A special audit exercise undertaken by the National Health Insurance Authority (NHIA), has found 10 national health insurance scheme managers, accountants and five service providers in the Ashanti Region culpable of misappropriating funds.
They have been interdicted and asked to report to the Ashanti Regional Serious Fraud Office (SFO) in Kumasi for further investigations.
The schemes involved are Asokwa, Manhyia and Subin Sub-Metropolitan Areas all within Kumasi Metropolitan Area, Sekyere East, Atwima Nwabiagya, Asante Akim North, Asante Akim South, Offinso, Ejisu-Juaben and Afigya Sekyere Districts.
The service providers are Yaw Opoku Mensah Chemical Shop, Western Pharmacy and Saint Dominic Pharmacy, at Sekyere East District.
The rest are Apikrist Pharmacy and A.A Adams Pharmacy at Offinso District.
Briefing the media in Accra on Friday, Mr Sylvester Mensah, Executive Secretary of NHIA said though the culprits had been interdicted and being investigated, "until SFO completes its investigations and submit the findings; we cannot say they have embezzled funds".
Information available indicated that at the Asokwa Sub-Metropolitan Scheme Office, the officials could not account for 569,104.02 Ghana cedis being revenue for the payment of provider claims.
The accountant at Sekyere East District could not account for 66,121 Ghana cedis of premium and processing fees.
He however admitted the offence and refunded 10,000 Ghana cedis, while the scheme manager misapplied 800,000 Ghana cedis meant for claims for other purposes.
It was directed that the scheme should cease transacting business with the following unaccredited providers: Yaw Opoku Mensah Chemical Shop, Western Pharmacy and Saint Dominic Pharmacy.
At Atwima Nwabiagya District, the scheme overpaid four service providers 7,544.30 Ghana cedis, and the scheme manager, accountant and claims manager were directed to refund the money immediately.
At Asante Akim North District, the scheme manager misappropriated 7,650 Ghana cedis being premium and processing fees, and in addition transferred 25,906 Ghana cedis of claims monies for administrative purposes.
Findings at Asante Akim South District showed that the scheme could not account for 3,393 Ghana cedis of premium collected and also transferred 44,320 Ghana cedis for administrative purposes.
At Offinso District the scheme transacted business with unaccredited providers who did not submit claims, but were reimbursed for services provided.
It was directed to cease any transaction with Apikrist and A.A Adams Pharmacies.
At Ejisu Juaben District, the scheme could not account for 5,145 Ghana cedis being premium collected and the scheme manager together with the accountant were asked to refund the money.
On indiscriminate use of monies meant to pay claims for other purposes, the report said Manhyia Sub-Metropolitan Scheme had acquired a building for use as an office accommodation at a cost of 148,000, Ghana cedis and the scheme manager was asked to step aside, while investigations continued.
It said the scheme manager at Afigya Sekyere District misapplied 133,351.87 Ghana cedis meant for claims for administrative purposes, and the manager was asked to step aside while investigations continued.
At Subin Sub-Metropolitan Area, the scheme spent 23,702 Ghana cedis on preliminary expenses towards the acquisition of a piece of land but it is yet to acquire the land.
The report called on schemes to seek the approval of the NHIA before transferring claims' monies for other purposes.
Source: GNA
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