National Health Insurance Authority Suspends Three Pharmacies Over Suspected NHIS Fraud

The National Health Insurance Authority (NHIA) has temporarily suspended three pharmacies from operating under the National Health Insurance Scheme (NHIS) over alleged fraudulent claims and irregular service transactions.

In a public notice released on Thursday, May 14, the Authority stated that the action followed a routine claims verification exercise which uncovered suspected irregularities linked to the affected facilities.

The pharmacies affected are DELDEM PHARMA LIMITED, PARAMEDICA PHARMACY and DESH CHEMIST.

According to the NHIA, the suspension took effect on May 14 and was necessary after investigators identified significant irregularities in claims submissions and service transactions associated with the facilities.

The Authority said the findings raised “reasonable suspicion of fraud and abuse” under the NHIS Provider Service Agreement.

During the suspension period, the pharmacies are prohibited from providing services or dispensing medicines under the NHIS until further notice.

The NHIA also cautioned healthcare providers against fraudulent activities, reminding them that defrauding or attempting to defraud the Scheme constitutes an offence punishable by a fine, imprisonment of up to 10 years, or both.

The statement, signed by NHIA Chief Executive Victor Asare Bampoe, reaffirmed the Authority’s commitment to transparency, accountability and the responsible management of public funds in delivering quality healthcare services across Ghana.