The National Health Insurance Authority (NHIA) has announced that it has settled health provider claims up to April 2026, assuring Parliament that delays in payments are largely due to statutory claims processing timelines rather than funding constraints.
Officials of the NHIA disclosed this when they appeared before Parliament’s Economy and Development Committee, chaired by Eric Afful, to answer questions on claims payments and membership enrolment under the National Health Insurance Scheme (NHIS).
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Paid up to April
Addressing the committee, the Chief Executive Officer of the NHIA, Dr. Victor Asare Bampoe, said the Authority has paid virtually all accredited healthcare providers up to April 2026.
He explained that only a few health provider claims remain unpaid because they submitted their claims late or their claims required further verification.
“As we speak, we have paid all providers up to April this year. The few exceptions involve providers who submitted their claims late or whose claims had issues requiring further processing,” he told the committee.
Committee Chairman Eric Afful directed the NHIA to submit a detailed list of all health facilities that were yet to receive payments for Parliament’s review.
Members of the committee questioned why the NHIA was still about two months behind in reimbursing healthcare providers.
Responding, the NHIA CEO explained that the delay in settling health provider claims is largely dictated by provisions of the law governing claims processing.
According to him, healthcare providers are given 60 days after the end of each service month to prepare and submit their claims, after which the NHIA also has a statutory period to validate and process payments.
He said the full process allows up to 90 days, but the Authority has significantly reduced the turnaround time.
“The turnaround time has improved considerably. The two-month gap we are talking about may involve claims that have not even reached the Authority for processing,” he explained.
80% universal health coverage
The committee also sought explanations for declining NHIS enrolment in some regions, including the Northern, Oti, Volta and Western North regions.
Responding on behalf of the Authority, the Director of Membership and Regional Operations, Sebastian Alagpulinsa, said the NHIA has shifted its focus toward achieving 80% universal health coverage nationwide.
He disclosed that national NHIS coverage has already increased from 66.2% to nearly 70% of the population.
According to him, regional variations in enrolment are influenced by several factors, including out-of-pocket healthcare costs and accessibility challenges.
To improve enrolment, particularly in regions with lower coverage, the NHIA said it has introduced several interventions, including:Â Online registration from home; Expanded community registration outreaches; Group registration exercises; and intensified public education campaigns.
Officials expressed confidence that these initiatives would help increase active membership and move Ghana closer to achieving universal health coverage.
The Economy and Development Committee requested further details on region-specific strategies to reverse declining enrolment and improve access to health insurance services across the country.