The National Health Insurance Authority (NHIA) has suspended three pharmacies from the National Health Insurance Scheme (NHIS) over suspected fraudulent claims and irregular service transactions. In a public notice issued on Thursday, May 14, the Authority announced that DELDEM PHARMA LIMITED, PARAMEDICA PHARMACY, and DESH CHEMIST have been placed under “immediate temporary suspension” following a routine claims verification exercise.
According to the NHIA, the suspension, effective May 14, was prompted by investigations that uncovered “material irregularities in claims and service transactions” linked to the facilities. The findings, it said, raised “reasonable suspicion of fraud and abuse under the NHIS Provider Service Agreement.”
As a result, the affected pharmacies are barred from providing services or dispensing medicines under the NHIS until further notice. “The pharmacies are not permitted to provide services or dispense medicines under the NHIS during the suspension,” the statement said.
The NHIA has therefore advised NHIS members seeking pharmaceutical services to visit other accredited providers across the country. “NHIS members who require pharmaceutical services are encouraged to seek care from other credentialed NHIS providers nationwide,” the NHIA stated.
The NHIA also issued a strong warning to all accredited healthcare providers, stressing that it would not tolerate practices that threaten the sustainability of the scheme. “The Authority will not tolerate fraudulent or abusive practices that undermine the sustainability of the NHIS, which may deprive members of quality healthcare services,” the statement warned.
The Authority further reminded service providers of the legal consequences of defrauding the Scheme. “A healthcare provider providing services under the National Health Insurance Scheme who defrauds or attempts to defraud the Scheme commits an offence and is liable on summary conviction to a fine or a term of imprisonment of not more than ten (10) years or both,” the notice added.
The statement, signed by the Chief Executive of the NHIA, Dr. Victor Asare Bampoe, reaffirmed the Authority’s commitment to accountability and the proper use of public funds. “The NHIA remains committed to ensuring transparency, accountability, and the prudent use of public funds in delivering accessible and quality healthcare to all residents of Ghana,” the statement said.
Source: Myjoyonline.com