Be active on health insurance, help eliminate extortion

Dr. Bernard Okoe-Boye, Chief Executive Officer (CEO) of the National Health Insurance Scheme (NHIS), has asked all Ghanaians to ensure that they are active on the Scheme to enjoy the benefits.

He also urged them to support the Scheme’s effort to eliminate the extortion of money from clients (co-payment) in some accredited Government and private health facilities across the country.

Dr. Okoe-Boye said this when he inaugurated a nine-member Co-payment Committee to identify accredited health facilities that charged clients illegal fees.
Apart from the nine-member national Committee, there would be Regional Committees in all 16 regions and sub-Committees at the District level, which will report to the Ministry of Health (MoH) through the National Health Insurance Authority (NHIA) for remedial actions to be taken against culprits.

The CEO said the move was to repose confidence in the Scheme and support the country’s Universal Health Coverage – ensuring that every Ghanaian had the needed health services without suffering financial hardship by 2030.

He said: “Sometimes they (the clients) go through the unpleasant experience of being asked to pay certain money even when they are active on the insurance scheme and covered by us.”

This was because the prices of medicines the Scheme paid to service providers were low compared with the market prices and delayed payments of claims submitted to NHIS.

The CEO, however, said they had taken aggressive measures to address the twin major challenges impeding the success of the Scheme, which sometimes made hospital managers take illegal money from citizens.

Dr. Okoe-Boye said after a review, the Scheme, since July 2022, had increased the prices of some medicine as high as 300 percent and reduced the default payment to nine months.

Although he said the Committee was not to arrest service providers, at the extreme of the findings of extortions, health facilities found culpable would lose their credentials from the Authority.

Urging Ghanaians to register and be active members of the Scheme, he said: “You’re better off with the health insurance cover even with an issue of co-payment than not being covered at all".

He was confident that the work of the Committee with support from relevant stakeholders would “deal significantly with the issue of illegal charges… and when we succeed, I believe, every Ghanaian will then be in a hurry to be active on the National Health Insurance Scheme,” Dr. Okoe-Boye said.

He, therefore, asked the Committee to be diligent with its work and involve monitoring and evaluation officers in Regional and Districts offices to make its work successful.

As part of efforts to create awareness and increase registered members on the Scheme, the CEO said they would declare December as an “Active month,” to encourage Ghanaians to know their status to be able to benefit from the Scheme.
He noted that though it took a month for registered members to be active on the Scheme, during the campaign in December, anyone who registered would have their card active immediately.

Mrs. Vivian Addo-Cobbiah, Deputy CEO, Operations, NHIS, noted that when the team works assiduously, co-payment would be over, thereby, assuring Ghanaians, especially those who were on the Scheme to register.

Dr. Francis Asenso-Boadi, Chairman of the Committee, said they appreciated their appointment and pledged that they would work diligently to achieve the goal that the Committee had been set up for.

Other members of the Committee are: Titus Sorey, Emmanuel Bukari, Daniel Adin-Darko, Albert Kwaku Ampofo, Vida Adutwumwaa Boateng, Raymond Avinu, Baba Sadique Zankawah, William Omane-Adjekum.

The NHIS covers about 95 percent of all ailments that are presented in Ghanaian health care facilities, including maternity care (such as ante-natal and Caesarean section), oral and eye care services.

It also covers Out-patient Services (OPD), In-patient Services (IPD), and emergencies such as brain/heart surgery due to accidents, road traffic accidents, as well as industrial and workplace accidents.