NHIA urges amendment of Health Insurance Act to accommodate free primary healthcare

The National Health Insurance Authority (NHIA) has called for Parliament's Health Committee to back the amendment of the Health Insurance Act, 2012 (Act 852) to enable the implementation of the government's Free Primary Healthcare initiative and population-based payment methods. NHIA Deputy Chief Executive Officer Dr Kwesi Djokoto made the request during the Health Committee's visit to the Authority on October 12.

Dr Djokoto argued the amendment was vital to align the legal framework with new healthcare financing and service delivery approaches. He informed that the Ministry of Health is currently drafting the amendment and urged the committee to prioritize its process. Dr Djokoto highlighted that NHIA faces challenges such as claims leakages, illegal co-payments, and a mismatch between healthcare tariffs and the NHIS's funding capacity.

NHIA is addressing these issues through digital solutions, tariff reviews, and an anti-fraud and illegal payments directorate. These measures aim to curb fraudulent claims, unauthorized charges, and ensure appropriate sanctions for wrongdoing. Dr Djokoto also requested support for NHIA's 2027 capital budget, stressing that while the Authority has the infrastructure to function, continued investment is required to enhance its systems.

He also emphasized the need for stronger sanctions against fraudulent practices and illegal co-payments to promote accountability and protect the scheme's integrity.