Nationwide Well being Insurance coverage Authority (NHIA) says the Scheme will all the time be in arrears to its service suppliers per its fee association, it could be troublesome to find out an correct arrears place at any cut-off date.
In accordance with NHIA, the service suppliers have 60 days to submit claims while the NHIA has 90 days to vet, course of and pay these claims.
Kwabena Mintah Akandoh, the Rating Member on the Parliamentary Choose Committee on Well being, in respect of the Nationwide Well being Insurance coverage Fund (NHIF) and the sustainability of the Nationwide Well being Insurance coverage Scheme (NHIS) said though the scheme has struggled since its inception to fulfill claims of lively members from service suppliers, current misapplication of funds collected as levies and SSNIT contributions for different authorities tasks along with will increase in “non-core actions of the fund” has positioned the fund into “medical comatose”.
As on the finish of March 2022, Mr Akandoh disclosed that service suppliers have been owed over GHS2.5bn as a consequence of non-payment of claims filed way back to July 2021.
“Ghanaians are dropping hope within the NHIS opposite to what the Akufo-Addo authorities needs us to consider. The common use of the scheme or common encounter per member per yr has diminished from 2.87 a yr in 2016 to 2.75 instances a yr in 2021 as a consequence of a number of elements together with the truth that most personal service suppliers aren’t ready to supply companies to cardholders. NHIS playing cards at the moment are diminished to getting used for major or primary companies at most well being amenities. That is clearly expressed within the common declare per member decreasing from GHS97.70 in 2016 to GHS69.02 in 2021. Cardholders don’t have any religion that they may obtain good service ought to they use their playing cards for secondary or tertiary well being companies.”
Nonetheless, in a press launch issued by the Scheme and signed by Richard Barima Sarpong, Communications Supervisor, Company Affairs Directorate at NHIA, copied DGN On-line, defined that based mostly on the fee preparations as said, it could be troublesome to find out an correct arrears place at any cut-off date, as the quantity concerned would rely upon when claims have been submitted to the NHIA.
“For instance, between 25 to 30 % of healthcare suppliers have submitted their October to December 2021 (final quarter) claims as of March 2022. It will likely be fairly faulty to state emphatically that the NHIA owes GHC2.5 billion to suppliers for claims submitted as much as March 2022”, he famous.
Mr Barima Sarpong added that the Ministry of Finance throughout the yr 2021 launched a complete quantity of GHC1.393 billion, being Nationwide Well being Insurance coverage Levies (NHIL) income, from the Consolidated Fund to the Nationwide Well being Insurance coverage Fund (NHIF) based mostly on the Allocation Formulation accepted by the Parliament of Ghana on April 5, 2021.
Out of that quantity, GHC1.266 billion was handled as fee for liabilities of the federal government to the NHIA, leaving an quantity of GH127 million, which in the usual accounting reporting framework was attributed to the 2021 monetary yr.
He talked about additionally that the NHIA’s funding cowl for claims has been declining since 2009. The Authority’s funding fund had a closing stability of GHC104.32 million in 2014, however it declined to GHC77 million on the finish of 2016 with disinvestments of GHC39.82 million in that very same yr.
“Funding cowl as of the tip of December 2021, stood at GHC100.72 million. It’s instructive to notice that there have been no disinvestments since 2017,” the assertion mentioned.
By Vincent Kubi