The National Health Insurance Authority (NHIA) says it will introduce a biometric verification system at the various health facilities that have signed onto the scheme next year.
The authority said the initiative is to stamp out fraudulent claims it sometimes receives from health facilities they work with.
The initiative was announced by the Chief Executive Officer (CEO) of the NHIA, Dr. Bernard Oko Boye, at a meeting with President Akufo-Addo at Jubilee House. The meeting saw the authority present its policy framework to the president for his signature.
Briefing the president on some positive measures the authority was undertaking, the CEO said that the introduction of the biometric verification system would help them get real-time evidence of beneficiaries visiting the health facilities.
He explained that the authority had observed that some health facilities on the scheme present fraudulent claims for payments, but blamed that on the manual system of verification for the past 19 years.
“Next year, we are going to have biometric verification. For these 19 years that the scheme has been running, we pay claims ‘in the dark’ because hospitals give us documents that these people came to see us.
“We have no real-time evidence that they were actually there. And we have cases that have been prosecuted in court, where claims were fraudulently generated,” he stated.
Dr. Oko Boye continued that, “Starting next year, with the help of the National Identification Authority, when you go to the hospital, you will be biometrically verified so that before the month ends, I know that Komfo Anokye Hospital saw 5,000 patients. They can’t send me bills for 6,000 people. That alone will cut out fraud in the system.”
Another positive initiative he mentioned was the launch of an application for self-registration with the use of the Ghana Card, instead of the previous manual system where people had to be physically present at their offices to sign up for the scheme.
He also stated that people aged 70 years and above will no longer have the usual waiting time to be on the scheme.
Further work has been done for prostate cancer treatment to be covered under the scheme, as with breast cancer, among others.
PAYMENT OF CLAIMS
The CEO told the president that the authority technically owes five months’ arrears, though the last payment was in April this year.
He explained that, per their arrangement, three months are taken out for submission and verification of claims before payment.
He was hopeful, however, that the five months’ worth of arrears, which were part of a year’s debt when this government took over, would be cleared.
CHALLENGES
Dr. Oko Boye mentioned some challenges the scheme is facing before the President. He said the processing fee of GH₡6 was to be looked at, as it has been the same for over a decade. He called for a national conversation on that subject.
The other challenge he mentioned was illegal charges by some facilities under the scheme. He remarked that the facilities claimed the payments were not realistic and payments were not regular, thus the illegal charges.
However, he added that the Board of the NHIA has moved to curtail the menace. He told the president that from next year, facilities charging illegally would be called to explain their accounts, or in a worse-case scenario, would be de-credentialed.
PRESIDENT AKUFO-ADDO
President Akufo-Addo, on his part, stated that it was no secret that the Health Insurance Scheme was an important policy that the New Patriotic Party government implemented in the country.
He further stated that the government had a major legacy to protect the scheme for future generations, adding that he was “very happy to hear about the improvements that you have brought about,” especially the expansion and the management of claims.
He believed that the sooner claims were filed electronically, the greater the guarantee for Ghanaian taxpayers.
He commended the Authority, especially for the introduction of the 70-year package, jokingly stating that, “some of us have vested interests,” a statement that generated amusement at the meeting.
