ASUNAFO NORTH NIHIS SCHEME MANAGER ORDERED TO STEP ASIDE (PAGE 35)

THE newly appointed Chief Executive Officer (CEO) of the National Health Insurance Authority (NHIA), Mr Sylvester A. Mensah, has ordered the manager of the Asunafo North District Mutual Health Insurance Scheme, Mr J. Appau, to step aside immediately to pave way for an investigation into his alleged gross misconduct.
Consequently, he has set up a three-member committee chaired by a representative of the Brong Ahafo Regional Minister, Mr Kwadwo Nyamekye-Marfo, to investigate the matter and report to the NHIA within 21 days.
The other members of the committee are Mr Nicholas Afram Osei, the National Claims Manager of the NHIA, who is to move to the region to act as the regional manager and also take responsibility of the Asunafo North scheme, together with Mr Aimee Yuori, the head of the Legal Department of the authority.
As part of his decision to restructure the scheme in the region, Mr Mensah also directed that the scheme managers of Tano North and Berekum, Messrs Amankona Diawuo and Stephen Kankam, respectively, were to report to the regional office of the scheme to be re-assigned by the acting regional manager.
He described the transfer of the two as promotions.
Furthermore, Mr Mensah directed that the current Regional Manager, Mr William Sabi, should move to the national headquarters of the scheme in Accra to take temporary responsibility of the claims department.
Again, Mr Mensah ordered that the Public Relations Officer of the scheme in the region, Mr Michael Appiah Sarpong, should move to the Corporate Affairs Department of the NHIA in Accra.
The CEO made the changes when he addressed the core management staff of the 19 schemes in the region at the Eusbett Hotel in Sunyani as part of his nationwide familiarisation tour.
He also announced that forensic audit would be conducted in all the schemes throughout the country to determine whether or not they were operating effectively.
According to Mr Mensah, some of the schemes were applying their premiums on administrative and overhead expenses.
Accompanied by other directors and consultants of the NHIA, Mr Mensah said clinical audit would also be conducted on all claims paid previously to service providers to ascertain their veracity.
He, therefore, advised the scheme managers to get their records ready as a team would soon embark on random checks.
The CEO observed that some of the schemes had as many as 15 members constituting the board of directors superintending over between six and seven core management staff.
He alleged that in some cases, some of the board members took loans which were eating into the accounts of the scheme, a situation he said would not be tolerated.
Mr Mensah noted with concern the laxity on the part of the staff, especially those responsible for the Information and Communication Technology (ICT) sections, saying that in certain cases, those responsible for data entries were reluctant to do the work at the expense of subscribers.
He, therefore, charged the scheme managers to effectively supervise their staff or else be held responsible.
Mr Mensah again alleged that fraud had been detected in some instances and warned that whoever was caught for that offence would face the full rigours of the law.
He emphasised that it was not the intention of the government to sack any staff, since they were all public servants, but cautioned them to do the right thing.
Mr Mensah also identified delays in the printing of identification cards for clients as a teething problem, stressing that the issuance of temporary ID cards to subscribers had some cost implications which the authority was putting in place mechanisms to address.
According to him, the campaign promise by the National Democratic Congress (NDC) before the 2008 general election to institute a one-time payment of premium by subscribers would become a reality by the end of next year.
Mr Mensah said the entire NHIS needed a rethinking and, therefore, the NHIA was conducting legal review of the system to make it more viable, efficient and effective.
He observed that some of the schemes had poor office accommodation, improper layouts and lack of space.
According to him, the various assemblies and the Regional Co-ordinating Councils (RCCs) had critical and central roles to play in the operations of the schemes, especially in the areas of housing the schemes in their respective districts.
The CEO announced that 120 medicines had now been added to the essential drug list, and expressed the hope that the measure would address the problem clients faced in accessing the required medication when they attended health facilities.
Mr Mensah gave the assurance that the conditions of service of the staff would be looked at to bridge any disparities.
The Brong Ahafo Regional Minister, Mr Kwadwo Nyamekye-Marfo, urged the scheme managers to discharge their work professionally and avoid politicisation of the programme, for which some of them were noted.
“Do not read politics into the scheme and insulate yourself from politics because a change of government does not affect you as public servants,” he stressed.
Mr Nyamekye-Marfo appealed to the authority to ensure that subscribers were issued with their cards promptly and to also improve upon the quality of pictures on them.