<<Print>>

Fraudulent practices at the various implementation levels of the National Health Insurance Schemes (NHIS), could undermine the sustainability of the scheme. Information available to the National Health Insurance Authority (NHIA) indicates that some schemes members undertake what is described as �shopping� by moving from one health facility to the other with their identity cards to collect expensive drugs to sell to chemical shops. There is also a fraudulent practice called �Fast track� which enable registered members on admission at hospitals to pass on their bills to the scheme. Mr Ibrahim Wiredu, Public Relations Officer of NHIA made this known at a health fair at Kyebi at the weekend. It was organised as part of activities marking the 10th anniversary celebration of the enstoolment of Osagyefo Amotia Ofori Panin as Okyenhene. He said some members of staff of some of the schemes also connive with service providers to over bill the NHIS, then pay kick backs to them before paying the claims of the service providers. Mr Wiredu said some service providers are also not adhering to the agreed tariffs and the NHIS drug list while others were engaged in irrational prescribing. He said the NHIA had introduced some common Information Technology platform, which could help check some of the fraudulent practices and that the Authority was also engaged in forensic auditing of some suspected schemes and those found to have engaged in any malpractice would be sanctioned. Mr Wiredu called on Ghanaians to be vigilant in the implementation of the scheme and should not allow some few greedy ones to collapse it He said the NHIA under its new leadership was undertaking an overhaul of the scheme including the governance and legal framework of the NHIS, to make it stronger and more efficient to withstand present and future challenges. Mr Wiredu said a number of private health institutions were getting accreditation to provide care for NHIS card bearing members. He acknowledged the delay in the payment of claims of service providers but explained that the Authority had never failed to pay for genuine work done. He said the Authority was taking measures to improve upon the claims processing and payment on line. Mr Eugene Gyimah-Kropah of the East Akim Municipal Health Insurance Scheme observed that the increasing use of health facilities by the large number of registered members of the scheme is creating a number of inconvenience for them at the health facilities. He therefore appealed to the chiefs and opinion leaders to intervene to ensure that more health personnel are posted to health facilities in the Municipality. Nana Asabea Ofori Atta, Wife of the Okyenhene who organised the fair, called on the people to take responsibility for their health needs because government policies alone could not assured them of all their medical requirements. As part of the health fair, more than 800 people were underwent medical examination and HIV counselling and testing.