NHIA inaugurates first-ever adjudication committee to resolve NHIS disputes

The National Health Insurance Authority (NHIA) has inaugurated its first-ever Adjudication Committee to ensure the fair, impartial and timely resolution of disputes under the National Health Insurance Scheme (NHIS).

The 10-member committee was inaugurated by the Chairman of the NHIA Governing Board, Lawrence Nii Okantey Adjetey, at the Authority’s head office in Accra on Monday, October 26.

The committee was established under Section 106 of the National Health Insurance Act, 2012 (Act 852), marking the first practical implementation of the adjudication mechanism provided for under the law since its passage.

It is chaired by retired Justice of the Superior Courts of Judicature, Justice Abdul Yusif Asibey.

Other members include Dr Alex Peasah Koduah of the Medical and Dental Council, Professor Vida Yakong of the Health Facilities Regulatory Agency, Joyce Adu of the Institute of Chartered Accountants, and Pharm. Samuel Antwi Kwakwa of the Pharmacy Council.

The remaining members are Nelly Bernice Wallace of the Department of Social Welfare, Sophia Gifty Wiredu of the Nurses and Midwives Council, and Dr Senanu Kwesi Djokoto, Deputy Chief Executive Officer in charge of Operations at the NHIA.

Speaking at the inauguration, Mr Adjetey said the committee would provide a credible mechanism for resolving disputes and grievances arising from the administration of the NHIS.

He urged members to discharge their duties with independence, integrity and impartiality, warning against any conduct that could undermine public confidence in the adjudication process.

He also called on the members to uphold due process, avoid conflicts of interest and maintain strict confidentiality in handling cases.

Mr Adjetey said the committee had an opportunity to establish standards and procedures that would guide future adjudication within the Authority.

Meanwhile, the NHIA Chief Executive, Dr Victor Asare Bampoe, has pledged management’s full support for the committee to ensure the transparent and timely resolution of disputes.

In a speech read on his behalf by the Deputy Chief Executive Officer in charge of Human Resources and Administration, Raphael Segkpeb, Dr Bampoe said the committee would provide an independent forum for reviewing contested decisions involving members’ benefits, claims processing, provider accreditation and entitlements under the NHIS.

He said management would provide the committee with the necessary records, information and officers to facilitate its work.

“Management will respect the Committee’s determinations and give effect to them without delay,” he stated as quoted in a news release shared on Tuesday.