NHIS to reform its membership enrollment, claims management

Ghana News

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The newly appointed Deputy Chief Executive in charge of Operations is confident that the new administration will revive the National Health Insurance Scheme (NHIS) which is at the crossroads and needs reforms to survive into the future.

Dr Lydia Baaba Dsane-Selby said the two most important areas that needed to be reformed were in Operations, which is at the center of the NHIS with its core mandate in the law being membership enrollment and claims management. 

She added that the focus is not only about processing the claims but also credentialing providers and auditing them to remove fraud, reforms which she believes the NHIS has the capacity to implement successfully. 

Recently, the Ghana Chamber of Pharmacy complained that its members have been put out of business and cannot supply health facilities with urgently needed medicine under the health insurance scheme.

Ghana's biggest social intervention programme, the National Health Insurance Scheme (NHIS) is on the brink of collapse.

The scheme is reeling under a suffocating debt of GHC1.2 billion as at March 2017, with service providers threatening to revert to the dreaded cash and carry policy.

The scheme which has over 11 million subscribers risks grinding to a halt if alternative funding arrangements are not made.

Under the Scheme, patients with NHIS cards, receive health services for a period having paid some premiums to the National Health Insurance Authority.

But, Dr Dsane-Selby assured staff during a recent durbar, that Executive Management will lead the Scheme to advise the Ministry of Health on the reforms that are required.

She said this was timely as Ghana’s NHIS is touted globally as one of the most innovative and creative social health intervention programs in the world and needed to continue to be innovative and creative to keep the NHIS as a global leader.

The new CEO encouraged everyone to continue to support the new CEO and his team to carry on with this important social intervention programme, believing in the staff’s good work to get the NHIS not only to survive but become the envy of the world again.