NHIA pays over GH¢834m in claims

The National Health Insurance Authority (NHIA) has paid a total of GH¢834 million in claims to health service providers across the country so far this year.

The payment formed part of efforts to clear all vetted claims and restore confidence in the National Health Insurance Scheme (NHIS).

The event, which brought together members of the media, was held at the NHIA headquarters to provide updates on the authority’s direction under the new leadership and to address lingering concerns about the scheme’s effectiveness and credibility.

The Chief Executive Officer of the NHIA, Dr Victor Asare Bampoe, who announced this at a press conference in Accra last Monday, explained that the amount paid included GH¢555 million disbursed just last week, with an additional GH¢30 to GH¢40 million currently being processed for payment.

He stressed that all vetted claims submitted to the authority had been honoured.

Beyond the ongoing payments, he stated the government had also begun implementing measures to ensure more predictable and timely funding for the scheme.

He further recalled that as part of this, the President had directed the Ministry of Finance to begin strict compliance with Section 52 of the National Health Insurance Act, which mandated the release of funds from the National Health Insurance Levy (NHIL) within 30 days.

The finance ministry is expected to adhere to this legal provision, a development the NHIA believes will be a “game changer” in addressing long-standing delays in reimbursement to health facilities.

“There's also the uncapping of the fund, the repeal of Act 947, which means that we'll be getting more funding. So there'll be more funds. It'll be getting to us more regularly, so we can pay more regularly. So that's the game changer,” he said. 

Out-of-pocket, public trust

Dr Bampoe disclosed that the Authority was implementing measures to eliminate out-of-pocket payments at health facilities.

These payments, he lamented, which have become a major source of public dissatisfaction, contradict the core objective of the scheme to provide financial risk protection in accessing health care.

The NHIA, he said, was engaging service providers to ensure strict adherence to the approved tariffs, while simultaneously deploying customer service desks across the country to educate members on their entitlements and support them in reporting illegal charges. 

The authority believes that ending these unofficial payments will significantly restore public confidence in the scheme and make it a more attractive alternative to private insurance.

Additionally, all members registering for the NHIS will now receive a comprehensive booklet that outlines all conditions covered by the scheme and other relevant information.

In a similar vein, Dr Victor Asare Bampoe highlighted that one of the core priorities of the new NHIA leadership is strengthening internal controls within the Authority. 

He stressed that restoring public trust in the NHIA depends heavily on demonstrating financial discipline, transparency, and accountability—goals that these internal reforms are designed to achieve.

Therefore, he said the NHIA was taking concrete steps to tighten its financial and administrative systems to reduce leakages, curb illegal charges and improve efficiency.

He explained that improving internal controls would help ensure that funds were properly utilised and service providers were held accountable.

Measures being implemented include enhanced auditing processes, better verification of claims, and the deployment of staff to health facilities to support monitoring and customer service.

Dialysis

Dr Bampoe confirmed that the government, under the Mahama Cares initiative, would expand dialysis services to more facilities nationwide, with end-stage renal failure included in the covered conditions.

He said that although there are currently 20 health facilities offering free dialysis, plans were underway to increase this number as part of a broader government initiative under the programme.

Dr Bampoe indicated that a committee established by the Minister of Health is finalising its report on the implementation strategy, which is expected to be launched within the 120-day timeline promised by the President.

The expansion, he said, aimed to make dialysis treatment more accessible, sustainable, and integrated into routine healthcare delivery across the regions.