Dr. Bernard Okoe Boye
The National Health Insurance Authority (NHIA) has held a stakeholder engagement with heads of health institutions and organisations in the country to find ways of ending co-payment by subscribers of the Scheme.
The day’s meeting afforded the participants the platform to deliberate dispassionately on co-payments and proffer ways to solve the challenge.
Giving his opening remarks, Chief Executive Officer (CEO) of the NHIA, Dr. Bernard Okoe Boye, said the meeting was necessitated by the growing phenomenon of illegal charges otherwise known as co-payments demanded from National Health Insurance Scheme (NHIS) members by accredited service providers.
The NHIA CEO explained that every six out of 10 calls received by the NHIA call center is related to co-payment including some NHIS patients being detained by some providers over extra payments demands.
Dr. Okoe Boye said a survey conducted by the Authority showed that the menace is pervasive across all regions and provider types.
“At the tertiary and secondary care levels, NHIS members are made to pay for most services including all laboratory investigations and about 80 per cent of medicines prescribes, whereas at the primary care level, apart from blood film for malaria, all other laboratory investigations and about 50 per cent of medications prescribed are paid for by members in addition to other services,” he explained.
He said the practice, which is illegal, is assuming an alarming dimension in health facilities to the extent that it is now becoming a norm rather than an exception.
“What is even more disturbing is the fact that these acts are being perpetuated in outright violation of the Law (Act 852) and contractual agreement between the Authority and credentialed health providers,” he said.
Dr. Okoe Boye said the unfortunate practice by providers defeats the mandate of the Authority and the Scheme, thereby impacting negatively on its operations and making it unattractive to the public indicating that there has been a decline in membership enrolment and renewals over the past year regardless of the numerous interventions by the Authority.
“This is seriously threatening to erode the gains we all have made as a country, hence the need for an immediate action to stem the tide,” he said.
He thus noted that the meeting was to bring to the attention of the participants the challenge of co-payment so together they can identify solutions.
“The authority on its part has taken steps to address concerns of both members and provider alike by establishing information desk, formation of multi-stakeholder groups to review the tariffs and medicine prices, establishment of co-payment committees to promptly attend to the needs of members and providers and prioritizing claims payment,” he said.
By Jamila Akweley Okertchiri