The National Health Insurance Authority (NHIA) has intensified its campaign against illegal charges for services covered under the National Health Insurance Scheme (NHIS), taking the fight directly to hospital wards in the Eastern Region.
A team from the NHIA’s Corporate Affairs Directorate, under its Provider and Client Relations unit, visited the Eastern Regional Hospital in Koforidua as part of a rigorous regional campaign drive targeting facilities that impose unauthorised fees on patients presenting valid NHIS cards for services captured in the scheme’s expanded Benefit Package.
Engaging the hospital’s management and entire staff, Ms Yakubu said the practice would not be tolerated, describing illegal charges as “totally unacceptable” and putting credentialed healthcare providers found culpable on notice of severe sanctions.
Ms. Yakubu said the Eastern Region engagement forms part of the NHIA’s broader institutional drive to enforce its zero-tolerance policy against illegal charges, a position consistently championed by the Authority’s Chief Executive, Dr. Victor Asare Bampoe.
“Healthcare providers accredited under the NHIS have a responsibility to uphold the integrity of the scheme. Any facility found demanding payments for services already covered under the benefit package should expect the appropriate sanctions.”
Ms Yakubu
In recent months, Dr. Bampoe has repeatedly cautioned that unauthorized fees imposed by accredited healthcare providers erode public confidence in the National Health Insurance Scheme, warning that such practices send the message that the NHIS card cannot be relied upon to access covered healthcare services.
She explained that the Provider and Client Relations unit exists precisely to resolve legitimate complaints and grievances raised by active NHIS members at the point of need, positioning the Koforidua visit as part of that mandate rather than an isolated inspection.
New Tools to Curb the Practice
Madam Mercy Wiredua Awuah used the engagement to highlight two mechanisms the Authority is deploying to curtail illegal charges. The introduction of the One Time Attendance Code (OTAC) digital solution, and the establishment of a permanent Anti-Fraud and Illegal Payments Directorate.
Together, the measures point to a shift from one off crackdowns toward a standing institutional infrastructure built specifically to detect and deter unauthorised billing.
“Our objective is not only to investigate complaints but also to strengthen collaboration with providers while ensuring that every active NHIS member receives the services they are entitled to without unlawful financial demands,”
Madam Mercy Wiredua Awuah
The emphasis on technology and dedicated oversight mirrors steps the NHIA has taken elsewhere this year to tighten claims verification, including the temporary suspension of facilities found to have irregular claims and service transactions, part of a broader push the Authority has described as protecting the integrity of a scheme built on trust.
Hospital Management Pledges Cooperation
Responding on behalf of the facility, the Eastern Regional Hospital’s Medical Director, Dr Aiden S. Saanwie, welcomed the engagement and pledged management’s support for the NHIA’s anti-illegal charges campaign, signalling buy-in from the provider side of a relationship that has not always been friction-free.
On the spot, the visiting team also turned its attention to patients, educating NHIS active members present at the facility on their rights and responsibilities under the scheme and promising improved healthcare services going forward. The team rounded off the visit by presenting copies of the NHIS membership book and branded souvenirs to the hospital’s management.
Part of a Wider National Push
The Koforidua visit adds to a pattern of enforcement activity the NHIA has pursued over the past year, from inaugurating a dedicated committee to investigate co-payment practices to suspending accredited pharmacies over irregular claims.
Dr Bampoe has framed the effort as a shared responsibility rather than a one-sided crackdown, arguing that protecting the scheme’s integrity depends on cooperation between regulators, providers and the public.
Whether the Eastern Region campaign meaningfully reduces illegal charges at the ground level will likely depend on how consistently the Authority follows similar engagements across other regions, and how quickly tools such as OTAC and the new Anti-Fraud and Illegal Payments Directorate become fully operational nationwide.
For now, the Koforidua visit stands as a visible signal that the NHIA intends to keep the pressure on accredited providers found charging NHIS members for services they are entitled to receive free of charge.
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