Ghana: Outstanding Releases to Healthcare Providers - NHIA Set to Pay Gh¢800m Claims... Disburses Gh¢400m Today

The National Health Insurance Authority (NHIA) is set to pay GH¢800 million to mixed tier health facilities across the country with GH¢400 million released today.

This significant disbursement covers claims for April and May, this year to address outstanding claims for the healthcare providers.

A statement released and issued by the Chief Executive Officer, NHIA, Dr Da-Costa Aboagye, and copied the Ghanaian Times in Accra, yesterday, said the release underscores the NHIA's commitment to improving the sustainability and efficiency of healthcare delivery under the National Health Insurance Scheme (NHIS).

"The release not only bridges the debt gap but also reinforces our commitment to a robust and efficient healthcare system. Our continuous efforts to release funds in a timely manner are intended to ensure that outstanding payments are within the agreed three-month reimbursement period," it added.

According to the statement, the payment was crucial for enhancing the quality of care provided to NHIS members and supporting the operational needs of healthcare facilities, adding that the recent payment followed a series of previous disbursements aimed at settling outstanding claims.

Earlier in the year, the NHIA released GH¢300 million to cover claims up to January 2024 for various health facilities.

On August 17, 2024, it also released GH¢151 million to cover claims from March 2024 for higher-tier healthcare providers and from April 2024 for lower-tier facilities.

This was preceded by a GH¢135.6 million payment in July, which settled claims up to February 2024 for higher-tier providers and up to March 2024 for lower-tier facilities.

On Tuesday, April 30, 2024, the NHIA released GH¢170,775,035.07 to cover predominantly claims of January and February 2024 for lower-tier facilities, which formed the majority of healthcare providers, and up to November 2023 for upper-tier facilities and healthcare providers.

Again, on Friday, March 22, 2024, the NHIA paid GH¢180 million to various categories of healthcare providers across the country for claims submitted and vetted up to December 2023.

On February 13, 2024, it also paid GH¢130,244,000.00 to 4,850 mission, public, private, and quasi-public healthcare providers nationwide largely for claims submitted for the month of October 2023.

The statement indicated that the prompt payment enhances the quality of care provided to NHIS members and supports the operational needs of healthcare facilities.

"The NHIA's ongoing financial support is a positive step towards strengthening Ghana's healthcare system, maintaining strong partnerships with healthcare providers, and ensuring the delivery of quality healthcare services to all NHIS subscribers," it added.

Currently, the statement said the NHIS Benefit Package covers over 95 per cent of disease conditions affecting residents and includes over 550 formulations on the NHIS medicines list, ensuring comprehensive coverage for all diseases under the scheme.

It expressed gratitude to healthcare providers for their dedication and crucial role in the success of the NHIS and assured stakeholders of its commitment to engaging with them to address any concerns and improve the efficiency of service delivery, claims processing, and payments.

This article was originally published by the Ghanaian Times