NHIA suspends three pharmacies over suspected NHIS fraud

The National Health Insurance Authority (NHIA) has suspended three credentialed pharmacies from the National Health Insurance Scheme following a routine claims verification exercise that uncovered suspected fraudulent and abusive practices.

In a statement dated May 14, 2026, the NHIA announced that DELDEM PHARMA LIMITED at Iron City in Weija, PARAMEDICA PHARMACY on Guggisberg Avenue in Ablekuma, and DESH CHEMIST at Amasaman along Odumase High Street have been placed under immediate temporary suspension from participating in the NHIS.

According to the Authority, the decision took effect on May 14, 2026, after investigations identified material irregularities in claims and service transactions linked to the three facilities.

The NHIA said the findings raised reasonable suspicion of fraud and abuse under the NHIS Provider Service Agreement.

“This action follows a routine claims verification exercise conducted by the NHIA, which identified material irregularities in claims and service transactions associated with these facilities. These irregularities have raised reasonable suspicion of fraud and abuse under the NHIS Provider Service Agreement,” the statement said.

NHIA suspends three other health facilities

During the suspension period, the pharmacies are barred from providing services or dispensing medicines under the NHIS.

“These Pharmacies are not permitted to provide services or dispense medicines under the NHIS during the suspension,” the statement added.

The NHIA has advised NHIS members in need of pharmaceutical services to seek care from other credentialed providers across the country.

“NHIS members who require pharmaceutical services are encouraged to seek care from other credentialed NHIS providers nationwide,” it said.

The Authority warned all healthcare providers that fraudulent and abusive practices that threaten the sustainability of the Scheme will not be tolerated.

It further noted that under Ghana’s health insurance laws, any provider who defrauds or attempts to defraud the NHIS commits an offence and may, upon summary conviction, face a fine, a prison term of up to 10 years, or both.

The NHIA stressed that it remains committed to transparency, accountability, and the prudent use of public funds to ensure accessible and quality healthcare for all residents of Ghana.

Read the statement below

The NHIA has taken decisive action.

Following a routine claims verification exercise, three credentialed pharmacies have been suspended from the National Health Insurance Scheme over suspected fraudulent and abusive practices.

This serves as a strong warning to all healthcare… pic.twitter.com/2pHY2l6cXI

— NHIS Ghana (@NHIS_Ghana) May 14, 2026