By Alex Ababio
The Ashanti Regional Director of the National Health Insurance Scheme (NHIS), Mr. Muniru Mohammed Muntaka, has issued a strong caution to health service providers across the region against illegal charges imposed on insured patients, announcing that strict enforcement measures against illegal charging will begin in earnest in the first quarter of 2026.
He stressed that such practices undermine the integrity of Ghana’s healthcare system and violate statutory regulations governing the scheme.
Speaking in an exclusive interview with Ghanaian Watch at his office in Kumasi, Mr. Muntaka , however, underscored the importance of strengthening collaboration between the NHIS and healthcare providers to ensure quality and affordable healthcare delivery to citizens, particularly the vulnerable.
“Our partnership with healthcare providers is unflinching, and we need to build on it and make it better,” he said. “For us to achieve this, we must be guided by the rules of engagement that recognize that our members are not supposed to pay out of pocket.”
Enforcement Measures to Begin in 2026
The Ashanti Regional Director announced that strict enforcement measures against illegal charging will begin in earnest in the first quarter of 2026.
“We believe in dialogue, but enforcement will begin between January and March,” he stated. “Once the enabling environment is created, we will crack the whip.”
He disclosed that NHIS is analyzing operational data to identify factors influencing non-compliance among providers, adding that stakeholder consultations have already been conducted in Accra to build consensus on tariff adjustments.
“Once the new tariffs are rolled out, we will take action against any facility found culpable,” he said.
Legal Framework Against Co-Payment
Mr. Muntaka clarified that so-called co-payment practices remain illegal under Ghana’s health insurance laws.
“Some people call it co-payment, but Ghana does not recognize co-payment in its statutory books,” he stressed. “It is simply illegal charging.”
He explained that NHIS contractual agreements clearly prohibit out-of-pocket payments for valid insured services.
“Once a member presents a valid NHIS card and their details are verified, they are not supposed to pay,” he said.
He cited Act 652 as mandating NHIS to ensure equitable healthcare access for all citizens.
Illegal Charges Widespread Across Health Facilities
Mr. Muntaka revealed that illegal charging remains a major challenge affecting the NHIS, noting that various categories of healthcare providers have been implicated.
“In terms of abuse, although we are yet to conduct scientific data analysis, I can say that many health facilities are culpable,” he said. “You can find CHPS compounds, clinics, government hospitals, Christian Health Association facilities, and even major institutions such as the KNUST Hospital engaging in such practices.”
However, he commended some healthcare providers for adhering strictly to NHIS contractual agreements by refraining from charging illegal fees.
He encouraged insured clients to report illegal charges, assuring them of confidentiality.
“Members who report illegal charges will remain anonymous,” he said. “But we require reasonable evidence to investigate and take action against culprits.”
Sanctions Against Offending Facilities
Mr. Muntaka disclosed that NHIS Ashanti has already taken disciplinary action against several health facilities found guilty of illegal charges.
“Sanctions range from warning letters and retrieval of funds to suspension and termination of contracts,” he said. “We have retrieved money from some facilities and refunded affected members.”
He added that NHIS district offices operate complaint registers to document and investigate patient grievances.
“In some cases, we successfully recover monies paid illegally and return them to members,” he revealed.
He further disclosed that over 80 per cent of health facilities nationwide depend heavily on NHIS accreditation for survival.
“Scientific data shows that most facilities cannot meet economic thresholds without NHIS partnerships,” he stated.
Tariff Review to Address Inflation
Mr. Muntaka explained that NHIS management is reviewing medicine prices and treatment tariffs to align with rising healthcare costs caused by inflation.
“We had to review our medicine list because inflation has affected drug prices,” he explained. “For instance, if Paracetamol cost GH¢1 last year and now sells at GH¢1.50, maintaining the old price indirectly disadvantages providers.”
He disclosed that NHIS consultants conducted a comprehensive cost analysis of healthcare production expenses, including utility bills and operational costs, to guide tariff adjustments.
“Our consultants did a very good job analyzing production costs for services provided by health facilities,” he noted. “Once the revised tariffs are rolled out, we will clamp down on facilities that continue to charge NHIS members illegally.”
Payment Delays and Claims Processing
Addressing concerns about payment delays to health providers, Mr. Muntaka attributed the issue partly to delayed claims submissions.
“When providers delay submissions, it delays processing,” he explained. “Over 90 per cent of facilities that submitted claims on time have received their payments unless they are under investigation.”
He argued that regular payments to healthcare providers eliminate any justification for illegal patient charges.
“If funds are available to providers, why should they still demand out-of-pocket payments from NHIS members?” he questioned.
Commitment to Regular Provider Payments
Mr. Muntaka criticized previous administrative practices that delayed provider payments for extended periods, stressing that the current management is determined to avoid such setbacks.
“The current management will not repeat situations where payments were delayed for up to nine months while facilities were still expected not to charge patients,” he said. “That approach could collapse the health insurance system.”
He announced that uncapping NHIS funds has significantly improved the scheme’s financial capacity.
“With funds uncapped, I can state authoritatively that there are facilities in the region we do not owe,” he added.
Strengthening Provider Collaboration
Mr. Muntaka acknowledged the critical role healthcare providers play in sustaining the NHIS, noting that despite financial challenges in the past, providers demonstrated resilience and cooperation with the scheme.
“We have engaged a lot with providers, and we expect that cooperation to continue,” he stated. “There were days we could not pay them, but they never broke the camel’s back. They held the fort, and it has been far better for all of us.”
He expressed optimism about the future of the partnership, indicating that improved relations between the NHIS and healthcare providers would significantly enhance healthcare delivery nationwide.
“There are better days ahead. Once we rekindle that relationship, we will get things right,” he added. “At the end of the day, the health needs of the average Ghanaian, especially the vulnerable, are what are dear to His Excellency President John Dramani Mahama and the entire nation.”
Call for Increased NHIS Registration
Mr. Muntaka urged residents to register with NHIS to protect themselves from illegal healthcare charges.
“People who are not insured are more vulnerable to exploitation,” he warned. “When you are insured and a facility demands payment, insist on your rights and request a receipt if forced to pay.”
He reiterated NHIS’ commitment to ensuring equitable healthcare access for all Ghanaians.
“Ghanaians have accepted the National Health Insurance Levy, which they pay through indirect taxes,” he said. “It is unacceptable for insured citizens to still pay out-of-pocket when they visit health facilities.”
Mr. Muntaka concluded by reaffirming NHIS’ determination to protect patients and strengthen partnerships with healthcare providers.
“We frown upon illegal charges because they are a disservice to the people of Asanteman and Ghana as a whole,” he stated. “Together, we can build a health system that serves everyone fairly and efficiently.”
Ghana’s Progress Towards Universal Health Coverage
Mr. Muntaka described Ghana’s progress toward Universal Health Coverage (UHC) as encouraging but incomplete, revealing that national health insurance coverage remains below the internationally accepted benchmark.
“As a country, we expect to register about 26,993,904 people as of 2025,” he explained. “Currently, at least 80 per cent of the population should be covered to meet international standards.”
According to NHIS data, the scheme registered 22,335,819 members by the end of 2025, representing 66.2 per cent national population coverage.
“That is remarkable, but we aspire to do better,” he noted. “The nation still needs to register almost 4.6 million more Ghanaians to reach our target.”
He also highlighted population dynamics as a factor influencing coverage targets, explaining that population growth and mortality rates continue to affect projections.
“When you factor in births and deaths, we are still hopeful of registering roughly one million additional members, which is achievable with the current leadership and motivation within the NHIS workforce,” he said.
Mr. Muntaka indicated that efforts to curb illegal charges by health facilities are central to improving public confidence in the scheme.
Public Education and Community Engagement
The Ashanti Regional Director emphasized the importance of public awareness and community participation in ensuring the success of the NHIS.
“Sometimes, as a nation, we can have very good policies, but if people do not understand or appreciate them, we will face challenges,” he explained. “That is what we are trying to avert.”
He disclosed that NHIS management has intensified stakeholder engagements to ensure communities take ownership of the scheme.
“Our Chief Executive strongly believes in a deliberative, collaborative, and inclusive approach where everybody is brought on board,” he stated. “We have a duty bound by rules and regulations, and once we comply with them, we will succeed.”
NHIS Coverage in Ashanti Region
Mr. Muntaka described the Ashanti Region as a critical healthcare hub with a comprehensive network of medical facilities, including CHPS compounds, clinics, primary hospitals, and major referral centers such as Komfo Anokye Teaching Hospital.
The region currently has approximately 600 accredited healthcare facilities under NHIS.
According to 2025 projections, Ashanti Region has a population of about 5,751,616, with NHIS registering approximately 2.95 million residents, representing 51.3 per cent coverage.
“This is remarkable but not satisfactory,” he admitted. “To achieve Universal Health Coverage, we need to register about 4.6 million residents.”
He highlighted that the region also has one of the highest numbers of vulnerable persons, estimated at over 920,000 according to Ghana Statistical Service data.