This is contrary to the widespread reports that private health service providers operating in the country were the ones solely engaged in such dubious acts.

The Northern Regional Manager of the NHIA, Alhaji Hudu Iddrisu, brought this to the fore at the 2017 end of year performance review meeting held in Tamale.

“Surprisingly, most of the facilities that are involved in these activities happen to be those owned by the state. Public health facilities put up and paid by the government.”

“All these negative practices create the impression that the NHIS has not created the financial access to the healthcare as it is supposed to do.”

Alhaji Iddrisu further stated that, “We are aware of all the happenings in some of the facilities accredited by the Authority to provide services to our members. You can call it top-up, co-payments, or any other name.”

According the outraged NHIA Boss, the ongoing illegality could cause public discontent for the Scheme and affect its enrollment or renewal rate.

“Medicines found on the NHIA’s list are being sold to gullible NHIS members whilst some of those prescribing deliberately prescribe outside the NHIA’s list to cause card bearers to still buy these medications even though alternatives are on the list that should have been given to them free of charge. Yet these providers who are indulged in this at the end of every month submit claims to the Authority for payments including medicines and the services for which they have already collected monies from our members.”

Alhaji Hudu Iddrisu entreated those corrupt service providers to stop extorting monies from the state for no work done.

Alhaji Hudu Iddrisu said at the end of December 2017, the Authority in the Northern Region raked in Ghc879,609.00 representing 89.7 percent of its annual target.

He commended management and staff in all the district offices saying, “Your wonderful performance, commitment, dedication and sacrifice despite the numerous challenges has brought us this far.”

The annual performance review meeting is key on the operational calendar of the National Health Insurance Authority.

It offers managers the opportunity to review their past performance to enable them restrategize for the years ahead.

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By: Abdul Karim Naatogmah/citifmonline.com/Ghana

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According to him, imprisoning the perpetrators, regardless of the amounts involved will serve as a deterrent to persons who indulge in such acts.

Speaking on the Citi Breakfast Show on Tuesday Dr. Annor said the current laws that regulate the National Health Insurance Scheme (NHIS) “are weak” thus making it easy for people to loot from the coffers of the Authority.

[contextly_sidebar id=”qL1j8e9vf2L37voUcjxPqK9HtcrVg4QX”]He added that because of the weak laws, persons who are caught stealing the NHIA’s monies are usually sentenced to pay what he described as “peanut” fines by the courts.

“…Human beings are human beings, you don’t put a meat before a dog and tell the dog not to eat the meat, so you have to make sure that you make the rules and regulations so difficult to steal,” he said.

When asked which people steal the NHIA’s funds, Dr. Annor mentioned service providers, internal staff “and everybody who gets the opportunity because the system has not been well disciplined enough.”

“The law is weak; the law treats crime against our health money like any crime. So if somebody steals banana he might as well have stolen GHc20,000 from the NHIA fund – the two of them will be treated the same – because both are crimes and both are punishable by probably about 250 penalty units according to the law.”

“And the judge would have the option to either fine or add some imprisonment or both. And most of the time, after the trial goes on for almost about six or seven years, the persons are just given little fines. For somebody who has committed a crime, that fine is peanut – he will pay and commit the crime again. But as a nation we should be able to say that there should be compulsory imprisonment for whoever commits crimes against our health funds as most nations do,” he added.

The NHIA boss noted that most developed nations do not take their health funds lightly, adding that “if you go anywhere near their health funds you will be in jail, you will not be given a fine and asked to go home.”

Dr. Annor took over the administration of the debt-ridden NHIA some nine months ago.

According to him, the governing New Patriotic Party has so far paid about GHc900 million out of the GHc1.2 billion debt they inherited at the NHIA.

Speaking on the Citi Breakfast Show, Dr. Annor, among other things, proposed a four-point agenda which, if addressed immediately, he believes could help revamp the health insurance scheme and put it on a better pedestal for growth.

The proposal includes a change in NHIA’s finance model,  making the manual processing of claims electronic, instituting tight quality assurance measures as well as the strengthening of the laws governing the scheme.

Click below for the full interview on the Citi Breakfast Show:

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By: Godwin Akweiteh Allotey/citifmonline.com/Ghana
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According to HISPAG, most of its members are owed about 20 months of claims, a situation that threatens their operations.

[contextly_sidebar id=”5rpX74M6x4syR9pf8z8bgzwjav2MHZgz”]Speaking to Citi News, Public Relations Officer of the Association, Joseph Christian Amoah, the perennial delay in payment of the claims by the NHIA, is seriously undermining quality healthcare service delivery.

“Government should cash out as early as possible to salvage the situation, it can be next month, It can be next two months, it can be next three months, because providers are thinking, and they are taking a decision on a particular move and that move is cash and carry,” he said.

The Association is therefore calling on the government to take action to have the situation fixed as soon as possible, to prevent any future inconveniences.

Chief Executive Officer of the NHIA, Dr. Samuel Annor in 2017, said government was going pay to the National Health Insurance service providers the monies owned its members.

The Authority owes the service providers some GHc1.2 billion covering a 12-month period. Dr. Annor told Citi News that all other arrears will be cleared in due course.

The NHIA has always struggled with the payment of claims, a situation largely blamed on the lack of a sustainable funding approach for the scheme.

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By: Farida Yusif/citifmonline.com/Ghana

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He said that any move to use NHIS funds for any other purpose other than the Scheme’s core mandate would defeat the intent and purposes of the policy.

[contextly_sidebar id=”YAy1LV1LBnejA0s55Xutf5SZ3mvpN0sF”]Dr. Prah was speaking at an annual health insurance stakeholders meeting held at Winneba, on the theme: “Collaborative Efforts to Control Five Diseases that Increase the Utilization Rate among NHIS Subscribers within the Effutu Senya Municipality.”

The meeting was designed to find a better and effective way of dealing with diseases including malaria, skin diseases, rheumatism and joint pains, diarrhoea, typhoid fever, anaemia, urinary tract infections, hypertension, intestinal worms, and acute eye infection.

Malaria has been the leading health challenge in the catchment areas of the scheme since 2014, and stakeholders attributed the challenge to the inability of the people to adhere to malaria control guidelines offered by health officers.

Dr. Prah said the Management of the NHIA must concentrate on the execution of the core mandate of the Policy to enable millions of poor and vulnerable people to benefit from it.

He said if the NHIA settled claims submitted to the Authority with dispatch, clients of the scheme would definitely enjoy the numerous healthcare benefits listed under the Policy.

He attributed the reintroduction of the “cash and carry’’ system in some accredited service providing facilities to the inability of the NHIA to pay medical claims submitted to it in good time.

Dr. Prah explained that, the drugs that the service providers used for NHIS clients were given to them on credit by drug manufactures, which they must strive to pay back at the agreed period so as to maintain their credit worthiness.

Commenting on drug prescription issues, Dr. Prah advised health personnel manning the various clinics, CHPS Compounds and maternity homes, to always strive to adhere to their job description to avoid risks.

Reverend S. K. Nyarko, the Scheme Manager for Effutu Awutu Senya, on behalf of the management, expressed appreciation to stakeholders in the area for their continued co-operation and commitment towards the attainment of the aims and objectives of the Scheme.

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Source: GNA

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The sin tax, which is a levy deliberately slapped on users of tobacco, alcohol and sugar, is a module in some countries like Thailand, Australia, Switzerland, Korea among others, to support the prevention of resultant diseases from the consumption of these products.

[contextly_sidebar id=”OIYkhx3hmAZg47I2O8bRuq8HMtIHFrV3″]According to Dr. Da Costa Aboagye, who has done extensive work in health insurance, public health promotion, what government needs to do, is to develop a sustainable preventative strategy to help people take control over their lives.

“This means people consuming alcohol; high sugar and tobacco are discouraged from doing so by increasing taxes on such products. When these taxes are increased, it is assumed that alcohol, excessive sugar, tobacco consumers may not be able to buy in excess of what they would normally consume. The idea is to help people live a healthier lifestyle.”

“Such taxes are thus used to “prevent” the likely resultant diseases of such products like diabetes, non-communicable diseases (NCDs) and others. The ‘sin taxes’ are geared towards the prevention of diseases, not treatment of diseases. The NHIS is unfortunately medical and treatment focused, and unless their activities incorporate health promotion and prevention strategies, it cannot advocate for the use of sin taxes,” he noted.

According to him, in all countries where tobacco, sugar and alcohol are specially taxed to support health delivery, it is used to support health promotion and prevention of diseases which will in effect, reduce the disease burdens and saves cost.

“Normally in Thailand, Australia and other countries making good use of this module, there is a health promotion fund where these monies are channelled into,” he explained.

The World Health Organisation (WHO), encourages such taxes; “but the core must be directed towards prevention of diseases and health promotion (health and wellbeing) strategies.  The main idea is to promote healthier lifestyles and preventative measures of diseases,” Dr. Da Costa Aboagye stressed.

As a National Health Insurance Finance expert in the UK, he advised that the government should be mindful of the clear distinction between “health and wellbeing, and ‘healthcare.”

“There are other prudent sustainable ways to finance the NHIS than the current proposal by the NHIA and because the NHIS in Ghana is only medical and treatment focused without any health promotion or wellbeing commitments, advocating for “sin taxes” will be unjustifiable,” he argued.

According to him, it will be a mistake to increase taxes on such products to fund treatments of the resultant diseases than funding prevention of illnesses. He said the implication is that, such businesses would have to either increase the costs of their products, which will then be passed onto consumers, who will then have to consume such products, eventually get sick, before such taxes can be used to treat them.

Dr. Aboagye said, unless the NHIA champions health promotion with funds from the ‘sin tax’, it will be wrong and unjustifiable to advocate for tobacco, sugar and alcohol special taxes.

He suggested that, the new global direction for health care is health promotion (health and wellbeing) and preventative measures, and thus advised the NHIA to take bold steps to fund health promotion and wellbeing activities, with some of its limited resources.

“This will in effect, reduce the NHIS cost burdens in a long term. We must not create a disease –oriented NHIS healthcare system, but a health and wellbeing oriented healthcare where prevention of diseases is key to sustainability of medically financed healthcare like our NHIS.”

Dr. Da Costa Aboagye said since President Akufo-Addo is a co-chair of the Eminent Persons for the United Nations Sustainable Development Goals, it presents the NHIA and the government a huge opportunity to focus on Health and Wellbeing and disease preventative strategies to achieving the Goal 3.

This he said can also serve as a justification for slapping taxes on alcohol, tobacco and sugar, in the national interest.

Dr. Aboagye narrated that the NHIA should rather engage with the Ghana Health Service’s Director General, Dr Anthony Nsiah Asare, and Health Promotion Department to foster synergy on how to make “Sin taxes” justifiable and workable by developing a compressive health promotion strategy and structures to cater for the health and wellbeing of all Ghanaians.

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By: citifmonline.com/Ghana

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“There is so much we want to do within a limited budget. You will be responsible for leading the policy direction and advising government so that we can take the decisions that will fundamentally improve the NHIS. [It] is struggling and we got to prevent this steady creepy towards cash and carry and resuscitate the scheme. You got to put together your minds [and] efforts so that we work in partnership to rescue this scheme, to resuscitate it, to improve it and make it benefit the masses of our people.”

Dr Bawumia was speaking at the inauguration of a 17-member Board of Directors for the nation’s insurance authority.

The Board which chaired by  a former President of the Ghana Medical Association, Prof. Yaw Adu-Gyamfi, includes the Chief Executive of the NHIA, Dr. Samuel Yaw Annor, a Deputy Minister of Health Kinglsey Aboagye-Gyedu, a Deputy Minister of Finance, Abena Osei-Asare, Director-General of the Ghana Health Service, Dr. Anthony Nsiah-Asare, and the National Insurance Commissioner, Lydia Lariba Bawa.

Others are Dr. Dennis Addo of the Social Welfare Department, Kwasi Ampedu-Kissi of SSNIT, Dr. Isaac Charles Noble Morrison of the Medical and Dental Commission and Rev Richard Kwasi Yeboah of Organised Labour. President Akufo Addo also appointed Dr. Sylvester Yaw Oppong and Joyce Zimpare to the Board.

The rest of the members areAnna Pearl Akiwumi-Siriboa, a legal practitioner, Dr. Nicholas Ankomah Tweneboa, a helath professional, Vahandi-Naa Dr. Mohammed Nantogmah Mahama, also a health professional and Kwasi Asante with a Finance background.

The Challenge:

The Health Insurance Authority is currently saddled with a GHc1.2billion debt to service providers. It announced in May, 2017 that it had disbursed GHc 60million among some service providers. That was however not enough as the Pharmacy Council Ghana and the Christian Health Association of Ghana (CHAG) continue to express worry over the debt. But the Chief Executive of the Authority, Dr Samuel Yaw Annor shortly thereafter, declared the Scheme bankrupt as he observed thus;

“The NHIA is at a stage where one will say it is almost bankrupt; in that we have no reserves and we owe people so much. And this has come about because we have increased our membership so much but we have not increased the funding appropriately.”

Vice President Bawumia therefore urged the Board to work at lifting the Scheme out of its indebtedness and repositioning it to benefit the consumer;

“You are coming to this job at a very critical time. We have seen that the scheme has faced significant challenges. Chief Executive knows that everywhere he turns people are chasing him to pay debts. We have to manage this better and ensure that we have better health delivery. We have to make sure that the resource envelop is properly allocated and efficiently spent so that the patient will be the beneficiary”.

On their part, Chairman of the Board, Prof Yaw Adu-Gyamfi, promised to work with other stakeholders to take the scheme out of its conundrums.

“We are aware of the challenges facing the Authority not excluding the following; areas in provider payment reimbursement, the huge funding gap, the false claims management, the poor quality assurance, the high administrative cost and the organizational structural problems and some of the operational inefficiencies. All these we will seek to address as a Board and with all the other stakeholders.”

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By: Sixtus Dong Ullo/citifmonline.com/Ghana
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Speaking to workers of the National Health Insurance Authority (NHIA) in Ho during their midyear review workshop, the Minister observed that, some workers have over the years allowed their political inclinations to override their professional ethics thus thwarting the efforts of successive governments towards improving the operations of the scheme.

He said the current government would not hesitate to sanction any worker who compromises his or her professional ethics along political lines.

“I want you to know that Ghanaians gave an overwhelming endorsement to the NPP to govern this country for the next four years. So it doesn’t matter your political colour, if you want to be with the NHIA you must be totally committed to the change agenda of our government. If you think that your political affiliation would not permit you to be part of our agenda, jump off the tree before you are pushed off”  he stated.

The mid-year review organized by the NHIA, is to among other things afford the organization the opportunity to take stock of its performance over the period, and strategize towards the attainment of its annual goals.

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By: King Nobert Akpabli/citifmonline.com/Ghana

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The Pharmacy Council Ghana; and the Christian Health Association of Ghana (CHAG) have variously threatened to withdraw services to the scheme.

They are collectively owed over 1.2billion cedis.

Speaking to Citi News, the Corporate Affairs Director of the NHIA, Dr Adjetey Annan said the Authority had received GHC 60 million from government for the disbursement.

“We have received some releases from  Central Government. The Health Minister sometime back indicated that government was going to release funds for NHIS to clear its debts. The monies come in tranches. As we speak , we’ve received a release of 60 million which is being disbursed to reimburse providers…We are expecting 70 million to also hit our account sooner or later and when that happens that also will go into reimbursement of providers whom we owe for quite a number of months…Government is doing its best to address this issue of backlog of arrears.”

He has however refuted claims that the Authority has increased health insurance premium from fifteen Ghana cedis to fifty Ghana cedis.

NHIS is broke, we can’t pay our debts

The new Chief Executive Officer, Dr. Samuel Annor had earlier disclosed that the scheme was broke and unable to pay service providers.

“The NHIA is at a stage where one will say it almost bankrupt; in that we have no reserves and we owe people so much. And this has come about because we have increased our membership so much but we have not increased the funding appropriately,” he added.

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By: Marian Ansah/citifmonline.com/Ghana

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This is according to the new Chief Executive Officer, Dr. Samuel Annor.

[contextly_sidebar id=”V1Vi4xONviusKkhHIpxwCd4DfpLHC7bZ”]Dr. Annor said the authority is paying two months of the arrears it owes service providers.

The Authority owes the service providers some GHc1.2 billion covering a 12-month period of arrears.

Dr. Annor told Citi News that all other arrears will be cleared in due course.

“Since the current government assumed office, this payment which most subscribers will be receiving on Monday will be the fourth payment since we assumed office. The one going this week will probably be twice of what they received during the previous one.”

“Previously they were being paid maybe one month at a time, they might receive two months this time and probably by June or July there will be more payments. So we are working along the clock to reduce the debt stock,” he added.

NHIS is broke, we can’t pay our debts

Dr. Annor, had earlier disclosed that the scheme was broke and unable to pay service providers.

“The NHIA is at a stage where one will say it almost bankrupt; in that we have no reserves and we owe people so much. And this has come about because we have increased our membership so much but we have not increased the funding appropriately,” he added.

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By: Godwin Akweiteh Allotey/citifmonline.com/Ghana
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He made this known when Dr. Annor and other functionaries of the NHIA paid a courtesy call on him during the observation of Awukudae at the Manhyia Palace last Wednesday.

Otumfuo Osei Tutu expressed appreciation for the visit, and admonished Dr. Annor to keep faith with Ghanaians and work hard to meet their expectations.

[contextly_sidebar id=”DXzYylRuX0YXvqZlXxE1h3v3ldbITyIh”]He conveyed his hope in the new leadership of the NHIA to manage the health insurance scheme to the benefit of all Ghanaians.

Accompanying the Chief Executive, were Prof. Adu-Gyamfi and some directors of the scheme in the Ashanti Region.

Dr. Annor was at the Manhyia Palace to seek the blessing and support of Manhyia Palace in implementing the vision of President Nana Addo Dankwa Akufo-Addo.

The NHIS is currently in a critical situation and owes its service providers arrears of over One billion Ghana Cedis.

Dr. Annor was appointed in March 2017 by President Nana Addo Dankwa Akufo-Addo, to replace Nathaniel Otoo who resigned in February.

Dr. Annor is a consultant obstetrician/gynaecologist and a partner of Lister Hospital.

He is the General Manager of the Birim Oil Mill, an oil palm factory at Kade in the Kwaebibrem district of the Eastern Region.

He was also the first Board Chairman of Ghana Airport Company Limited in 2007.
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By: citifmonline.com/Ghana

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