The National Health Insurance Scheme (NHIS) has issued a warning to health facilities that engage in unauthorized charges from subscribers, threatening to suspend their credentials.
This decision comes in response to numerous complaints from NHIS members regarding unauthorized fees for services, investigations, and medicines that should be covered by the scheme.
In a statement released by the NHIS, the authority stated that the actions of these health facilities are a violation of Section 35(1) of Acts 852, and point 16.0 on “forbidden conduct” in the Master Provider Service Agreement.
As a result, the NHIS is considering the potential suspension of non-compliant facilities and is committed to enforcing adherence to the law and contractual agreements.
Specifically, the Juaboso Government Hospital and the Enchi Government Hospital, along with other credentialed health facilities, have been implicated in engaging in unauthorized charges against NHIS subscribers in the Western North Region. Residents have come forward to verify the NHIS report, sharing instances where the hospitals collected money without issuing payment receipts, despite the individuals having valid NHIS cards.
As a result, residents are calling for government intervention to address what they see as a scandal involving illegal charges at health facilities.
One resident expressed frustration, stating, “My grandmother is over 100 years old. When I send her to the hospital, I am asked to pay before I come for medicine, and I do not understand. What is being said is true.”
Another resident added, “Right now, the Juaboso government hospital has become expensive. If you do not have money, you cannot go there. If you have insurance, they will take it and look at it, but the insurance is of no use to the hospital. What kills me is that if your child is sick and dying and you do not have money, they will not take care of you because you do not have money. If they write the medicine for you and you do not have money, how will you go and pay?”
The NHIS’s warning to health facilities engaging in unauthorized charges is a step towards ensuring that subscribers receive the benefits and coverage they are entitled to.
The scheme is committed to protecting the rights of its members and enforcing compliance with the approved medicine list and tariffs.
Hopefully, this warning will lead to positive changes in the way health facilities interact with NHIS subscribers, ensuring that they receive the quality care they deserve.
