NHIS logo
The Health Service Providers, under the National Health Insurance Scheme (NHIS), made the observation during a stakeholder’s meeting organized by the Directorate of the Bawku West District NHIS at Zebilla in the Upper East Region.
Clients of the scheme had accused the Health Service Providers of prescribing medicines for them to buy outside the health facilities instead of giving them the medicines as they were covered by the Scheme.
However, in responding, the District Scheme Manager, Mr Akuure Dennis Apam, told the stakeholders that with the introduction of the Capitation Model by the Scheme, there would be no more delays in the reimbursement.
He explained that currently, the Scheme was implementing the Capitation model, where money would be paid directly to the Health Service Providers to provide health services and assured the subscribers that they would not experience such problems when the model was implemented fully.
The Scheme Manager expressed concern about abuse and defrauding of the Scheme by both clients and Health Service Providers and said another new intervention, which was being implemented to help improve upon the effective running of the Scheme was the Biometric Card Registration, which was ongoing.
Mr Apam blamed some Health Service Providers for billing the Scheme for drugs that had not been provided to clients and also accepting inactive cards and warned them to desist from such acts since it amounts to breaching the contract with the scheme.
He mentioned the persistent shortage of drugs at most facilities, multiple attendance by clients, adverse selection by clients, inadequate staff, inadequate office accommodation, limited means of transport, frequent and prolonged network challenges, coupled with equipment breakdowns as some of the major challenges facing the smooth operation of the Scheme.
Among the achievement for the third quarter, he said, the Scheme made 64 per cent coverage of vulnerable groups and 84 per cent coverage of school children.
He said before the end of the year, the Scheme would have achieved all its set targets and urged all stakeholders, including the Traditional and Religious leaders to see the Scheme as their own property and help contribute to its sustainability.
