Delay in payment of claims affects patients - GMA tells NHIS authorities

Keta, May 31, GNA - The Ghana Medical Association (GMA) has asked the authorities of the National Health Insurance Scheme not to sacrifice the interest and welfare of patients in their bid to fight fraud within the system. The GMA accused the health insurance authorities of using their fight against fraud to unduly delay payment of claims to service providers under the scheme. This was contained in a press release to climax the third National Executive Meeting of the GMA at the weekend at Keta. The release read by Dr Emmanuel Adom Winful, National President, said huge outstanding claims being owed the facilities had enormously affected the provision of quality service.

"There are shortages of drugs and other items as suppliers are no longer willing to supply on credit because of the indebtedness of the facilities," the release said. He cited the Korle-Bu Teaching Hospital, being owed GHC 2.7 million, the Central Regional Hospital, GHC 693,791.10 of up to nine months claims, while GHC 1,089 is owed to the Eastern Regional Hospital. The GMA said it had no qualms about clinical audits of the schemes but they should not be used to frighten service providers from demanding the payments of their claims.

The Association expressed worry that the NHIS which is an important health care financing intervention had unfortunately been bedevilled by challenges, some unavoidable since its inception, threatening its collapse. The Association asked the government to introduce greater efficiency into the administration of the scheme and also to take steps for prompt payment of outstanding claims to salvage the scheme from collapse. It also complained about the Health Insurance Authority's inability to assist the facilities in capacity building and technical support. The Association asked for the full implementation of full implementation of "on-call duty facilitation allowance" and the payment of outstanding claims to doctors to cover May this year. It also urged that issues pertaining to rent and accommodation allowances for doctors be addressed while all bottlenecks inhibiting the implementation of all agreements be removed to ensure industrial harmony within the medical sector. Dr Winful, during interaction with journalists, expressed his disapproval of the suspension of the Saint Anthony's Hospital at Dzodze, the only facility on the NHIS in the Ketu North District, because of an alleged fraudulent collusion between the facility and the Mutual Scheme in the district.