NHIA Denies Blowing GhC10 m On Prescription Forms
The attention of the National Health Insurance Authority (NHIA) has been drawn to a publication by the ‘Daybreak’ newspaper of Tuesday 11th.
September 2012, captioned “NHIS Blows GHC 10 Million”, which subsequently found its way to other media, including social media.
The publication makes false and inaccurate statements as well as unsubstantiated allegations and innuendos about the printing and delivery of NHIS prescription forms. Ordinarily, the NHIA would have ignored such a mischievous and ill-conceived piece of writing.
Indeed the original newspaper story was intended to achieve a specific purpose and intent, which is clearly political. The authors and their collaborators deliberately avoided cross checking the facts with the NHIA before publication, a behavior that breached the ethics of journalistic practice.
The NHIA wishes to clarify and respond to the issues raised as follows:
1. The NHIS has not paid GHC10 million for prescription forms as was falsely alleged.
2. The NHIA did not initiate any procurement process for prescription forms.
3. The Ministry of Health and the NHIA have never jointly signed any document in respect of the procurement of prescription forms, as that does not arise under any circumstance.
4. Volta Impex Limited was not incorporated in March 2011 as reflected in the publication.
The facts of the matter are that as part of cost containment measures to curtail the exponential increases in claims expenditure over the years, the NHIA through stakeholder engagement and collaboration developed a new prescription form with features which include serial numbers, unique facility/ provider codes, and unique identifiers for prescribers, to control prescribing and dispensing of medicines. This comes against the fact that the cost of medicines accounts for more than 53% of the total claims expenditure of the NHIS.
Moreover, routine monitoring and evaluation activities and clinical audits unearthed systemic abuses and fraud in the prescribing of medicines on the NHIS over the past 7 to 8 years.
In 2011, more than GHC 270 million was paid for medicines alone under the NHIS benefit package. Granted that about 10% of this expenditure could be attributed to leakages, as the Authority’s preliminary Clinical Audit findings revealed, a radical reform was required.
This informed the conception of a new prescription form by the NHIA, which initiative engaged extensive stakeholder consultation in arriving at a desired and acceptable format.
The Ministry of Health (MOH) consequently adopted and owned the new uniform prescription form for country-wide use in replacement of the existing MOH prescription forms in use by all service providers.
The Ministry of Health subsequently took up the responsibility of procuring the booklets for use and secured through the procurement process, the printing and delivery of an initial 100,000 copies, out of the estimated 2 million booklets, for a pilot with selected healthcare facilities in Accra. Following the pilot, the Ministry of Health directed modifications to the final design of the prescription form. This was consistent with best practice but caused delays in the date originally scheduled for migration onto the new prescription forms.
The Ministry of Health requested that the NHIA finance the initial printing, which is intended to cover an 18-month use period. Upon the NHIA Board’s approval the Authority paid 50% of the total printing cost, against a performance guarantee from the suppliers’ bankers in line with public service and procurement practice.
The contract remains active and the printing of the remaining booklets is ongoing. About one million booklets are due for delivery within the next 3 weeks. Full delivery of the entire order of prescription forms, by the revised contract terms, will be due by late October 2012.
It is worth stating that the total cost of GHC 10 million covers 2 million booklets, each containing 50 triplicate forms with security features, serial numbers and fields for unique identification of prescribers and providers as well as regional and district origins of claims submitted. Each booklet costs less than GHC5. Over 5,000 Service Providers would use the Prescription Forms across the country.
The benefits of the proposed new prescription form include ease of linking claims to drug prescriptions, ease of tracing clients in times of doubt, elimination of irrational prescribing, reducing abuse, abating of fraud and ensuring value for money in the interest of the tax payer.
It is unfortunate that individuals and organized groups continue to bad mouth the NHIA despite the palpably substantial and extensive improvement and operational efficiencies the Scheme has witnessed, particularly over the past three and a half years.
It is also regrettable that the issue of new prescription forms as adapted and procured by the MOH to address inherent leakages and abuse should become a subject of attacks via the media intended to cause disrepute and opprobrium to the NHIA and its leadership.
The NHIA wishes to assure the general public that it remains focused on its mandate to serve NHIS subscribers, is resolute in its determination to reduce abuse and fraud in the NHIS value chain, and will sustain its commitment to sound management principles, accountability, efficiency and continuous improvement of access to health care for all residents of Ghana.