In a determined push to safeguard public funds and restore integrity within Ghana’s healthcare financing system, the National Health Insurance Authority (NHIA) has declared a clampdown on fraudulent claims made by healthcare service providers.

The latest development follows heightened scrutiny and calls for accountability under the administration of NHIA Chief Executive, Dr. Victor Asare Bampoe.

The declaration came during a high-level meeting between the NHIA leadership and the Board of Directors of the Komfo Anokye Teaching Hospital (KATH) in Kumasi.

Dr. Bampoe, speaking on the sidelines of the engagement, said the new measures are part of a broader reform agenda inspired by President John Mahama’s directive to reset the Authority and accelerate Ghana’s journey towards universal health coverage.

“We are going to put measures in place to ensure that if there are any illegalities in terms of fraudulent claims, those detected are dealt with. It is taxpayers’ money, and we don’t want it going into the wrong hands,” Dr. Bampoe stressed.

The NHIA, established in 2003 to manage the National Health Insurance Scheme (NHIS), has over the years faced persistent concerns about abuse of funds and inflated or fictitious claims by some health facilities.

These fraudulent practices have strained the scheme’s finances, delayed reimbursements to genuine providers, and undermined public trust in the system.

Dr. Bampoe assured that alongside the crackdown on fraudulent practices, the Authority is enhancing efficiency in claim processing and payments.

“Because of what the President did in uncapping the fund, there is a lot of funding. We will be paying more regularly,” he said.

His words were backed by action. On May 21, the NHIA announced the disbursement of over GHS259 million to accredited health facilities across the country.

The payment, which covers claims from public, private, mission, and quasi-public providers, is the latest in a series of reimbursements that have pushed total claims payments for 2025 to over GHS1.1 billion.

The disbursement was completed within a 21-day turnaround window, indicating significant improvements in operational efficiency.

A detailed breakdown of the payment shows:

GHS112.6 million (43%) went to public health facilities,

GHS104.6 million (40%) to private providers,

GHS40 million (15%) to mission hospitals, and

GHS2.3 million (1%) to quasi-public institutions.

In a statement issued by the NHIA Corporate Affairs Directorate, the Authority reaffirmed its dedication to transparency and accountability.

It credited ongoing reforms and support from stakeholders for the progress made so far and called for collective vigilance in identifying and reporting any instances of fraud within the system.