Workers cautioned against double medical claims

Ho, Jan. 17, GNA - Mr Charles Agboklu, Board Chairman of the Ho Municipal Mutual Health Insurance Scheme (HMMHI) has cautioned workers against claiming cost of drugs already paid for by Health Insurance Schemes from their employers.

He said it is an act of fraud, punishable under the laws establishing the National Health Insurance Scheme. Mr Agboklu was addressing a review meeting of the scheme. It was attended by heads of departments or their representatives and service providers on Tuesday in Ho.

He said scrutiny of hospital attendance records of staff of certain organizations with departmental agreements to reimburse cost of employees medical care suggested that some were making dual claims. Mr Agboklu called on heads of organization to streamline policies to prevent such anomalies.

Mr Prosper Pi-Bansah, Scheme Manager, speaking on the status of the scheme, said out of a target population of about 200,000 the scheme had registered only 24,857, representing a mere 12 per cent. He said by the close of December 2006, the scheme collected 431,811,000 cedis as premium and expended close to 2.6 billion cedis on claims presented on members of the scheme by service providers. Mr Pi-Bansah said the scheme had mapped out community visits and other forms of publicity to increase membership to enhance its viability.

Mr Robert Adatsi, a member of the vetting committee of the scheme, called on the authorities to allot enough time for public education on the scheme, especially among the youth.

In answer to concerns that some important drugs were not covered by the scheme, Mr Adatsi suggested that doctors use generic names of drugs on prescriptions instead of specific brands.

Dr John Elizah, Ho Municipal Director of the Ghana Health Services, urged scheme members to avail themselves of complaints procedures in case of poor service and staff misconduct.