The Chief Executive Officer (CEO) of the National Health Insurance Authority (NHIA), Dr Dacosta Aboagye, says that illegal fees charged at healthcare facilities are a significant factor in the NHIS’s unpopularity.
According to him, the illegal fees charged will soon be eliminated using an adjustment formula.
Speaking in a yet-to-be-aired interview on Upfront, he stated that the NHIA is developing an automatic adjustment formula to address the gap between tariffs and the actual market value of goods and services.
Dr Aboagye explained that the current review of the medicines list and tariffs aims to align them with economic realities, noting that the review will enable sanctions against providers who violate the policy.
“The challenge is that the tariffs are inadequate, very low. They are telling me that please review the tariffs and when I started, I told you that there is a team, a strategic purchasing unit is now reviewing the tariffs with all the stakeholders.”
His remarks come after the NHIA announced a review of its medicines list and tariffs to reflect the present economic situation of the country.
Dr Aboagye stated that this is among measures adopted to deal with the challenge of illegal payments, popularly known as ‘copayments’, charged to clients of the insurance scheme.
He said the NHIA paid an average of GH₵180 million monthly as claims to help facilities in March 2024.
The scheme made this payment to ensure servicing its debt stays within the 90-day window for the payment of vetted debt.
However, reports of illegal charges at some health facilities persist despite improvements in payment made to the health facilities.
On the back of this, Dr Aboagye emphasised his outfit’s plans to stop co-payment by seeking parliamentary approval for an automatic price adjustment system.
“There is a committee that will be set up. Immediately the prices go up, the committee will sit up and bear in mind, we can cover this within our allocation formula because always you can have 30% excess in terms of what you have planned. This year, we do have it.”
“So if I guarantee the automatic price adjustment like we do in the fuel field, now the problem will be that, in Ghana here, things will not go down. If providers are actually getting what they want, the prices that they get it – I believe that it will be morally not right for them to be charging our clients under the 95% of what we cover,” he said.
READ ALSO: