The National Health Insurance Authority (NHIA) is calling on healthcare providers to maintain high professional standards to ensure the smooth operation of the National Health Insurance Scheme (NHIS).
This follows a midyear performance review by the NHIA’s Bono Regional Office, which highlighted both progress and challenges in membership enrollment and claims payment.
The NHIS has been a cornerstone of Ghana’s healthcare system since its inception in 2003. Designed to ensure equitable access and financial protection for essential health services, the NHIS aims to provide comprehensive coverage for all Ghanaian citizens.
However, in an exclusive interview with 3News’ correspondent in Sunyani, the Bono Regional Director of the National Health Insurance Authority (NHIA), Isaac Badu Amponsah, raised concerns over reports of illegal charges by some healthcare facilities in the region despite claims payment by government.
“In fact, we are not pleased with this kind of menace that is going on, most complaints that were coming from our service providers were in regard to late payments of claims as at now we’ve paid seven months claims for this year up to April and June July, so I don’t see why our facilities should be charging our members.” Mr. Amponsah stated.
The Bono Regional NHIA Director noted that backlog of claims, which has been an albatross on their necks over the years has seen a drastic improvement since the new administration took over the management of the scheme.
A total amount of over GHC1.5 billion has been released by NHIA over the last seven (7) months underscoring the Authority’s ongoing commitment to supporting healthcare providers.
He revealed that out of the total amount, public health facilities received GHC120,700,932.62 representing 45%.
Private health facilities have been paid GHC100,210,906.44 representing 37% while mission health facilities have also been allotted GHC46,761,808.96 which constitute 18% of the total funds paid.
“This prompt payment of claims to service providers by the President, His Excellency John Dramani Mahama, is in line with his commitment to ensuring that healthcare providers are resourced and maintain debt free status for the year 2025 and the years ahead. This is to help improve quality healthcare delivery and eliminate the co-payment menace that is battling the success of the scheme.” He emphasized.
He issued a strong warning to erring providers, stressing the need for ethical practices to safeguard the scheme’s benefits for all Ghanaians. “We will not tolerate any illegal charges. NHIS members must report such incidents for immediate action and recovery.”
Mr. Amponsah also encouraged NHIS members to report any illegal charges to the NHIA for investigation and possible refunds.
The NHIA Bono Regional Office recently held its 2025 Midyear Performance Review Meeting, assessing key indicators like membership coverage, claims processing, and operational hurdles.
Mr. Amponsah revealed that the region is working toward its 2025 target of 1,088,781 active members. So far, 843,129 enrollees have been registered—representing 77.3% of the goal. However, Universal Health Coverage has seen a slight decline, dropping to 63% from 68% last year.
On a positive note, the region has made strides in indigent enrollment, reaching 65% of its target, while mobile renewals stand at 59%.
Regarding claims payment, over 1.5 billion Ghana Cedis has been disbursed to healthcare providers this year, with public facilities receiving 45%, private facilities 37%, and mission facilities 18%.
