NHIA increases payments for medicines, services

The National Health Insurance Authority (NHIA) has reviewed upwards the agreed 2020 increment of medicine and service tariffs for service providers by 30 per cent effective July 1, 2022.

This was after the scheme and stakeholders undertook a market survey of prices and agreed on the figure largely on the basis of inflation and some other variables.

The Chief Executive of the NHIA, Dr. Bernard Okoe Boye, who made this disclosure, said the increment, which had been communicated to service providers, would halt co-payment and illegal collection.

He explained that the last time a review was done was about five years ago, but that the scheme realised that the charges were unrealistic so about two years ago, together with stakeholders, a scientific review of the prices was done to reflect current prices.

Using paracetamol as an example, he said if the current market price was GH¢2 and higher than what the NHIS would pay, the service provider would prescribe the medicine but would not dispense it to the patient to avoid making losses.

“Some would tell you that they do not have the medicine so you should go and buy it outside their facility. Others would find a way to let you buy from them although the medicine was captured in the agreed list,” he explained.

The reviewed medicines and tariffs include treatment of the newly added four childhood cancers, clinical family planning services, hydroxyurea for sickle cell anaemia, and other new formulations.

A statement issued by the NHIA explained that the review was in accordance with the National Health Insurance Act 852, (Act 2012).

It said the latest development was done in consultation with the NHIA credentialled healthcare service providers and other critical stakeholders in the health sector.

Per the mandate of the NHIA, the reviews are done periodically following a very rigorous scientific process.