Fraudulent practices at the various implementation levels of the National Health Insurance Scheme (NHIS), can undermine the sustain ability of the scheme, the National Health Insurance Authority has warned.
The authority said information available to them showed that some scheme members undertake what is described as "shopping" by moving from one health facility to the other with their identity cards to collect expensive drugs to sell to chemical shops.
Mr Ibrahim Wiredu, Public Relations Officer of NHIA, made this known at a health fair at Kyebi at the weekend as part of activities to mark the 10th anniversary celebration of the enstoolment of Osagyefo Amotia Ofori Panin as Okyenhene.
He said members of staff of some of the schemes also connive with service providers to over bill the NHIS, then pay kick backs to them before paying the claims of the service providers.
Mr Wiredu said some service providers do not adhere to the agreed tariffs and the NHIS drug list while others are engaged in irrational prescribing.
He said the NHIA has introduced a common information technology platform which can help check some of the fraudulent practices in' addition to forensic auditing of some schemes suspected to be involved in malpractices.
Mr Wiredu called on Ghanaians to be vigilant in the implementation of the scheme and not allow a few greedy ones to collapse it.
He said the new leadership was working on overhauling the scheme including the governance and legal frame to make it stronger and more efficient to withstand present and future challenges.
Mr Wiredu said a number of private health institutions are getting accreditation to provide care for NHIS card bearing members.
He acknowledged the delay in the payment of claims of service providers but explained that the Authority had never failed to pay for genuine work done.
He said the Authority is taking measures to improve upon claims processing and payment on line.
Mr Eugene Gyimah-Kropah of the East Akim Municipal Mutual Health Insurance Scheme observed that the increased number of registered scheme members attending the health facilities in the municipality is putting pressure on the staff.
He therefore appealed to the chiefs and elders to intervene to ensure that more health personnel are posted to the Municipality.
Nana Asabea OforiAtta, wife of the Okyenhene, who organised the fair, called on the people to take responsibility for their health needs because government policies alone cannot cover all their medical needs.
As part of the fair, more than 800 people underwent medical examination and HIV counselling and testing.
