Private health facilities on the National Health Insurance Scheme (NHIS) have threatened to revert to the ‘cash and carry’ system of healthcare if the government does not address their reimbursement concerns.
A statement from the Private Health Facilities Association of Ghana gave the government up to December 16, 2019, to address the indebtedness.
Among their grievances, the facilities are demanding outstanding payments spanning as far back as 2018.
The association noted that facility contracts with the government state that: “the NHIA will make payments within ninety (90) days of receipt of a claim unless written notice of a dispute or discrepancy is furnished the provider within thirty (30) days of the claim.”
According to the Association, the most recent reimbursement covered the month of February 2019 and only 30 percent of the facilities have received payment “leaving a huge unsettled gap of nine (9) to ten (10) months which is a flagrant contravention of the National Health Insurance Act 852 and the L.I 1809 sections 37 and 38 respectively.”
“Private facilities are overburdened with debt from suppliers, banks (loans and overdrafts), inability to settle mandatory payments to GRA and SSNIT. Prosecutions and constant harassment have become a disincentive to operate.”
The Association also called for an upward review of medicine tariffs, which they say they have not benefited from since 2015.
The group also complained that the removal of the 17.5% VAT on imported medicines led to a 30% price cut on medicine tariffs sanctioned by the NHIA and consequently occasioned “heavy losses”.
“With these revelations in sight, we are initiating a full scale “CASH AND CARRY” on the 16th of December, 2019 if payments outstanding from 2018 to some of our members and that of 2019 is not cleared to alleviate the intensity of our woes and distress. We know this action will most likely spark an unnecessary uproar and erode confidence in policy execution by government but we have no option.
This is not the first time the private health facilities have made such a threat.
In 2018, the Upper East Chapter of Private Healthcare Providers Association of Ghana (PHPAG) called on the National Health Insurance Scheme (NHIS) to as a matter of urgency suspend the implementation of the 2018 price-list for medicines else its members will advise themselves.
According to them, the downward revision of the prices of drugs under the NHIS medicine list without cognizance of market prices coupled with late reimbursement of claims would only hurt their businesses.
