Health service providers complain of delays in payment of claims

NHISMr Frank Torblu, Executive Director of Health Insurance Service Providers Association, has expressed worry about the delay in the payment of the National Health Insurance Scheme (NHIS) claims.

Mr Torblu said the situation has affected the smooth running of the Scheme and urged government to ensure timely release of funds for the payment of the claims to help improve health delivery.

He was speaking during a panel discussion in Accra on Ghana Journalist Association programme dubbed: “Business Advocate” on Ghana Television supported by BUSAC Fund, Denmark Embassy and United States Agency for International Development .

Speaking on the topic: “The implementation of the NHIS, and the effects on the country,” Mr Torblu commended government for initiating the scheme, but said it only covered 38 per cent of the population.

He was of the view that there should be the creation of a separate regulatory body to spearhead the affairs of the private health insurances in the country.

Mr Torblu expressed concern about the inability of authorities to involve service providers in policy formulation before the law on the scheme was passed, and that their outfit had to write to Parliament and the Ministry of Health on some of their concerns.

He called for a review of the scheme’s medicine list since most of the medicines are not on the insurance list.
The capitation grant should be across the country and not some selected regions, saying it brings disparity in the payment mechanisms to the providers who are providing equally the same services across the country.

He called for broader consultation with stakeholders to address some of the pertinent issues affecting the scheme.
Mr Selorm Kodzo Adonoo, Deputy Director of Communication, National Health Insurance Authority explained that the Scheme is a social policy intervention that ensures access to basic healthcare services to all citizens.

Mr Adonoo said the Authority was established under the National Health Insurance Act 2003, Act 650, as a body corporate, but a new law, Act 852 has replaced ACT 650 in October 2012 to consolidate the NHIS, remove administrative bottlenecks, introduce transparency, reduce opportunities for corruption.

He said currently the Scheme has a membership of 10.54 million as of 2014, ensuring equity in health care coverage, access by the poor to healthcare services and the protection of the poor and vulnerable against financial risk.

Mr Adonoo said the establishment of a separate regulatory body to run the private insurances was not necessary, adding that the Authority is up to the task to perform such functions in an effective and efficient manner.

He said the Authority has 160 districts offices across the country as part of decentralization process and committed to provide financial risk protection against the cost of quality basic health care for all.

Mr Adonoo said the scheme medicine lists was based on a broader consultative discussions by stakeholders and finds it absurd for individuals to blame the Authority for failing to exclude some of the drugs from the lists.

Source: GNA

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