Private NHIS service providers threaten to withdraw services from March 1
Two private sector associations providing healthcare services under the National Health Insurance Scheme (NHIS) have threatened to withdraw their services from March 1, this year if the government does not take action to address the challenges confronting them.
The two — the Private Health Facilities Association of Ghana and the Health Insurance Service Providers Association of Ghana (HISPAG) — said utterances by and inaction on the part of the government were having a toll on their sustainability and effective operations.
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Addressing a press conference in Accra yesterday, the Executive Director of the HISPAG, Mr Frank Torblu, said an announcement by the government that it owed providers only three months’ arrears had caused the Pharmacy Council and other institutions that provided them with medical supplies to put their services on hold.
In reality, however, the government was in arrears of between nine and 14 months, he said.
Harassment
Additionally, Mr Torblu said, the announcement on the arrears had resulted in harassment from the Ghana Revenue Authority (GRA), which is dragging the associations to court and threatening to close their facilities because they had delayed in paying their pay as you earn (PAYE), although they had not earned anything yet.
“It is sad for us to put our lives at risk to save the lives and credit patrons of the NHIS at our own inconvenience but suffer at the hands of our debtors, such as the Social Security and National Insurance Trust (SSNIT) and the GRA,” he said.
He appealed to SSNIT, the GRA, utility providers and prosecutors to critically examine the situation in which NHIS service providers found themselves and appreciate their circumstance.
He said the refusal of the government to pay them for over nine months was giving them reason to believe the rumours making the rounds that it was planning to stop private facilities from providing services under the NHIA.
“We pray that what we are hearing is not true. The gains made by the NHIS over the years will be eroded, while its purpose as the biggest social intervention in the country will be defeated,” Mr Torblu said.
Tariffs
The associations also expressed worry over the scheme’s current tariff regime, saying it was not realistic and could bring down their businesses.
“The pricing regime, which is reviewed annually, should at all times be made to reflect the market variables. Unfortunately, the most recent review in July of 2018 rather saw a further dip in pricing due to a tax waiver policy on imported and locally manufactured drugs,” Mr Torblu said.
He said the current medicines list was unfortunately obsolete and ineffective because due to prevailing economic factors, there had been a sharp increase in prices by almost 80 per cent on the market.
He said examples included Amoxicillin+Clavulanic Acid Tablet 625mg, which is sold on the market for GH₵25, while the scheme pays GH₵13.
He said Amoxicillin+Clavulanic Acid Tablet 1000mg was also sold on the market for GH₵37 but the scheme offered service providers GH₵19.32, while the market price for Salbutamol Inhaler was GH₵25, but the scheme paid GH₵12.60.
“The market price for Clindamycin Injection is GH₵15.88, but the scheme pays GH₵9.66; Cefuroxime Tablet 250mg, market price is GH₵25, yet the scheme pays GH₵12,” he added.
Demands
Mr Torblu said to ensure that their members were paid promptly and consistently, the associations wanted the Ministry of Finance to, as a matter of urgency, transfer all the 2.5 per cent workers’ health insurance levies to the NHIA.
“SSNIT should also transfer its 2.5 per cent NHIA deduction to the authority and the GRA should also account for the total amount received on behalf of the NHIA,” he urged.
Furthermore, he said, the associations wanted all private healthcare service providers reimbursed in full up to September 2019.
He explained that the practice whereby they were always paid a month out of so many months’ arrears was not helping their businesses, since they often did not have enough to settle people they owed, including the banks and the Pharmacy Council.