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NHIA responds to alleged delays in claims payment


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NATIONAL HEALTH  INSURANCE AUTHORITY

PRIVATE MAIL BAG, MINISTRIES - ACCRA GHANA

TEL: 021 244730/ 241690

FAX: 021 232325

DECEMBER 8,2009                        

                 

 

 

 

PRESS RELEASE

 

The National Health Insurance Authority has taken notice of media publications relating to its finances and wishes to throw light on the state of payment to Health Care Providers in the country.

 

It is worth noting that by the end of the year 2008, transfers to the Authority from the revenue collecting agencies were in arrears to the tune of GHc115.5 million, contrary to Clause 91 of the National Health Insurance Act, 2003 (Act 650) which states clearly that “The revenue or collection agency charged with the collection of the levy shall within 30 days of collection of the levy, pay the levy directly into the Fund”

 

This development continues to generate financial stress for the Authority and the schemes, as outstanding payments to providers for last year has not been recovered

 

From January 2009 to date the revenue collecting agencies have transferred a total of GH¢208.48 million to the Authority, representing less than 60% of expected year end transfers or inflows to the fund. 

 

The Authority has however made payments of GHc240.52 million to the 145 District Mutual Health Insurance Schemes across the country for payment of claims submitted as well as other administrative expenditure requirements.

 

The regional breakdown of payments made to the schemes so far are as follows:

 

1. Ashanti Region                          GH¢57, 979,482.31

2. Brong Ahafo Region                GH¢26,040,132.67

3. Central Region                          GH¢19,352,368.97

4. Eastern Region                          GH¢28,768,149.66

5. Greater Accra Region            GH¢28,883,790.52

6. Northern Region                        GH¢18,018,689.60

7. Upper East Region                    GH¢12,540,723.85

8. Upper West Region                   GH¢4,926,101.47

9.  Volta Region                              GH¢18,948,920.84

10. Western Region                        GH¢25,063,530.30

 

GRAND TOTAL                                 GH¢240,521,890.19

 

 

The amount received by the Authority clearly fell short of the total expenditure as stated above.

 

Faced with this situation, the NHIA has had to withdraw funds from the National Health Insurance Fund’s investments to make-up for the shortfall. Clearly, it is not the case of the NHIA investing in treasury bills but rather the case of the Authority disinvesting to absorb arrears due providers over the period

 

Returns received from the schemes reveal that out of the total of GH¢240.52 million transferred by the Authority for payments to providers approximately GH¢240.00 million have been applied to claims payment, representing 99.7 % utilisation for the purpose intended.

 

In addressing the general media concerns the council of the NHIA has directed immediate investigations into allegations that some schemes are investing funds intended for claims payment in treasury bills. The Authority however does not invest in treasury bills.

 

We invite the general public who have information relating to this and other matters that can advance the course of the scheme to forward such information to the Authority, for decisive action to be taken on the matter.

 

 

 

ERIC AMETOR-QUARMYNE

DEPUTY DIRECTOR

(CORPORATE AFFAIRS & STRATEGIC DIRECTION)

 

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