NHIA rebuffs allegations of not paying claims to service providers

The National Health Insurance Authority (NHIA) has dismissed accusations of not paying claims to health service providers thus crippling the businesses of pharmaceutical suppliers.

This comes on the back of complaints from the Chamber of Pharmacy Ghana that its members have not received more than three months of payment for medicines bought from them by NHIS accredited health facilities, a move the Chamber partly blamed on delayed claim payments by the NHIA.

This has led to the Chamber’s decision not to provide medicines to hospitals that have delayed in paying for drugs offered for more than three months.

But the National Health Insurance Authority says they have over the years, paid the service providers their claims, except for an outstanding five-month debt, and therefore do not understand why the providers refuse to pay the medicine suppliers for the drugs purchased.

“In my hand is a document claiming that in 2017, NHIS released over GH₵900 million. In 2018, we released over GH₵1 billion. In 2019, we released over GH₵865 million. In 2020, we have released over GH₵94 million. What this means is that whatever money we pay to the providers in terms of claim, 40 to 45% represents the cost of medicine. So if we pay you this amount which makes a total of GH₵2.896 billion and 40 to 45% is supposed to go into payment of medicines, then we should not be having this conversation. But of course, we do not control the purse of the service providers so when we pay them, we don’t determine what they use the money for,” said a spokesperson for the NHIA, Barimah Sarpong.

Continuing on Eyewitness News on Tuesday, Mr. Sarpong noted that the Authority is still in action to see to it that members of the Chamber of Pharmacy Ghana receive their money from the service providers.

He, however, gave the assurance that the Authority is working to clear the five-month debt owed the service providers.

“The good people of Ghana should be rest assured that NHIA will not go back to cash and carry and that we are committed to paying our claim. Just last week, we made payment. Yesterday, as late as 9pm, people were sitting in NHIS offices making payment of claims. Before this week closes, we would have made payment. So we make payment almost every month, sometimes every two weeks and every week. So it is not as if we don’t pay. We pay,” he noted.

Chamber cuts supply of drugs

The Chamber of Pharmacy earlier served notice that its members will no longer provide medicines to hospitals that have delayed in paying for drugs offered for more than three months.

This, it said, is to forestall any potential repercussions on the companies under the Chamber, from the delayed reimbursement by the National Health Insurance Authority through the Health Service Providers.

In a statement to announce the decision, the Chamber added that it will request payment guarantees before supplying any more medicines to hospitals that require their services.

The Chamber, however, expressed its commitment to provide quality and easy access to medicines at affordable prices for effective and improved healthcare delivery.

HISPAG demands payment

Meanwhile, the Health Insurance Service Providers Association of Ghana (HISPAG) has threatened to withdraw some of its services from March 2020 if arrears owed its members by the government through the National Health Insurance Authority are not paid.

According to them, no payment has been made for NHIA claims for up to 14 months.

Executive Director of HISPAG, Frank Torbu said the current situation has made it difficult to run their facilities and pay their employees.

“We want the National Health Insurance to pay our bills up to 2019 September. We also demand that a comprehensive reimbursement plan be put together for us to sign as parties to this whole process. We have an immediate action to take if all these conditions are not met. Effective March 2020, the providers will be compelled to withdraw some services which continue to create a financial burden, especially those that are not within our control.”