Accra, April 05, GNA – The Private Health facilities Association of Ghana have called on government to ensure that the National Health Insurance Authority (NHIA) pays in full all arrears up to the Month of December, 2021.
This includes outstanding payments owed some health facilities for the period of 2017 to 2020.
The Association made the call in a statement signed by its General Secretary, Mr Frank-Torblu Richard and copied to the Ghana News Agency in Accra.
It said the NHIA could not keep a claim duly submitted for more than four weeks without payment for such claim effected unless aberrations or anomalies were sighted.
The Association also demanded that Authority expedited the review of the medicine and service tariffs to reflect current market variables to enable health facilities provide expected healthcare as it envisioned.
It said the review committee should have a fair representation from the Private Health Facilities Association to guarantee the quality of review outcome.
“We request for a formal engagement with the Ministry of Health and the various health facility regulators to review or amend the credentialing threshold on staffing requirements and the possible allocation of health staff to private facilities,” it noted.
“Failure on the part of the Authority to comply with the set timelines, we will not at all hesitate to partially withdraw services (NHIS clients will have to pay the full cost of drugs covered under the scheme) to NHIS clients nationwide as our strategy for survival in these difficult times,” it cautioned.
“From our candid perspective on recent happenings with the scheme, Private Health
Facilities Association of Ghana whose members are some of the biggest beneficiaries of the scheme portends doom as we can confidently confirm without doubt that the National Health Insurance Scheme finds itself in a very precarious situation.
“It is also in a serious state of financial distress that needs an immediate lifeline if it will survive as the only healthcare intervention serving the ordinary Ghanaian,” it added.
The statement explained that the reimbursement delays to service providers; and arrears to service providers currently stood at between four to nine months (from July-August, 2021 to February, 2022), coupled with isolated cases indebtedness to some health facilities that span the period 2017 to 2020.
This, it said, was a disturbing development which put the service provider in an agonizing situation since over 90 per cent of revenue emanated from the scheme.
“In spite of the liquidity challenges faced by service providers, we have consistently managed to help sustain the scheme by serving clients who troop in to private health facilities daily for medical care.
“Beyond that, private health facilities have to deal with the difficulty of satisfying their obligations to employees and to Government institutions, revenue agencies, utility companies, creditors, etc., by extension, many health facilities are facing prosecutions in our various law courts,” it said.
The unfortunate trend of claims payment delays, the statement said, had triggered a sequence of ominous events, one in which the Ghana Chamber of Pharmacy had made an emphatic decision to cut supply of drugs to health facilities, charge interest of one per cent on debt owed them by health facilities and the engagement of legal services to prosecute defaulters
“With these prevailing circumstances, one naturally wonders how service providers manage to meet the ever increasing cost and expectation of efficient healthcare delivery while avoiding a potential collapse of their facilities.
“How does the NHIS expect a health facility to procure; Anti-Malarials like Artemether+Lumefantrine tablet 20mg+120mg at GH S5.40p and supply to clients at GHS 2.24p, a loss of Gh3.16p, Artesunate 120mg injection at GhS10.78p and supply at GHS6.25p, a loss of GHS4.53p.
Others were to procure Anti-Biotics like Amoxicillin+Clavulanic Acid tablet 625mg at GhS19.04p and supplied at GhS14.98p (for 14 tablet pack), a loss of GhS4.06p, Cefuroxime 500mg tablets at GhS9.85 and supplied at GhS8.90 (10 tablets), a loss of 0.95 pesewas.
It included Anti-Hypertensives like Lisinopril 10mg at GhS5.25 and supplied at GhS3.90 (30Tablets), a loss of GhS1.35, Amlodipine 10mg at GhS5.15 and supplied at GhS1.80 (30 tablets), a loss of GhS3.35
The rest were Corticosteroids Fluticasone + Salmeterol Inhaler, 250 microgram/50 micrograms (60 Doses) at GhS126.30 and supplied to NHIS clients GhS81.30, a loss of GhS45.00.
The statement also bemoaned how the NHIA only paid GhS402.84 for a cost of procedure for Hernia surgery in an adult, when the actual cost was GhS1, 131.00, causing a loss of Gh728.16.
GNA