NHIA lift ban on two hospitals

A three-month suspension which was placed on two hospitals in Kumasi by the National Health Insurance Authority (NHIA) for allegedly indulging in fraudulent activities has now been lifted.
The two hospitals are Atasemanso and County, which were providing services under the National Health Insurance Scheme (NHIS) in parts of the metropolis.
They were suspended between August 14 and November 13, 2009 on the allegations that they were involved in a number of wrongdoing including double billing, over-billing, irrational prescriptions, non-adherence to tariffs, poor quality care and unsupported claims, among others.
In an interview with the Daily Graphic on what the NHIA was doing about the case since the November 13, 2009 deadline had elapsed, the Deputy Director of Operations of the NHIA, Mr Anthony Gingong said the two hospitals had made the necessary corrections and the authority had therefore, informed them to resume operations from Tuesday January 12, 2010.
Mr Gingong said the basis for the suspension was to enable the affected service providers to correct some anomaly identified by the NHIA audit team, a move he said the two hospitals had so far made.
According to the Deputy Director of Operation, the position of the authority was to ensure that after the three month period, an affected health care facility would do the right, else the period for suspension would be extended to another three months.
He said it was unfortunate that some of the accredited health facilities under the NHIS were taking the health of the people for granted adding that the NHIA would not allow such things to continue.
He reiterated that where an accredited facility committed a mistake which could be corrected, the authority would suspend them till such a time that the needed correction had been made but when it bordered on criminality, the law would take its own course.
At a press conference on August 18, 2009 to announce the suspension in Accra, the Chief Executive Officer (CEO) of the NHIA, Mr Sylvester Mensah said the action by the authority was based on the results of investigations carried out by its clinical audit team between March 23 and March 27, 2009.
The sanction, according to Mr Mensah, was provided by the National Health Insurance Act 650 of 2003, which mandated the authority to secure the sustainability of the National Health Insurance Scheme (NHIS) through prudent financial administration at all levels.
At the time of the suspension, the two hospitals reportedly appealed against the NHIA’s decision but a review by healthcare professionals upheld the findings and decision of the NHIA.
Meanwhile, checks at the two hospitals in Kumasi at the story was being made indicated that the NHIA was yet to formally inform the health facilities to resume caring for NHIS subscribers.