NHIA Warns Healthcare Facilities Against Illegal Charges to NHIS Members
The National Health Insurance Authority (NHIA) has issued a strong warning to all credentialed healthcare facilities to immediately desist from charging members illegal fees for services covered under the NHIS Benefit Package.
In a statement, the Authority expressed concerns about reports of some facilities compelling NHIS members, including vulnerable patients, to make additional payments for services, medicines and procedures for which the Authority is responsible for reimbursing providers.
It reminded all healthcare providers that claims reimbursements are being processed and payments released regularly, while it had implemented significant upward adjustments to NHIS tariffs, including an increase of approximately 50 per cent, to improve provider reimbursement rates and address concerns about the cost of delivering healthcare under the Scheme.
“It is therefore unacceptable for any credentialed provider to continue imposing unauthorised charges on NHIS members under the pretext of inadequate tariffs, delayed claims payments or operational challenges.
“The NHIA will not tolerate practices that undermine the rights of members, erode public confidence and defeat the fundamental purpose of the National Health Insurance Scheme.”
Facilities and practitioners found engaging in such practices risk facing appropriate sanctions in accordance with the Authority’s regulatory and contractual provisions, it emphasised.
These may include recovery of unauthorised charges, suspension or termination of credentialing, and referral to the appropriate regulatory or law enforcement bodies where necessary.
The warning comes as the Authority announced it disbursed GH¢210.36 million to credentialed healthcare providers in October 2026, bringing total claims payments since the beginning of the year to GH¢2.325 billion.
The Authority further urged NHIS members not to remain silent when confronted with unauthorised charges.
“Members have the right to access covered healthcare services without being compelled to make illegal out-of-pocket payments, and are encouraged to demand clarification from the facility and report the matter to the NHIA through its established complaint and customer service channels for prompt investigation and redress.”
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