NHIA urges Parliament to amend Act 852 to support Free Primary Healthcare

The National Health Insurance Authority (NHIA) has called on Parliament to amend the National Health Insurance Act, 2012 (Act 852) to provide a firm legal foundation for the Free Primary Healthcare initiative. This legislative push aims to integrate population-based payment systems and strengthen the authority's ability to manage health financing effectively. The Free Primary Healthcare policy, launched by President John Mahama on April 15, 2026, is designed to eliminate out-of-pocket costs for essential medical services at various points of care, including community pharmacies and mobile health kiosks.

A central component of the requested reforms is the establishment of an Anti-Fraud and Illegal Payments Directorate. According to Dr. Kwesi Djokoto, the NHIA’s Deputy Chief Executive Officer in charge of Operations, this new body is necessary to combat unauthorized out-of-pocket charges frequently imposed on patients by some healthcare providers under the National Health Insurance Scheme (NHIS). By creating a dedicated directorate, the NHIA intends to enhance its capacity to detect irregularities in billing and claims submissions, ensuring the scheme remains sustainable and that providers are held accountable for misconduct.

During a recent engagement with Parliament’s Health Committee, Dr. Djokoto emphasized that while the NHIA has made significant strides in digital infrastructure—including electronic claims processing—technology alone is insufficient. He argued that these digital tools must be backed by a robust legal framework that includes stiffer sanctions for fraudulent activities. The proposed amendments to Act 852 would empower the authority to better police the system and reduce claims fraud, which continues to pose a risk to the efficiency of the national health insurance fund.

The NHIA’s appeal highlights a strategic shift toward digitisation and more rigorous oversight to safeguard public health funds. If approved, the legal updates will facilitate the rollout of more efficient payment models and ensure that the Free Primary Healthcare initiative achieves its goal of universal access. By addressing both the financial logistics of the scheme and the legal loopholes exploited by some providers, the NHIA aims to secure the long-term viability of healthcare delivery for all Ghanaians.