Ghana: NHIs Suspends 3 Pharmacies for Fraudulent Claims

The National Health Insurance Authority (NHIA) has announced the immediate suspension of three pharmacies from the National Health Insurance Scheme for suspected fraudulent claims.

The affected pharmacies are Deldem Pharma Limited, located at Iron City in Weija, PARAMEDICA Pharmacy, located at Guggisberg Avenue in Ablekuma and DESH CHEMIST, located at Amasaman, all in the Greater Accra Region.

The action follows a routine claims verification exercise conducted by the NHIA, which identified material irregularities in claims and service transactions associated with these facilities.

Consequently, they have all been placed under immediate temporary suspension from participating in the National Health Insurance Scheme (NHIS).

A statement issued by the NHIA in Accra signed by Chief Executive , Dr Victor Asare Bampoe and copied The Ghanaian Times yesterday said "These pharmacies are not permitted to provide services or dispense medicines under the NHIS during the suspension."

"These irregularities have raised reasonable suspicion of fraud and abuse under the NHIS Provider Service Agreement."

NHIS members who require pharmaceutical services are encouraged to seek care from other credentialled NHIS providers nationwide.

"NHIA wishes to serve notice to all credentialled healthcare providers, that the Authority will not tolerate fraudulent or abusive practices that undermine the sustainability of the NHIS, which may deprive members of quality healthcare services," it stated.

The statement said all service providers are to take further notice that 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 10 years or both.

The NHIA, it concluded, remained committed to ensuring transparency, accountability, and the prudent use of public funds in delivering accessible and quality healthcare to all residents of Ghana.

Read the original article on Ghanaian Times.