Mahama Warns Hospitals Against Extra Charges on NHIS Patients, Orders NHIA Crackdown

President John Dramani Mahama has warned health facilities against charging patients additional fees for services covered by the National Health Insurance Scheme (NHIS), directing the National Health Insurance Authority (NHIA) to monitor and sanction facilities that engage in the practice.

Speaking at the 68th Annual General Meeting of the Ghana Medical Association (GMA), the President said he had received complaints that some healthcare providers continued to demand money from patients even after they presented their NHIS cards to access services covered by the scheme.

"I've just received complaints that despite the fact that people present their NHIS cards, still money is extracted from them before they receive service. The NHIA is putting a service and going from facility to facility, and any facility caught charging extra fees outside the insurance will be dealt with," he said.

NHIA to Intensify Monitoring

The President said the NHIA would intensify its monitoring of health facilities to identify those imposing unauthorised charges, warning that any facility found culpable would face sanctions.

He stressed that patients enrolled on the NHIS must not be made to pay additional fees for services they are entitled to receive under the scheme.

Call for Stronger Fraud Prevention

President Mahama also called for stronger measures to prevent fraud and waste within the NHIS, saying the government would support the NHIA and healthcare providers to protect resources allocated to the scheme.

He noted that the improved financial predictability of the scheme should enable health facilities to procure medical supplies and sustain healthcare delivery without imposing unauthorised charges on patients.

Background to the NHIS and Illegal Charges

Ghana's National Health Insurance Scheme, established in 2003, is one of the most ambitious universal health coverage programmes in Africa, covering over 17 million Ghanaians. The scheme is funded primarily through the National Health Insurance Levy (a 2.5% levy on goods and services), social security contributions, and government allocations.

Despite its broad coverage, the NHIS has faced persistent challenges, including delayed reimbursements to healthcare providers, which often lead to facilities imposing informal charges on patients. This practice, widely reported across the country, has undermined public confidence in the scheme and pushed many patients to pay out of pocket for services that should be covered.

The NHIA has previously warned against illegal charges, but enforcement has been inconsistent. In recent years, the Authority has introduced measures including electronic claims management and patient verification systems to reduce fraud and improve accountability. However, complaints of informal payments persist, particularly in rural and underserved areas where monitoring is weaker.

Political and Policy Context

President Mahama's warning comes as his administration seeks to strengthen the NHIS as part of its broader healthcare reform agenda. The government has pledged to improve the scheme's financial sustainability and expand access to quality healthcare.

The President's directive to the NHIA is also seen as a response to growing public frustration over the cost of healthcare, particularly amid Ghana's economic challenges. Many households continue to face financial barriers to accessing care, and informal charges at health facilities have been a recurring source of public outcry.

GMA Conference Focus on Emergency Care

The President's remarks come as the GMA concluded its 68th Annual General Conference, where the Association outlined a seven-point reform agenda for emergency healthcare. The GMA called for a dedicated and sustainable funding mechanism for emergency care, the nationwide expansion of the electronic bed management system, expanded hospital bed capacity, and stronger ambulance services.

The Association also urged the government to strengthen preparedness against Ebola following the detection of the Bundibugyo strain in neighbouring Nigeria, calling for intensified public education, designated quarantine facilities, and proactive funding for outbreak response.

What's Next

The NHIA is expected to intensify its monitoring of health facilities across the country, with the President's directive providing fresh impetus for enforcement. Facilities found to be charging unauthorised fees could face sanctions, including suspension from the NHIS or financial penalties. The government has also signaled that it will explore ways to improve the scheme's financial predictability to reduce the pressure on healthcare providers to impose informal charges.