The National Health Insurance Scheme (NHIS) has threatened to revoke accreditation for certain medical facilities that have been accused of defrauding its members.
This comes after several member complaints about unapproved charges for plan-covered services, tests, and medications.
This, according to NHIS, is against Section 35(1) of Acts 852, and the authority was prompted to issue a warning to health facilities engaged in such practices by point 16.0 on “forbidden conduct” in the Master Provider Service Agreement.
The statement underlined the possibility of suspending non-compliant facilities and restated the pledge to keep an eye on and enforce compliance with the law and contractual obligations.
“The authority is to make sure that the authorized medicine list and tariffs are followed by the certified health care providers in line with NHIS Act 852, Sections 35(1) and (2).
The Authority has verified numerous grievances from our esteemed members regarding illicit billing for services, inquiries, and medications covered by the NHIS Benefit Package.
The Master Provider Service Agreement, which was signed with the Authority, contains Point 6.0 on “Forbidden Conduct” and Section 35(1) of Act 852, both of which are violated by this practice.
The Juaboso Government Hospital, Enchi Government Hospital, and other accredited medical facilities have come under fire for allegedly bringing unlawful charges against Western North Region NHIS subscribers.
The NHIS report has been corroborated by Juaboso District residents, who have shared stories of hospital authorities collecting money without providing payment receipts for legitimate NHIS cards.
Locals are calling on the government to step in and handle this scandal of charges that are not authorized at medical facilities.
“My grandma is more than a century old. I don’t understand why they want payment in full before I come for her medication when I send her to the hospital. “What is being expressed is accurate,” a resident voiced their displeasure.
“The Juaboso government hospital has become expensive right now,” stated another. You can’t go there if you don’t have money. Your insurance will be taken and examined to see if you have it, but the hospital will not be able to use it. What gets to me is that without money, if your child is ill and on the verge of death, they won’t take care of you. How are you going to pay if they prescribe for you and you don’t have any money?
