The National Health Insurance Authority has temporarily suspended three pharmacies from operating under the National Health Insurance Scheme over alleged fraudulent claims and irregular service transactions.
In a public notice released on Thursday, May 14, the NHIA said the decision followed a routine claims verification exercise that uncovered concerns involving the affected facilities.
The pharmacies affected are DELDEM PHARMA LIMITED, PARAMEDICA PHARMACY, and DESH CHEMIST.
According to the Authority, the suspension took effect on May 14.
The NHIA stated that investigations revealed “material irregularities in claims and service transactions associated with these facilities”.
It further noted that the findings had “raised reasonable suspicion of fraud and abuse under the NHIS Provider Service Agreement”.
With the suspension now in force, the pharmacies are barred from offering services or dispensing medication under the NHIS until further notice.
“The pharmacies are not permitted to provide services or dispense medicines under the NHIS during the suspension,” the statement said.
The NHIA has therefore advised NHIS subscribers seeking pharmaceutical services to visit other accredited providers across the country.
“NHIS members who require pharmaceutical services are encouraged to seek care from other credentialed NHIS providers nationwide,” the NHIA stated.
The Authority also cautioned all accredited healthcare providers against engaging in activities that could undermine the sustainability of the scheme.
“The Authority will not tolerate fraudulent or abusive practices that undermine the sustainability of the NHIS, which may deprive members of quality healthcare services,” the statement warned.
The NHIA further reminded providers of the legal penalties for defrauding the Scheme.
“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 ten (10) years or both,” the notice added.
The statement, signed by the NHIA Chief Executive, Dr. Victor Asare Bampoe, reiterated the Authority’s dedication to transparency, accountability, and the responsible management of public funds.
“The NHIA remains committed to ensuring transparency, accountability, and the prudent use of public funds in delivering accessible and quality healthcare to all residents of Ghana,” the statement said.
