NHIA Proposes Incentive System To Curb Illegal Charges By Health Facilities
The National Health Insurance Authority (NHIA) is considering a new incentive-based strategy aimed at reducing illegal charges imposed on members of the National Health Insurance Scheme (NHIS) by some healthcare providers.
The proposal was made by the Acting Director of the Anti-Fraud and Illegal Payment Directorate of the NHIA, Isaac G. Akonde, during a three-day capacity-building workshop for staff of the Authority’s Quality Assurance Directorate held in Sogakope on May 21, 2026.
Mr. Akonde suggested that compliant healthcare facilities—those that do not charge NHIS members illegally—should be rewarded through public recognition and prioritised processing of claims, including prompt vetting and payments.
According to him, such recognition would enhance the reputation of compliant facilities and naturally attract more NHIS members seeking reliable and transparent healthcare services.
He further proposed that facilities found engaging in fraudulent claims or illegal charging practices should be publicly identified and sanctioned, adding that market-driven consequences could discourage malpractice within the health sector.
Mr. Akonde noted that feedback from the Illegal Payment Task Committee indicates that illegal charging remains a systemic challenge affecting healthcare providers across all categories.
He acknowledged concerns raised by providers regarding low tariffs under the NHIS but indicated that improved tariff structures are expected to be introduced soon alongside stricter enforcement measures.
He also highlighted new technological interventions, including the One-Time Attendance Code (OTAC) and the Biometric Member Authentication System (BMAS), which are expected to strengthen monitoring and reduce abuse within the scheme.
The NHIA official added that his directorate is currently developing additional fraud-prevention policies and regulations for approval by executive management.
At the workshop, the Director of Legal at the NHIA, Annette Obenewaa Adutwum, also disclosed that the Authority is reviewing its Provider Service Agreement, which has been in operation for over a decade, to align it with current institutional reforms and strategic objectives.
Earlier, the Acting Deputy Director of Credentialing, Eugene Segbefia, welcomed participants and explained that the workshop was designed to harmonise operations across directorates and strengthen interdepartmental collaboration.
The training brought together staff from several NHIA directorates, including Management Information Systems, Claims, Provider and Client Relations, and Human Resources, with presentations focusing on their roles and contributions to the Authority’s overall mandate.
-Cecil MENSAH
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