HEALTH INSURANCE AUTHORITY WARNS HEALTH CARE PROVIDERS (PAGE 36)

THE Brong Ahafo Regional Manager of the National Health Insurance Authority (NHIA), Mr William Selby, has cautioned that the authority would deal ruthlessly with any health care provider who collects money from insured clients of the National Health Insurance Scheme (NHIS).
He alleged that even though people who had enrolled with the scheme were not supposed to pay for health care, some healthcare providers still went ahead to collect money from insured clients, an act he described as illegal.
Mr Selby gave the warning at Goaso in the Asunafo North Municipality in the Brong Ahafo Region.
He also stated that monitoring teams had been established in all the regional capitals and they had been charged with the responsibility to closely monitor both the scheme and healthcare providers to ensure that they followed the laid down procedures and policies of the NHIS.
Addressing the annual general meeting of the Asunafo North Municipal Health Insurance Scheme, the regional manager again stated that accreditation teams would also move around to assess the available infrastructure of all health facilities, their equipment and quality of service.
According to him, any hospital, health centre or clinic whose services did not merit the required standard would be advised to improve upon their services or the NHIA would review its status.
In his report, the Chairman of the Board of Directors of the scheme, Mr Ignatius Kwabena Addai, stated that as of December, 2007, the scheme had registered 55,345 clients, representing 54.06 per cent of the district’s population of 102,374.
He gave the breakdown as indigents, 107; pensioners, 156; people over 70 years, 3,083; SSNIT contributors, 3,454; informal, 18,474 and under 18 years, 30,071.
According to Mr Addai, the scheme collected a total premium of GH¢728,205.00, made up of GH¢96,684 from internally generated funds and GH¢631,521.00 from the NHIA.
He added that total attendance at the various health facilities stood at 116,647 with an average expenditure of GH¢7 per client.
Recounting the achievements of the scheme, the chairman noted that the scheme targeted 52 per cent enrolment for the year under review, but it managed to secure 54 per cent coverage.
He gave the assurance that the scheme would work harder to ensure that 61,031 clients, representing 58 per cent of the total population, were registered.
According to Mr Addai, the scheme was able to settle all claims that had been received and vetted, adding that it had never been in distress.
He, however, mentioned the lack of spacious office accommodation, inadequate staff, difficulty in getting old clients to register, clients’ abuse of the system by multiple visits to clinics, as well as non-compliance to the gatekeeper system, as some of the challenges of the scheme.
The Municipal Chief Executive (MCE) for Asunafo North, Alhaji Ishak A. Bonsu, stated that about 57 per cent of the population in the municipality had still not registered with the scheme. He said since insurance thrived on numbers, there was the need to intensify efforts at mobilising a lot more people to join the scheme.
“While campaigning for more people to register, we also appeal to the hospital authorities and their staff to pay the needed attention to patients who visit their facilities, as it would be unfortunate for a registered member to be discriminated against because he or she holds a national insurance card,” he declared.
The Asunafo North Scheme Manager, Mr Jephthah Appiah, said the scheme would institute fraud control measures for stakeholders to have functional and administrative control systems, that is, policies and procedures, undertake periodic monitoring and evaluation exercise on the activities of stakeholders and also to ensure that over 70 per cent of members whose cards were about to expire, renewed their membership.
He stated that the scheme embarked on promotional activities, such as community durbars and mass public education in the communities, and also gave talks to organised bodies like churches and hairdressers at Akrodie, Kasapin, Asumura and Dominase.