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National Health Insurance Scheme


NHIA pays claims arrears to Health Providers |4/22/2020

The National Health Insurance Authority (NHIA) has made substantial payments to service providers to reduce the outstanding claims due them.


 Last Monday the Minister of Finance, Hon. Ken Ofori-Atta announced in Parliament that the government had made available an amount of GHS 300 million to the Authority as part of measures to provide liquidity to healthcare providers and the pharmaceutical industry to help fight the COVID-19 pandemic currently facing the country.  


 Subsequently, as at 7th April, 2020 barely a week after the announcement, the NHIA has released GHS 207, 539, 276.62 Million so far to its credentialed service providers.

  The on-going payments will move lower tier providers (CHPS, health centers and maternity homes) claims paid close to November 2019.  


  In the order of payments, public health facilities  received Ghs106, 484, 179.54 representing 51.3% of the payments whiles the private service providers have been paid Ghs57,845,459.99 pegged at 27.9%.    Mission health facilities (CHAG) have received Ghs40, 227, 826.58 representing 19.4% and Quasi-Government service providers have been paid Ghs2, 981,810.51 representing 1.4% of the total payments made so far.

  For this year 2020 alone, the NHIA has so far paid out a total of Ghs363, 930, 660.51 to service providers and aims to further reduce any outstanding claims to ensure that NHIS members continue to receive quality healthcare across the country.   As part of efforts to reduce congestion and staff risk of contracting the COVID-19, all NHIS District Offices outside the lockdown areas are operating at a reduced capacity.

  The four (4) Claims Processing Centre’s (CPC’s) throughout the country will only receive manual claims invoices by appointment whereas electronic claims submissions can be made online at any time.


 NHIS members are also advised to renew their membership promptly by dialing *929# from any mobile network with a mobile wallet to enjoy uninterrupted healthcare services.   Revised NHIS Medicines List  In accordance with NHI Act 2012, (Act 852) section 33, subsection 2, the Health Minister, Hon. Kwaku Agyemang - Manu on 7th April, 2020 approved the revised NHIS Medicines List.  The NHIS Medicines list was reviewed in consultation with healthcare providers and relevant stakeholders and its implementation is effective 1st April, 2020.


The approved Medicines List will be available on the NHIS website – www.nhis.gov.gh.   Background   The National Health Insurance Scheme (NHIS) was set up to provide financial risk protection against the cost of basic health care for all residents in Ghana in 2003 with ACT 650 that got revised in 2012 to ACT 852.  


Since its inception, the NHIS has over the years grown to become a major instrument for financing health care delivery in Ghana and infact is the financial mainstay of over 4, 600 credentialed healthcare service providers in the country accounting for more than 85% of funds that flow into healthcare facilities to treat NHIS members.   


The Scheme is credited with improvements in the healthcare-seeking behaviour of many people in Ghana who now tend to seek medical attention earlier than before, thereby avoiding unnecessary deterioration in their health conditions.


  The NHIS continues to provide financial access to healthcare for many people who otherwise could not afford the cost of their healthcare.  


  More people are visiting various NHIS credentialed health institutions across the country on account of the Scheme. In fact, the NHIS in November 2019, recorded the highest active membership since its inception and is still growing.    

  Source: NHIA Corporate Affairs Directorate

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