35(1) of Acts 852 and point 16.0 on “forbidden conduct” outlined in the Master Provider Service Agreement.
The authority emphasized its commitment to monitoring and enforcing compliance with the law and contractual agreements, highlighting the possibility of suspending facilities that fail to adhere to the regulations.
“In accordance with the NHIS Act 852, Sections 35(1) and (2), the authority is to ensure that the approved medicine list and tariffs are adhered to by the credentialed health service providers. There have been several complaints from our cherished members on illegal charges on services, investigations, and medicines within the NHIS Benefit Package, which have been confirmed by the Authority.
This practice is an affront to Section 35(1) of Act 852 and Point 6.0 on “Forbidden Conduct” as detailed in the Master Provider Service Agreement signed with the Authority.”
The Juaboso Government Hospital, along with the Enchi Government Hospital and other accredited health facilities, is facing scrutiny for allegedly imposing unauthorized charges on NHIS subscribers in the Western North Region.
Residents of the Juaboso District have confirmed the NHIS report, citing instances where hospital authorities collected money without providing payment receipts despite the presentation of valid NHIS cards.
Local residents are now calling for government intervention to address this scandal involving illegal charges at health facilities.