The National Health Insurance Authority (NHIA) has called for amendments to the National Health Insurance Act, 2012 (Act 852), to support the rollout of the Free Primary Health Care initiative and population-based payment reforms.
The Deputy Chief Executive in charge of Operations, Dr Kwesi Djokoto, made the call during a working visit by members of Parliament’s Select Committee on Health to the NHIA head office.
Speaking on behalf of the Chief Executive, Dr Victor Asare Bampoe, he said changes to the law were needed to align the Authority’s legal framework with the planned healthcare and payment reforms.
Dr Djokoto also identified claims leakages, illegal co-payments charged by some healthcare providers and the gap between approved tariffs and available funding as three major risks to the sustainability of the National Health Insurance Scheme.
He said interventions were underway to address the challenges and protect the scheme’s ability to provide accessible, affordable and quality healthcare to Ghanaians.
Illegal co-payments, sometimes referred to as “top-ups”, occur when providers charge patients additional amounts for services that should be covered under the applicable insurance arrangements.
The NHIA is seeking the support of the parliamentary committee to strengthen the legal and operational framework governing the scheme as the government pursues reforms in primary healthcare financing and service delivery.
The proposed changes are intended to help safeguard the scheme’s sustainability and improve access to healthcare for its members.
