April 24, 2024

The Tamale Metropolitan Office of the National Health Insurance Authority (NHIA) has caught five hospitals in the area for charging unsuspecting clients illegal fees also known as co-payment.

The facilities are Tamale Central hospital, Tamale West hospital, SDA hospital, One Heart hospital and KABSAD Medical Center.

The issue of illegal fees slapped on NHIS beneficiaries seeking medical care has persisted for years now despite efforts by the scheme managers to stop the menace.

This has left many Ghanaians using the NHIS cards to access healthcare services with little or no confidence in the social intervention programme.

However, this time round, the authorities of the policy have decided to bite hard on the recalcitrant service providers engaged in such dubious and illegal practice.

Mr. Abdul Ganiyu Ahmed, the Tamale Metro NHIS Manager in a media interview said his outfit has monitored the activities of these facilities over a period and has uncovered a lot of such illegalities being perpetuated by some of the healthcare providers.

“When we started it, we called them to our office, had a discussion with them and signed an agreement for them to go and sin no more. But what we have actually realized is that the practice has increased compared to the past.

“What we actually did was that, a team of personnel went there and did sampling of patients that visited the hospitals and their health insurance cards were active; we got to know that almost all of them paid for the services that are being rendered there.

“So far, it’s only one or two drugs that we realized that they are not covered under NHIS like (the IV paracetamol, tramadol injection and Nugel O), that is the only legality that they have done and we know but the others are all things that are covered under health insurance.”

He lamented that such unlawful practices continue to undermine public confidence and trust in the NHIS and stated this must be seized henceforth.

According to him, some patient relatives are allegedly asked to pay some tokens before they are allowed to see their babies, emphasizing this is unacceptable.

The Manager stated this is a clear violation of the agreement signed between the healthcare service providers and the National Health Insurance Authority.

“So we are telling the facilities that these things must be stopped and the agreement they signed must be implemented to the latter.”

Refund

Mr. Abdul Ganiyu Ahmed said the NHIS will insist for the facilities to refund the dubious fees taken from the affected clients.

He added the Claims Processing Center will also invite the facilities to present their claims for the period under review to be audited for the necessary deductions to be made.

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