Monday, 15 April

NHIA directs service providers to discourage copayments

Health News
NHIA directs service providers to stop copayments

The National Health Insurance Authority (NHIA) has issued directives to healthcare service providers participating in the National Health Insurance Scheme (NHIS), to discourage the practice of imposing copayments on patients.

The Authority emphasised its ongoing efforts to dissuade service providers from engaging in such practices, as they undermine the fundamental principles upon which the scheme was established.

Dr Bernard Okoe Boye, the Chief Executive Officer of NHIA, conveyed these directives through a statement released on February 5, 2024. 

The statement highlighted that demands for additional payments from beneficiaries undermine public confidence in the scheme, impacting enrollment rates and hindering the nation's pursuit of Universal Health Coverage.

Furthermore, the statement acknowledged the Ministry's support and mentioned a recent communication outlining restrictions on payment demands issued to all healthcare facilities nationwide. 

Despite these efforts, reports from NHIA monitoring officers revealed that certain facilities continued to engage in the practice of imposing copayments on patients.

In response to this, the NHIA management expressed its intention to enforce clause 15 of the contract with accredited providers.

This clause stipulates that any subscriber who has been asked to make a payment beyond the scope of the agreement is entitled to a prompt refund from the provider, within fourteen days of such payment being brought to the attention of NHIA.

The NHIA is also empowered, according to the statement, to deduct any such subscriber payment from the provider's reimbursement for submitted claims or capitation transfers.

In conclusion, the statement emphasised the NHIA's commitment to upholding the integrity of the National Health Insurance Scheme by curbing copayment practices and ensuring compliance with contractual obligations

Source: Mensah