The Acting Upper East Regional Director of the National Health Insurance Authority (NHIA), Mr Kasimu Abudulai, says the Authority is no longer in arrears to providers, given the three-month cycle of claims adjustment.
He said the claims payment would check illegal charges and statements such as “They are owing us, they have not paid us,” common among NHIA accredited facilities, were therefore, statements of the past, as the Authority had made payments up to December 2023.
“Only last week, the Authority made payments up to December 2023 for all providers that have submitted their claims, except a few that may have challenges due to vetting”.
“This means that, effectively, the Authority is no more in arrears to providers, given the three-month cycle of claims adjustment,” he said.
Mr Abudulai was speaking at the Authority’s Regional 2023 Annual Performance Review meeting in Bolgatanga, on the theme: “Health Heroes; 20 years strong.”
The meeting brought together Municipal and District Directors of the Authority and other stakeholders within and outside the Region to take stock of their activities and strategize to improve on their performance in 2024.
To further mitigate the practice of illegal charges, the Acting Director said the Authority had introduced two new policies; the Sunshine Policy and the Pulpit Policy.
He explained that per the Sunshine Policy, all payments made to providers could be accessed by citizens if they logged onto “nhis.gov.gh/payments,” to search the particular facility of interest, saying “This is to enhance transparency in claims payments to all stakeholders, and help put everyone on the same page.”
On the Pulpit Policy also referred to as Customer Service Point, which was rolled out in the Region, he said NHIA staff would be stationed at health facilities to address immediate concerns of National Health Insurance Scheme (NHIS) card holders.
That, he said would improve the healthcare experiences of NHIS members and prevent illegal charges, “I will, therefore, call on all healthcare providers to co-operate and support this policy to ensure its success and subsequent benefit to our cherished clients.”
Mr Abudulai said the Authority was not oblivious of the current challenges faced by providers due to the current economic situation and changes in their funding arrangements but had engaged experts from the health fraternity to restructure the framework of the NHIS tariff structure.
He said as part of the restructuring, the experts would review the current direct and indirect costs providers faced and introduce realistic service tariff that met the real cost of providers.
“Therefore, our dear providers should be reassured that in due course, a new service tariff that adequately covers their current operational costs will be out,” Mr Abudulai said.
Touching on the Region’s effort towards achieving Universal Health Coverage (UHC), Mr Abudulai said the Region ended the year under review with a drop in population coverage from 935,077 active members representing 70.45 per cent in 2022 to 863,494 active members representing 63.8 per cent in 2023.
He attributed the decline to the Bawku conflict, saying “The conflict in Bawku continues to exact devastating effects on membership drive activities in the four District offices in the Corridor, Bawku Municipality, Pusiga, Garu, Tempane and Bawku West.
“Until the conflict erupted, Bawku Municipality in particular was our largest membership mobiliser in the Region, always pushing our membership in the desired direction,” the Acting Director said.
The outgoing Regional Minister, Mr Stephen Yakubu, in his address, commended the Authority for the measures taken to clear arrears to service providers and the establishment of Co-payment Committee at all levels to curb illegal charges from service providers.
He called on management of health facilities in the Region to exhibit sincerity in levying their patients and advocated severe and stiffer punishment deterrent enough to stop illegal charges.
GNA
HT/LAA
08 April 2024
