Director urges stakeholders to ensure sustainability of NHIS

Mr. Bernard Brown, Greater Accra Regional Director of the National Health Insurance Authority (NHIA) has urged stakeholders to ensure the sustainability of the National Health Insurance Scheme (NHIS).

He said for the NHIS to be sustainable, there should be no fraud or spurious claims whiles the gatekeeper system must be actively working.

Mr. Brown made the appeal on Monday at the opening of the Greater Accra Regional NHIA third Quarter Stakeholders’ Engagement Meeting in Accra.

He said stakeholders such as health insurance managers, service providers (hospitals and pharmacies) and insurance subscribers played a critical role in ensuring the sustainability of the scheme.

He said sustainability had now become the watch word as far as NHIS was concerned; adding that, “the scheme must continue in perpetuity”.

The aim of the meeting was to create the platform for the Authority and stakeholders, especially service providers to discuss new policies as far as the claims situation and processing were concerned.

He noted that there were some agreed principles on the processing of claims, which sometimes, some service providers fell short of.

He said the workshop was essential because the law, which established the NHIS talked of the golden tripod – thus, the provider, the payer and their cherished members or clients; stating that the NHIS was the biggest social interventions by the government.

On the issue of fraud, Mr. Brown noted that the Authority was putting in place an e-claim system, which would go a long way to help prevent fraudulent claim payments; and the Authority’s clinical audit and legal departments were also being strengthened to enable them deliver on their mandates.

Mr. Brown in advice to the public said the NHIS was working; declaring that “NHIS is working everywhere”.