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Inappropriate billing said to be affecting NHIA

NHISSome health service providers  charge fees for the treatment of certain illness among pregnant women against Free Maternal Care (FMC) rate instead of Out-Patient-Department (OPD) rate.

Mr Augustine Boakye, Senior Monitoring and Evaluation Officer of the Northern Regional Office of the National Health Insurance Authority (NHIA), who made the allegation, said  “We have observed that some service providers classify all cases involving pregnant women and charge it under FMC because the tariff for FMC is a bit higher than the general OPD tariff”, he said.

He expressed the concern at stakeholders’ forum, organized by Send-Ghana, for expectant mothers, National Health Insurance Authority officials, representatives of health service providers and faith based organizations, in Tamale.

They took stalk of the FMC policy implementation in the region, its challenges and how it would be addressed.

The FMC was introduced on July 1, 2008, and incorporated into the National Health Insurance Scheme, to improve maternal health and reduce infant mortality in the country.

The policy exempts pregnant women from paying premium on registration or renewal of membership and they are at liberty to enjoy a full year free antenatal care, general services and medicines.

Mr Boakye explained that a general OPD treatment of malaria cost about GH¢10.00 while FMC malaria treatment cost GH ¢14 and that due to the tariff difference some health facilities bill pregnant women under FMC instead of the OPD.

He said the NHIA had also said some service providers submitted repeated claims ‘on same pregnant woman’, which increased the cost but it did not reflect the service offered.

Mr Boakye said some staff of hospitals took advantage of the ignorance of some expectant mothers, and extorted money from them, and indicated that the NHIA did not cover those services and medication.

He mentioned that items such as dettol, soap and other toiletries were catered for under the NHIS, saying “I don’t see why pregnant women need to buy all these items before they give birth. It is understandable if they are asked to buy them and use at home after they are discharged.”

Mr Boakye said to solve the problem of double registration the NHIA would start a biometric registration.

Mr John Nkaw, Programme Officer of Send-Ghana, said that maternal mortality was high in the region due to lack of funding, low sensitization, negative cultural beliefs and the stigmatization of women who give birth at health facilities.

He said some women refused to deliver at health facilities because of the bad attitude of some midwives and nurses.

Mr Jeremiah Tiimob, Administrator of the Tamale Central Hospital, appealed to expectant mothers to report cases of extortion to hospital authorities.

“The other alternative way to reduce some of these extortions is that patients should demand receipt of monies they pay” he said.

Mr Timob urged the NHIA to seek clarification on cases of extortion reported by subscribers rather than blaming service providers.

Source: GNA

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