The National Health Insurance Authority (NHIA) has announced that payments to NHIS-credentialed healthcare providers will now be made “swiftly”, following the government’s decision to lift the spending cap on the National Health Insurance Fund (NHIF).
The change, confirmed in a circular signed by the NHIA Chief Executive, Dr Victor Asare Bampoe, was communicated on Tuesday, March 25 2025.
It follows an announcement by Finance Minister Dr Cassel Ato Forson during the 2025 budget presentation in Parliament.
According to the NHIA, the move is in line with a campaign promise by President John Dramani Mahama to improve the reliability of the national health scheme.
“The reimbursement of vetted claims will be made swiftly and on a regular basis, starting this week,” Dr Bampoe stated.
The aim, he said, is to support uninterrupted service delivery by removing long-standing delays in paying service providers.
For years, healthcare facilities across the country, especially private clinics, have raised concerns about the late release of funds.
Some providers had threatened to exit the scheme altogether due to months of unpaid claims, while others resorted to charging illegal co-payments to offset costs.
The NHIA, in its statement, reminded service providers to comply strictly with the rules of the scheme.
Providers are expected to stop the practice of collecting co-payments and are warned against charging NHIS members any unauthorised fees.
Claims submitted must reflect actual patient attendance and must meet NHIA’s reporting standards.
The Authority also expects services to be delivered in accordance with established NHIS protocols.
“Any provider found to be in violation of the mutually agreed-upon NHIA policies, including the imposition of unauthorised charges, will be subject to sanctions without exception,” Dr Bampoe cautioned.
As part of efforts to increase accountability, the NHIA says it will continue to publish details of all claims paid on its website and increase monitoring of healthcare facilities across the country.
Attached is a copy of the statement
NOTICE TO ALL NHIS CREDENTIALED HEALTHCARE PROVIDERS
The National Health Insurance Authority (NHIA) wishes to inform all NHIS-credentialed healthcare providers that, following the recent uncapping of the National Health Insurance Fund (NHIF) as announced by the Finance Minister, Hon. Ato Forson MP and in fulfillment of a campaign promise by His Excellency John Dramani Mahama, reimbursement of vetted claims will be made swiftly and on a regular basis, starting this week, to ensure smooth service delivery.
In this regard, we expect your full cooperation and strict adherence to NHIA policies and guidelines. In particular, providers are reminded to:
* Stamp out illegal charges (co-payment) and refrain from imposing all unauthorized fees on NHIS members.
Ensure accurate claims submissions resulting from real patient attendance and compliance with NHIA regulations.
Deliver quality healthcare services in line with NHIS standards and protocols.
To uphold accountability, the NHIA will continue to publish details of claims paid on its website and enhance the monitoring of healthcare facilities nationwide. Any provider found to be in violation of the mutually agreed-upon NHIA policies, including the imposition of unauthorized charges, will be subject to sanctions without exception.
We count on your collaboration to maintain a transparent and efficient healthcare system for all.
