NHIA To Punish Providers Who Present False Claims

The National Health Insurance Authority (NHIA) says it is strengthening its legal and audit systems to easily detect financial infractions by service providers who present false claims to the Authority.

A former Medical Superintendent of the Essikado District Hospital, in the Western region, Dr N. K. Ametewee was on Thursday jailed 10 years by the Sekondi High Court for defrauding NHIA to the tune of four hundred and fifteen thousand Ghana cedis (GHC415, 000).

He was convicted and sentenced together with his accomplice and brother Francis Ametewee who served at the records department of Dr Ametewee’s private dental clinic in Anaji in Takoradi.

Francis was given a 5-year jail sentence.

Speaking to Starr News in Koforidua at a stakeholders Forum, the CEO of NHIA, Dr. Samuel Donkor said as part of measures to maximize financial efficiency of the scheme, Service providers indicted by its audit regime will be prosecuted and slapped with multiple fines on culprits.



“We are assuring them we are doing everything possible to maximize efficient use of the little fund we have. We are arranging to move the manual processing of our 30million cedis claim per year to electronic processing .We are strengthening our internal Policing force in terms of internal audit, our quality assurance divisions in making sure that our own staff comply and do things that do not lead to loss of revenue “.

He added “We are also using external people to clinically audit and vet the claims that come to us properly so that people who send undue or scrupulous claims to us even if we have paid will go back chase and recover what is due us. We are arranging to also strengthen the legal system that cover us so that people convicted for crimes against the authority receive mandatory prison sentences and fines which are 10 times the amount defrauded us.”

Dr. Samuel Annor also said the NHIA is courting public support for its proposal for government to increase VAT component to the scheme from current 2.5% to 3.5%, impose some levy on sugar, alcohol, tobacco to fund the scheme while allocating components of the oil revenue to the scheme to enable it become financially strong for efficiency.

Present at the Forum was Kojo Oppong Nkrumah, a Deputy Information Minister who pledged government’s commitment to making the scheme vibrant to provide quality healthcare to Ghanaians.

Meanwhile, the Association of Private Clinics have threatened to drag the National Health Insurance Authority to Court if the Authority fails to honour its latest promise of paying all debts owed its members.

Source:Starrfmonline.com