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The Chief Executive of the National Health Insurance
Authority (NHIA), Dr. Victor Asare Bampoe, has declared zero tolerance for
so-called “co-payments”—a misleading term often used to disguise illegal
charges imposed on members of the National Health Insurance Scheme (NHIS) by
service providers.
Dr. Bampoe emphasised that the Authority’s renewed crackdown
goes beyond the unlawful extraction of fees from members to also cover the
submission, or facilitation, of fraudulent claims by credentialed facilities.
He reiterated the declaration while addressing the media and
stakeholders during his on-going five-day working tour across four more
regions- Ahafo, Western, Western North and Central.
These measures, he stressed, are backed by Sections 31(1)
and 35(2) of the National Health Insurance Act (Act 852) of 2012.
Dr. Bampoe was accompanied by a high-powered delegation that
included Deputy Chief Executive for Administration and Human Resources, Raphael
Segkpeb; Acting Director of Corporate Affairs, Oswald Essuah-Mensah; Acting
Director of Claims, Dr. Abigail Cudjoe Derkyi-Kwarteng; Acting Director of
Membership and Regional Operations, Sebastian Alagpulinsa; and Head of
Corporate Communications, Faustina Dery.
More Audits to be Done
He cautioned that any institution or individual found
culpable will face strict sanctions, including mandatory refunds and possible
prosecution.
As part of this intensified accountability drive, Dr. Bampoe
revealed that the Clinical and Compliance Audit he commissioned into the
operations of the Akim Oda Government Hospital earlier this year that exposed
serious malpractices, including the imposition of illegal charges on NHIS
members between February and May 2025 will be replicated nationwide in
credentialed facilities.
“The hospital was subsequently sanctioned and ordered to
refund GH¢312,413.51 to the NHIA. The crackdown comes as part of renewed
efforts to protect National Health Insurance Scheme (NHIS) members from
exploitation, while safeguarding the NHIS funds to restore full confidence in
the Scheme.
He reiterated that credentialed facilities and individuals
who attempt to undermine the Scheme will face sanctions, refunds, and
prosecution where necessary.
He said illegal charges and fraudulent claims no longer have
a place in Ghana’s march towards Universal Health Coverage.
Crackdown
Dr. Bampoe made it clear that the crackdown is not merely
about punishment but about building trust and fulfilling the promise of the
NHIS as a shield against financial hardship in healthcare.
“We want every Ghanaian to walk into a health facility with
their NHIS card and receive care without fear of exploitation.
That is the vison of President John Dramini Mahama and that
is the legacy NHIA executive management is building,” he said.
He appealed for collective action, urging traditional
leaders, healthcare providers, NHIA staff, and citizens to play their part
He warned that the Authority would not hesitate to bring
down recalcitrant health facilities and individuals who continue to flout NHIA
regulations.
“The axe is already at the root of the tree,” he cautioned.
We are no longer tolerating illegal charges or fraudulent claims. If you’re a
credentialed facility and you’re submitting false claims or charging NHIS
members for services already covered, your days are numbered.” He said.
He dismissed the term “co-payment” as a misleading attempt
to normalize unlawful charges. “Some people call it co-payment, but that
dignifies it with a proper name.
These are illegal charges—unauthorized and
unacceptable. NHIS members should not be paying out-of-pocket for services and
medications already covered by the Scheme,” he stated.
The NHIA’s intensified actions are supported by the
Co-Payment Taskforce, established earlier this year to investigate the
widespread problem and recommend lasting solutions.
He said this enforcement measures are complemented by
education and engagement with stakeholders to drive lasting change.
Priorities
Reiterating the Authority’s priorities, Dr. Bampoe outlined
three key pillars guiding his leadership: the operationalisation of the Ghana
Medical Trust Fund, also known as Mahama Cares and the Free Primary Healthcare
for all Policies; empowering NHIA staff to deliver with excellence; and
decisively eliminating illegal charges disguised as “co-payments.”
Source: DOREEN ANDOH
Pictures: ISAAC MARANO HAGAN & EBENEZER DANSO
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