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ARRANGEMENT OF REGULATIONS
Regulation
PART I—REGISTRATION AND OPERATION
OF SCHEMES
1. Application of Part 1
2. Application for registration
as a scheme
3. Contents of constitution bye
laws or rules of a scheme
4. Further conditions for licence
5. Time for registration and
licensing
6. Duration and renewal of
licence
7. Fees for licence
8. Register of schemes
9. Interim management of a scheme
10. Transfer of business of a
scheme to another scheme
11. Management of a scheme
12. Qualification of a board
member of scheme
13. Qualification of manager or
principal officer of a scheme
14. Report on disqualified
officers
15. Investigation of officers of
scheme
16. Prohibition of discrimination
17. Prohibition of differences in
tariff for the same service
18. Health insurance identity
card
19. Minimum benefits to members
under health insurance scheme and
free public health care services
20. Excluded health care services
21. Suspension of and
discontinuation of benefit to a
member
22. Accreditation of health care
facilities
23. Qualification for
accreditation of a health care
facility
24. Specific accreditation
requirements for hospitals
25. Specific accreditation
requirements for community based
health planning and services
26. Specific accreditation
requirements in respect of health
professionals
27. Other matters relating to
accreditation of health care
facilities
28. Application for accreditation
29. Denial of accreditation
30. Accreditation certificate
31. Suspension or revocation of
accreditation of a healthcare
facility
32. Renewal of accreditation
33. Re-accreditation of health
care facility
34. Review of accreditation
35. Performance monitoring of
health care facilities
36. Method of monitoring
performance
37. Payment of tariffs to health
care facilities
38. Time for payment claims by
schemes
39. Power of scheme to refuse or
reduce claim
40. Intervention by service
providers in respect of
prescription
41. Re-imbursement for drugs
42. Particulars of drugs and
medicines
43. Complaint settlement
procedure of schemes
44. Reference of complaint to the
District Health Complaint
Committee
45. Complaint settlement
procedure of District Health
Complaint Committee
46. Time of decision and review
47. Records of complaint
48. Accounts
49. Audit
50. Duties and power of auditors
51. Annual report to the Council
PART II—DISTRICT MUTUAL HEALTH
INSURANCE SCHEMES—ADDITIONAL
PROVISIONS
52. Location of headquarters of
District Schemes
53. Minimum membership of a
scheme
54. Application for membership of
District Scheme
55. Mode and time of payment of
contribution
56. Exemption from payment of
contribution on basis of age
57. Participation in District
Scheme by a dependant
58. Means test for indigent
persons
59. Suspension and reinstatement
of a defaulting member
PART III—PRIVATE COMMERCIAL AND
PRIVATE MUTUAL HEALTH INSURANCE
SCHEMES-ADDITIONAL PROVISIONS
60. Payment of contribution to
private commercial and private
mutual schemes
61. Security deposit for private
commercial schemes
PART IV—MISCELLANEOUS
62. Use of Forms and variations
in the Forms
63. Interpretation
64. Transitional provision
65. Revocation
SCHEDULES
Schedule I
Form I
Form 2—Accreditation of health
care facility application form
Form 3—Certificate of
accreditation
Form 4—In-Patient Treatment
Costing Sheet
Form 5—Health Facility Attendance
Card
Form 6—Diagnostic Card
Form 7—Prescription Form
Form 8—Claims Form
Form 9—District Mutual Health
Membership/Household Registration
Form 10—Complaint Form
Schedule II—Minimum healthcare
benefits
Part 1—Minimum healthcare benefits
Part 2—Exclusion list
Part 3—Free public health
services
Schedule III—National Health
Insurance Scheme (NHIS)
operational abbreviation
interpretations
IN exercise of the powers
conferred on the Minister for
Health under section 103 of the
National Health Insurance Act 2003
(Act 650) and on the advice of the
National Health Insurance Council,
these Regulations are made this
14th day of September, 2004.
PART I—REGISTRATION AND OPERATION
OF SCHEMES
Regulation 1—Application of Part I
This Part applies to all health
insurance schemes licensed under
the Act.
Regulation 2—Application for
registration as a scheme
Application for registration as a
scheme shall be as in Form I
provided in Schedule I to these
Regulations and shall be
accompanied with the constitution,
bye-laws or other rules intended
to govern the operation of the
scheme as specified in section 13
of the Act.
Regulation 3—Contents of
constitution bye laws or rules of
a scheme
(1) The constitution, bye-laws or
rules referred to in regulation 2
shall provide among others for the
following:
(a) the conditions required for
membership;
(b) the benefit attached to
membership;
(c) the conditions upon which
dependants of a member may
participate in the scheme and the
number of dependants permitted on
the membership of one person;
(d) the giving of advance notice
to members of any change in
contribution, membership fee or
other subscription or any other
condition that affects membership;
(e) that the scheme is a body
corporate capable of suing and
being sued;
(f) the method of appointment or
election of the governing board of
the scheme;
(g) the method of appointment of
the principal officer or manager
of the scheme;
(h) the appointment of the
auditor for the scheme and the
duration of the appointment;
(i)
the manner of calling the annual
general meeting and special or
extraordinary meeting of members,
the quorum of meetings and the
manner of voting;
(j) the method for ratification
of decisions of the governing
board by the members; and
(k) the method for the amendment
of the constitution, bye-laws or
other rules that govern the
scheme.
(2) A scheme shall give written
notice to the Council of any
amendment to its constitution,
bye-laws or rules within thirty
days of the date of the adoption
of the amendment by the members.
(3) The notice shall be
accompanied with a copy of the
amendment certified by the
chairperson of the governing body
of the scheme.
Regulation 4—Further conditions
for licence
(1) For the purposes of section
15 of the Act, the Council may
require an applicant to produce a
business plan for the proposed
scheme.
(2) A business plan shall provide
for a projected annual balance
sheet and projected annual income
and expenditure for the first two
years of operation and after that
period the plan shall be for such
period as the Council shall in
writing direct.
Regulation 5—Time for registration
and licensing
The Council shall unless there is
delay or default on the part of an
applicant register and issue a
licence for the operation of the
scheme within sixty days of
receipt of the application.
Regulation 6—Duration and renewal
of licence
(1) A licence to operate a scheme
expires two years from the date of
issue of the licence.
(2) The licence may on an
application be renewed for periods
of two years at a time.
(3) An application for renewal
must be made not later than three
months before the expiry of the
licence.
Regulation 7—Fees for licence
(1) The following fees shall be
paid for the initial licence:
(a) district and private mutual
health insurance schemes, two
million cedis.
(b) private commercial health
insurance scheme, ten million
cedis.
(2) The following fees shall be
paid for the renewal of a licence:
(a) district and private mutual
health insurance schemes, one
million cedis;
(b) private commercial health
insurance scheme, five million
cedis.
Regulation 8—Register of schemes
(1) The Council shall establish
and maintain a register of
licensed schemes in a form
determined by the Council.
(2) The register shall contain
the following:
(a) the name and address of the
scheme and whether it is a
district mutual, private mutual or
a private commercial scheme;
(b) the date of registration of
the scheme; and
(c) such other particulars as
the Council shall determine.
(3) The register is a public
document and any member of the
public may inspect the register
without payment of a fee except
that there shall be a fee
determined by the Council for
extract from the register.
Regulation 9—Interim management of
a scheme
(1) Where the Council decides to
put a scheme under an interim
management team for the purposes
of section 2 of the Act, the
Council shall in writing direct
the governing body of the scheme
to convene a special meeting of
its members presided over by the
chairperson of the Council or such
person as the Council shall
determine not later than thirty
days after the date of the issue
of the directions.
(2) The agenda for the special
meeting shall be as follows:
(a) that the governing board of
the scheme be dissolved; and
(b) that an interim management
team be appointed to exercise the
powers of the manager or principal
officer of the scheme for a period
not exceeding twelve months.
(3) The board shall be informed of
the reasons for the Council so
acting and be given an opportunity
to be heard except that the
Council need not give the board
the opportunity if in its opinion
the opportunity would enable the
board or any other person to
dispose of any assets of the
defaulting scheme or take any
other action that would be
prejudicial to the members or
creditors of the scheme.
(4) Where after the notification
to call a special meeting the
board fails to do so the Council
shall immediately cause a
publication to be made in the
Gazette and the media calling a
general meeting of the members of
the defaulting scheme and inform
the members of the intention of
the Council to place the scheme
under an interim management team.
Regulation 10—Transfer of business
of a scheme to another scheme
(1) Where an interim manager
reports in writing to the Council
that in its opinion there is no
reasonable prospects of restoring
the defaulting scheme to sound
financial conditions and the
interim manager in consultation
with the auditors of the
defaulting scheme recommends the
revocation of the registration of
the scheme or the transfer of its
business or activities to another
scheme, the Council may act
accordingly.
(2) For the purposes of
subregulation (1) where transfer
of the business or activities of a
defaulting scheme is made, the
transferee shall,
(a) in exchange for the assets of
the defaulting scheme, take such
liabilities of that scheme as the
transferee and the transferor
shall agree with the approval of
the Council, including liabilities
to health-care providers and
members under claims which have
been submitted and assessed but
not yet paid as at a date (in this
regulation called "the cut-off
date") not earlier than three
months before the date on which
the Council approved the transfer,
but not including,
(i)
contingent liabilities in respect
of members of the defaulting
scheme which may accrue after the
cut-off date; or
(ii) liabilities for which an
officer of the defaulting scheme
may be held personally liable
because of fraudulent conduct or
any other cause;
(b) undertake to admit every
member of the defaulting scheme
who is a duly enrolled member on
the date of the transfer and is
qualified to receive the minimum
benefit under the defaulting
scheme;
(c) waive any waiting period in
relation to a member of the
transferring scheme who qualifies
to receive benefits under the
transferring scheme and count any
portion of the waiting period
served by a member of the
transferring scheme as part of the
waiting period of the scheme to
which the member is being
transferred.
(3) Upon the conclusion of a
transfer under this regulation,
the Council shall issue a
publication in the Gazette and the
media of the transfer.
Regulation 11—Management of a
scheme
(1) Every scheme shall in
accordance with section 54(1) of
the Act have a governing body
referred to in these Regulations
as the board.
(2) Every scheme shall determine
the size of its governing body
except that in the case of a
district mutual health scheme, the
membership of the body shall not
be less than seven members and not
more than fifteen members of whom
at least two should be women.
(3) Where for the purposes of
section 54(3) of the Act, a scheme
is managed by an independent body
corporate, a copy of the agreement
between the scheme and the body
corporate appointing the body as
the scheme manager shall be
submitted to the Council by the
chairperson of the governing body
within thirty days of the date of
the signing of the agreement.
(4) Where the chairperson of the
governing body of a scheme fails
to submit the copy of the
agreement within the time
stipulated in subregulation (4)
the Council may impose such
pecuniary or other penalty as it
considers appropriate.
(5) A member of the governing body
of a scheme who has an interesting
in a matter before the body shall
disclose the interest to the body
and shall not participate in a
discussion of the matter.
(6) A scheme manager or principal
officer shall keep in separate
accounts, monies for payment of
claims and monies required to meet
the administrative expenses of the
scheme.
(7) The monies for administrative
expenses shall not exceed twenty
per cent of the total funds of the
scheme unless the Council
otherwise directs in writing.
(8) The manager or principal
officer of a scheme is responsible
to the board of the scheme in the
management of the scheme, in
particular financial matters.
(9) A scheme manager that acts
contrary to subregulation (7) or
(8) commits an offence and is
liable on summary conviction to a
fine not exceeding 1000 penalty
units.
Regulation 12—Qualification of a
board member of a scheme
A
person does not qualify to be a
member of a governing body of a
scheme unless he has not under the
laws of this country or any other
country
(a) been adjudged or otherwise
declared insolvent or bankrupt
without being discharged;
(b) made an assignment to,
arrangement or composition with
creditors which has not been
rescinded or set aside;
(c) been convicted of an offence
involving corruption, fraud or
dishonesty; or
(d) been found liable for
misconduct or mismanagement while
in any employment.
Regulation 13—Qualification of
manager or principal officer of a
scheme
(1) The governing body of every
scheme shall in accordance with
section 54(2) of the Act appoint a
manager or principal officer for
the scheme who shall
(a) in the case of a corporate
manager, be approved by the
Council;
(b) in the case of an individual,
be a person who holds at least
(i)
HND in Accounting, Marketing or
Statistics; or
(ii) a professional qualification
in administration, finance or
insurance
and has reasonable experience in
administration.
(2) Every scheme shall in addition
to a manager have the following
other officers:
(a) an Information Systems
manager, who shall be a person who
holds a Bsc degree or an HND in
Computer Science and who has at
least one year experience in
Information Systems Management;
(b) a claims manager;
(c) a marketing or public
relations officer;
(d) an accountant, who shall be a
person who holds a Bsc degree or
an HND in accounting or an
intermediate certificate of any
nationally recognised professional
accounting body and who has at
least one year experience in
accounting practice.
(3) An officer shall apart from
the academic or professional
qualification
(a) be a person of a high moral
standing,
(b) not be a member of the board
of any other scheme; and
(c) not under the laws of this
country or any other country,
(i)
been adjudged or otherwise
declared insolvent or bankrupt
without being discharged;
(ii) made an assignment to,
arrangement or composition with
creditors which has not been
rescinded or set aside;
(iii) been convicted of an offence
involving corruption, fraud or
dishonesty; or
(iv) been found liable for
misconduct or mismanagement while
in any employment.
(4) Notwithstanding subregulations
(1) and (2) a scheme may with the
approval of the Council employ
such number of officers and
officers with lesser qualification
than prescribed as its governing
body may determine.
(5) The provisions of this
regulation is without prejudice to
the qualification required of
principal officers of a private
commercial health insurance scheme
as provided under section 45(1)(f)
of the Act.
Regulation 14—Report on
disqualified Officers
(1) Where the Council receives
information or a complaint that a
director, principal officer or
manager of a scheme has ceased to
be qualified, the Council must
immediately direct an
investigation of the complaint by,
(a) furnishing the board of the
scheme and the officer with
details of the information or
complaint; and
(b) requiring the officer to make
a written representation to the
board of the scheme within thirty
days of the date of the request.
(2) The board of the scheme must
after the investigation and
considering the representations of
the officer, take such action as
it considers appropriate and
inform the Council accordingly
Regulation 15—Investigation of
officers of scheme
(1) If the scheme to which a
complaint has been referred by the
Council under regulation 14(1)
fails or refuses to investigate
the matter, the Council shall
investigate the matter and direct
the scheme to comply with the
decision of the Council on the
matter.
(2) The cost of the investigation
under subregulation (1) shall be
borne by the scheme and the
Council may impose such pecuniary
penalty for the default as the
Council considers appropriate in
the circumstances.
Regulation 16—Prohibition of
discrimination
(1) A scheme shall not with
respect to the admission of
persons as members of the scheme
or as between its members in the
same class of the scheme,
discriminate against any person on
the basis of race, sex,
disability, marital status,
ethnic, social origin,
nationality, religion or creed,
(a) by subjecting the person to a
condition, restriction or
disability to which persons of the
same class are not subjected to;
or
(b) by conferring on persons in
the same class, a privilege or
advantage which is not conferred
on persons in the same class.
(2) A scheme that contravenes any
provision in subsection (1) shall
be required by the Council to pay
such pecuniary penalty as the
Council considers appropriate and
if the scheme fails to pay the
pecuniary penalty the Council may
revoke the licence of the scheme.
Regulation 17—Prohibition of
differences in tariff for the same
service
There shall be no discrimination
in the amount of tariff at the
point of rendering a healthcare
service in the same healthcare
facility.
Regulation 18—Health insurance
identity card
(1) The Health ID Card provided
for under section 65 of the Act
shall
(a) be issued to a member within
six months of the registration of
the member by the scheme;
(b) have a unique number specific
to the member;
(c) contain a picture of the
member; and
(d) state the address, age and
such other particulars as the
Council may direct.
(2) Upon the loss of a Health ID
Card, the scheme shall replace the
card upon payment of a fee
determined by the scheme.
Regulation 19—Minimum benefits to
members under health insurance
scheme and free public health care
Services
(1) For the purposes of section 64
of the Act, the minimum health
care benefits set out in Part 1 of
Schedule II to these Regulations
shall be available to members
registered with a scheme licensed
under the Act.
(2) A scheme may despite
subregulation (1) provide for its
members health care services over
and above the minimum benefits
specified in Part I of Schedule II
subject to the payment of such
additional premium as is agreed
upon by the scheme and the
members; and for this purpose the
scheme is not required to adhere
to the National Insurance Drug
List.
(3) A district mutual health
insurance scheme shall not provide
the healthcare services over and
above the minimum specified in
Part I of Schedule II unless it
has the prior approval of the
Council.
(4) The public health care
services specified in Part 3 of
Schedule II shall be paid for by
Government and shall be free. Part
1 Part 2 Part 3
Regulation 20—Excluded health care
services
The healthcare services set out in
Part 2 of Schedule II do not fall
within the minimum health care
benefit available under the
national health insurance scheme.
Regulation 21—Suspension of and
discontinuation of benefit to a
member
(1) A scheme may suspend a member
and discontinue the benefit to
which the member is entitled on
any of the following grounds only:
(a) failure by the member to pay
the member's contribution within
the stipulated period in the
constitution, bye-laws or rules of
the scheme;
(b) failure to pay any debt due to
the scheme in respect of the
member;
(c) submission of a fraudulent
claim with the knowledge or
support of the member;
(d) commission of any act of fraud
or dishonesty in relation to the
scheme; or
(e) non-disclosure of any material
information requested by the
scheme.
(2) Where a scheme suspends a
member under subregulation (1) the
scheme shall give at least seven
days notice of the suspension to
the healthcare facilities of the
scheme.
Regulation 22—Accreditation of
health care facilities
(1) The following health care
service facilities may be
accredited by the Council to
operate under the national health
insurance scheme:
(a) teaching hospitals;
(b) regional hospitals;
(c) district hospitals;
(d) quasi public hospitals, (such
as the Military, Police,
University, and Social Security
and National Insurance Trust
hospitals);
(e) health centres;
(f) dental clinics;
(g) private hospitals and health
clinics;
(h) maternity homes;
(i)
mission hospitals,
(j) pharmacies and licensed
chemical sellers facilities;
(k) private medical diagnostic
facilities and
(l) such other facilities as the
Council may determine.
(2) For purposes of accreditation
under these Regulations, the
Council may seek and rely on
information from relevant
regulatory bodies and such other
institutions as it considers
appropriate.
Regulation 23—Qualification for
accreditation of a health care
facility
The following is required of a
healthcare facility before
accreditation:
(a) the facility must have been
operating for at least six months
immediately before the date of the
initial application for
accreditation;
(b) the facility must have a good
record in the provision of health
care services over the period
specified in paragraph (a);
(c) the facility must have the
human resources, equipment,
physical structures and other
requirements that meet the
standards of the Council;
(d) the facility must accept the
quality assurance standards and
utilization review of the Council
and the payment mechanism approved
by the Council;
(e) the facility must adopt the
referral protocols, practice
guidelines and health resource
sharing arrangements of the
schemes as approved by the
Council;
(f) the facility must have its
own formal quality assurance
programme;
(g) the facility must recognise
and respect the rights of its
patients or customers;
(h) the facility must accept to
comply with the information system
requirements and regular transfer
of information, including any
reporting mechanism established by
the Council and the schemes to
which it is accredited;
(i)
the facility must maintain
accurate records of
(i)
its patients or customers;
(ii) services rendered;
(iii) results from the services;
and
(iv) health expenditure on
patients or customer care as is
appropriate;
(j) the facility must be willing
and able to comply with all
corrective actions directed by the
Council for the purpose of
ensuring quality health service;
and
(k) the facility must agree to
permit the Council or any person
authorised by the Council to
(i)
enter and inspect its premises and
health facilities; and
(ii) have access to inspect its
medical, financial and other
records relevant to health
insurance
Regulation 24—Specific
accreditation requirements for
hospitals
Hospitals and ambulatory surgical
clinics in addition to the
requirements under regulation 23
as a further condition for their
accreditation under the Act,
(a) must have been approved by the
Ministry of health;
(b) shall comply with
(i)
the provisions of the Private
Hospitals and Maternity Homes Act,
1958 (No.9) as amended and
Regulations made under that Act;
and
(ii) the Ministry of health's
approved guidelines for ambulatory
surgical clinics as well as other
administrative orders of the
Ministry in the case of ambulatory
surgical clinics;
(c) shall be a member of good
standing of any national
association of licensed hospitals
in the country, and
(d) shall have a quality assurance
programme.
Regulation 25—Specific
accreditation requirements for
community based health planning
and services
Community based health planning
and services shall in addition to
the requirements for accreditation
under regulation 23,
(a) be organised or managed by
members of the community for the
purpose of improving the health
status of the community through
preventive, promotive and curative
health services;
(b) be affiliated to at least one
health care facility accredited by
the Council, or have facilities
that are necessary to provide for
health services for its
beneficiaries as the Council may
determine; and
(c) have a quality assurance
programme.
Regulation 26—Specific
accreditation requirements in
respect of health professionals
Every health professional working
in a health care facility that
seeks accreditation shall,
(a) be duly licensed to practise
the relevant profession in Ghana
by the appropriate regulatory body
of the profession;
(b) be a member in good standing
of the relevant national
association of the profession;
(c) abide by the Code of Ethics of
the profession; and
(d) observe the practice
guidelines or protocols, peer
review and payment mechanisms of
the scheme.
Regulation 27—Other matters
relating to accreditation of
health care facilities
(1) The Council shall publish in
the Gazette and a news paper that
has national circulation the list
of documents that shall be
submitted and the conditions that
are required for accreditation.
(2) The Council may subject the
documents submitted for the
purpose of accreditation under
subregulation (1) to verification
and authentication.
(3) Initial accreditation is for a
period of five years and after
that period is renewable every two
years and may be revoked or
suspended after the Council has
given notice to the affected party
and granted that party a hearing.
(4) In granting accreditation, the
Council shall take into
consideration the installed
capacity in terms of equipment and
services available to the health
facility and may impose
limitations on the services to be
provided by the facility.
(5) Accreditation shall operate
prospectively and shall not take
effect until the issue of the
certificate of accreditation.
(6) A claim by a health facility
for services rendered before the
issue of a certificate of
accreditation to that provider is
invalid.
Regulation 28—Application for
accreditation
(1) Application for accreditation
shall be made to the Council and
shall be as in Form 2 in Schedule
I.
(2) The application for
accreditation shall be accompanied
with the accreditation fees and
any document required for the
accreditation.
(3) The Council shall within
fourteen days after the receipt of
the application cause to be
conducted
(a) verification of compliance
with the requirement, and
authenticity of the documents
submitted; and
(b) inspection of the facilities.
(4) A verification and inspection
report shall be prepared for and
submitted to the Council within
sixty days of the receipt of the
application by the Council.
(5) The Council shall make a
decision on the application and
inform the applicant of that
decision in writing within ninety
days of receipt of the
application.
(6) Where the Council is satisfied
that all the requirements for
accreditation have been met by the
applicant and the accreditation
fee has also been paid, the
Council shall grant accreditation
to the applicant.
Regulation 29—Denial of
accreditation
(1) Accreditation may be denied by
the Council on any of the
following grounds:
(a) non-compliance with any of the
requirements and conditions of
accreditation;
(b) revocation, non-renewal or
non-issuance of licence to operate
or practise as a health care
facility by the relevant
regulatory authority;
(c) fraud;
(d) change in the ownership of a
health care facility for the
purpose of evading the
consequences of impropriety or
violations of requirement or
conditions previously committed;
(e) non-compliance with any
safeguards provided under the Act
or these Regulations;
(f) such other grounds as the
Council may determine.
(2) An applicant who is denied
accreditation may apply for a
review of the decision under
regulation 34.
Regulation 30—Accreditation
certificate
(1) An accredited health facility
shall be issued an accreditation
certificate by the Council which
shall be as in Form 3 in Schedule
I.
(2) The accreditation certificate
shall
(a) contain an accreditation
number, which shall serve as the
identification number for the
purpose of the information systems
of the schemes;
(b) state the grading of the
facility; and
(c) be prominently and
conspicuously displayed in the
facility's office or place of
practice.
(3) An accreditation certificate
shall be surrendered by the holder
to the Council upon suspension or
revocation of the accreditation.
(4) An accredited health care
facility shall display in a
prominent and conspicuous manner a
sign to the effect that the
facility is accredited by the
Council.
(5) The sign mentioned under
subregulation (3) shall also be
placed outside the facility and
next to the facility's name.
(6) The Council may place a sign
outside a facility and next to the
facility's name indicating the
suspension or revocation of
accreditation of the facility.
Regulation 31—Suspension or
revocation of accreditation of a
healthcare facility
(1) The Council may suspend or
revoke an accreditation granted to
a health care facility if the
Council is satisfied that the
facility has
(a) failed to comply with any of
the requirements and conditions of
the accreditation;
(b) lost its licence to operate;
(c) been convicted of fraud; or
(d) been convicted of any offence
under the Act or under these
Regulations.
(2) Where the Council decides to
suspend or revoke an
accreditation, the Council shall
within fourteen days of making
that decision, give notice of the
decision to the affected health
care facility and give a hearing
to that facility within thirty
days after the notice.
(3) Where an accreditation is
suspended the Council shall in the
notice under subregulation (2)
inform the health care facility of
the acts or omissions that have
occasioned the suspension and give
the facility reasonable time to
remedy the wrong.
(4) A person dissatisfied with the
decision of the Council to suspend
or revoke an accreditation may
apply for review under regulation
44, 45 and 46 but shall do so not
more than sixty days after the
date he or she becomes aware of
the decision.
(5) The Council shall reinstate a
suspended accreditation where it
is satisfied that the act or
omission which gave rise to the
suspension has been remedied by
the healthcare facility within the
time given by the Council.
(6) Where an accredited health
care facility fails to remedy the
defects which gave rise to the
suspension, within the time
specified, the Council shall
revoke the accreditation.
(7) Where the Council suspends the
accreditation of a facility, the
Council shall within seven days of
the suspension, give public notice
of the suspension in such manner
as the Council shall determine.
Regulation 32—Renewal of
accreditation
(1) An application for renewal of
accreditation shall be submitted
to the Council not later than six
months prior to the expiration of
the previous accreditation.
(2) The application for renewal
shall be in such form and be
accompanied with such documents
and fees as the Council shall
determine.
(3) The accreditation of a health
care facility against whom
allegations of impropriety are
pending shall not be renewed until
investigations have been conducted
and the facility is absolved of
any impropriety.
(4) Where there are adverse
findings against the facility, the
renewal of accreditation shall be
denied.
(5) The accreditation of a
facility whose accreditation is
suspended shall not be renewed
until the suspension has been
lifted.
Regulation 33—Re-accreditation of
health care facility
(1) A healthcare facility whose
previous accreditation had lapsed
or whose application was denied
may apply for reaccreditation.
(2) A health care facility which
changes ownership, shall apply for
reaccreditation.
(3) Where accreditation lapses
because of a health care
facility's effort to evade the
consequences of a previous
violation or adverse findings of
impropriety, the application for
re-accreditation shall be treated
as an application for an initial
accreditation.
(4) A health care facility that
upgrades or downgrades its
facilities shall apply for
re-accreditation.
Regulation 34—Review of
accreditation
An accreditation is subject to
such review as the Council may
determine.
Regulation 35—Performance
monitoring of health care
facilities
(1) The Council in consultation
with the schemes shall develop and
implement a performance monitoring
system of accredited health care
facilities.
(2) Any monitoring system shall
safeguard against,
(a) gross or unjustifiable
deviation from current accepted
standards of practice or treatment
method;
(b) use of fake, adulterated or
substandard pharmaceuticals or
unregistered drugs;
(c) except as provided under
regulation 19(2) and for private
mutual and commercial health
insurance schemes, use of drugs
other than those on the National
Health Insurance Drug List.
Regulation 36—Method of monitoring
performance
(1) The monitoring system shall be
carried out, among others through
(a) periodic inspections of health
facilities and other offices;
(b) collection of data from health
care services rendered by health
care facilities;
(c) periodic review of collected
data to determine the quality,
cost and effectiveness of service
and adherence to accepted and
known standards of health care
practice;
(d) peer review; and
(e) a mandatory reporting
mechanism approved by the Council.
(2) For the purposes of monitoring
the performance of health care
facilities, every accredited
facility shall submit a quarterly
report to the Council which shall
include the following data for the
quarter:
(a) patients attended to,
classifying them into out patients
and admitted (in-patients)
patients as is applicable;
(b) bed occupancy;
(c) average length of admission of
patients;
(d) mortality rate;
(e) five most common causes of
admission;
(f) ten most common causes of
Out-Patients Department (OPD)
attendance
(g) types and the number of minor
and major operations performed;
and
(h) non-paying members of
insurance schemes that were
attended to.
(3) For the purposes of monitoring
the performance of pharmaceutical
service providers, every
accredited pharmaceutical service
facility shall submit a quarterly
report to the Council, which shall
include the following:
(a) number of patients on the
scheme attending the facility;
(b) number of patients attending
the facility outside the scheme;
(c) number of prescriptions served
(i)
fully,
(ii) partially,
(iii) unable to serve;
(d) interventions made and total
cost saved for the scheme from non
dispensing of irrational or
invalid prescriptions,
(e) top most five drugs dispensed;
and
(f) number and type of
extemporaneous preparations made.
Regulation 37—Payment of tariffs
to health care facilities
(1) In determining the tariffs to
be paid to health care facilities
and the schemes, the Council shall
consult the facilities and the
schemes.
(2) Payment for health care
services rendered by a health care
facility shall be made by either
of the following systems:
(a) capitation;
(b) fee-for-service; or
(c) any other payment system that
the Council may determine.
(3) Capitation means a payment
mechanism in a written agreement
by which a fixed rate of payment
for a fixed period is negotiated
with an accredited health care
facility to deliver health care
services to a person, family,
household or a group of persons
covered under the terms of the
agreement for health insurance
services.
(4) For a fee-for-service payment
the health care facility and the
attending health care personnel
shall file the claim in the Form 4
provided in Schedule I.
(5) Hospitals shall attach Forms
4, 5, and 6 in Schedule I to the
clinical records of a patient upon
admission.
(6) In the event of admission, the
patient shall not be discharged
unless the attending medical
practitioner and the patient sign
or thumbprint the forms provided
for under subregulation (4).
(7) A claim for payment of health
care services rendered under a
scheme licensed under this Act
shall be filed within sixty
calendar days from the date of the
discharge of the patient or the
rendering of the service.
(8) Except as provided under
regulation 54 in respect of
district mutual health insurance
schemes or except in the case of
an emergency, a claim for payment
not made within the stipulated
period is barred upon the expiry
of the period stated in
subregulation (7).
Regulation 38—Time for payment
claims by schemes
(1) A claim for payment of health
care service rendered which is
submitted to a scheme shall,
unless there is any legal
impediment, be paid by the scheme
within four weeks after the
receipt of the claim from the
health care facility.
(2) All claims shall be paid
directly to the health care
facility and on no account shall
direct payment be made to a
patient.
Regulation 39—Power of scheme to
refuse or reduce claim
(1) A scheme may deny or reduce
the payment of tariff claimed by a
health care facility where the
management of the scheme is
satisfied that the claim is
attended by any or all of the
following
(a) over-servicing of the patient
by the health care facility as
determined through peer review;
(b) unnecessary diagnostic and
therapeutic procedures and
intervention, as determined
through peer review;
(c) irrational medication and
prescriptions as determined
through peer review;
(d) fraud;
(e) gross and unjustified
deviations from current accepted
standards of practice or treatment
protocols or both;
(f) inappropriate referral
practices;
(g) provision of services other
than those for which accreditation
has been granted;
(h) use of fake, adulterated or
substandard pharmaceuticals,
(i)
in the case of district mutual
health insurance scheme, use of
drugs other than those provided in
the National Health Insurance Drug
List and traditional medicines
approved by the Food and Drugs
Board;
(j) false or incorrect
information; or
(k) the failure of the healthcare
facility without justifiable cause
to comply with agreement between
the scheme and the health
facility.
(2) Where a claim is refused or
reduced, the amount that is
refused or reduced shall not be
charged directly or indirectly to
the beneficiary involved.
(3) The outcome of a peer review
conducted by a professional
organization or a health care
facility without the authority or
consent of the scheme shall not
bind the scheme with respect to
payment of claims.
(4) When a claim filed by a
hospital with a scheme indicates
that bed occupancy rate of the
health care facility exceeds its
accredited bed capacity, the claim
shall be accompanied by a written
justification.
(5) Any operation performed beyond
the authorized capability of the
health care facility shall be
considered a violation, and a
claim for the operation shall be
denied by the scheme, except where
the operation is done in an
emergency or where referral to
higher category health care
facility is impossible.
Regulation 40—Intervention by
service providers in respect
of prescription
Where a healthcare provider
considers a prescription or
medication irrational or
inappropriate in the
circumstances, the health care
facility may after prior
consultation with the prescriber
intervene and, provide an
appropriate medication and make a
report to the scheme.
Regulation 41—Re-imbursement for
drugs
(1) The Council shall in
consultation with the Ministry of
Health and the Pharmacy Council
determine the quarterly price
indices of drugs and medicines on
the National Health Insurance Drug
List and for which re-imbursement
is to be paid by the schemes.
(2) Based on the quarterly
indices, the Council shall in
consultation with pharmaceutical
service providers regularly set
allowable percentage mark-up in
the prices of drugs and medicines
charged by health care facilities
and re-imbursement shall only be
made for drugs and medicines
within the allowable mark-up
price.
Regulation 42—Particulars of drugs
and medicines
(1) In order to support a claim
for drugs or medicines supplied to
a beneficiary under a scheme
licensed under the Act, the health
care facility shall specify the
generic name of each drug or
medicine administered to the
beneficiary.
(2) Form 5 in Schedule I shall be
used with appropriate
modification.
Regulation 43—Complaint settlement
procedure of schemes
(1) A scheme shall maintain a
register into which shall be
recorded every complaint received
from a member or a health care
facility
(2) A scheme shall provide for
(a) the manner in which
complaints are to be made;
(b) the person or authority to
whom a complaint should be made;
(c) the time within which the
complaint should be submitted
following the occurrence of the
cause of the complaint which shall
in any event not exceed fourteen
days;
(d) the time within which a
complaint is to be dealt with,
which time should be reasonable
and in any event not be more than
two months from the date the
complaint was lodged with the
scheme; and
(e) the person who deals with
complaints.
(3) A complaint may be submitted
as in Form 10.
(4) The scheme shall investigate
all complaints recorded in an
expeditious manner and take
appropriate steps to settle the
complaint.
(5) A scheme shall provide in
writing the remedies available to
complainants under this regulation
and the right of a complainant to
refer the complaint to the
district Health Complaint
Committee established under
section 8 of the Act where the
person is dissatisfied with action
taken by the scheme or the failure
by the scheme to attend to the
complainant within the time
required under subregulation (1)
(d).
Regulation 44—Reference of
complaint to the district health
complaint committee
(1) If a complaint is not settled
to the satisfaction of the
complainant within two months of
the date of the receipt of the
complaint by the manager, the
manager shall make a written
report to the District Health
Complaint Committee of the details
of the complaint and the action
taken in respect of the complaint
within thirty days from the date
of inability to settle the
complaint and inform the
complainant of the reference to
the District Health Complaint
Committee.
(2) Nothing in subregulation (1)
prevents the complainant from
referring the unsettled complaint
to the District Health Complaint
Committee after the expiration of
sixty days.
Regulation 45—Complaint settlement
procedure of District Health
Complaint Committee
(1) For the purposes of section
8(4) and (5) of the Act a health
care facility or a member of a
scheme who desires the settlement
of a complaint shall submit the
complaint to the relevant District
Health Complaint Committee, except
that a complaint from a health
care facility or a member of a
scheme shall not be entertained by
the District Health Complaint
Committee unless reference for
settlement was first made to the
scheme.
(2) The complaint shall be
supported with a written record
that the complaint was first
submitted to the scheme concerned
for action and there has been
failure to settle the complaint
within the stipulated time under
these Regulations or there is
failure to settle it to the
satisfaction of the complainant.
(3) Despite subregulations (1) and
(2), complaint of a scheme against
another scheme or its member or
healthcare facility shall be
submitted to the District Health
Complaint Committee and shall be
in writing.
(4) The District Health Complaint
Committee shall within seven days
of receipt of the complaint cause
a copy of the complaint to be sent
to the person against whom the
complaint is made.
(5) The person against whom the
complaint is made shall within
five working days from the date of
the receipt of the complaint or
such further period as the
Committee may permit submit a
response to the complaint to the
Committee.
(6) The District Health Complaint
Committee shall investigate the
complaint and invite the parties
for a settlement of the complaint.
(7) A District Heath Complaint
Committee shall in its
deliberations be guided by the
rules of natural justice.
Regulation 46—Time of decision and
review
(1) A District Health Complaint
Committee shall give its decision
on any complaint before it within
thirty days of receipt of the
complaint.
(2) A party to any dispute for
settlement who is dissatisfied
with the decision of a District
Health Complaint Committee may
apply to the Council within
fourteen days of the decision for
a review of the decision of the
Committee.
Regulation 47—Records of complaint
(1) A scheme shall keep records of
each complaint made to it and the
manner it is dealt with.
(2) The records shall be kept for
not less than twelve months from
the date the records are made and
shall be made available to the
Council as part of its annual
report to the Council.
(3) The Council may despite
subregulation(2) at any time
request a scheme to make its
complaints records available for
inspection.
Regulation 48—Accounts
(1) Every scheme shall keep proper
accounting records and the
accounting records of a scheme
shall be in a form approved by its
auditors.
(2) A scheme shall ensure that,
(a) moneys received are promptly
paid into its accounts;
(b) payments out of its moneys are
correctly made and properly
authorised; and
(c) adequate control is maintained
over its assets and over the
incurring of liabilities by the
scheme.
(3) The accounting records kept
under subregulation (1) shall,
(a) be sufficient to record and
explain the scheme's transactions;
(b) enable its financial position
to be determined with reasonable
accuracy at anytime; and
(c) be sufficient to enable
financial statements to be
prepared and audited in accordance
with this regulation.
(4) Within three months after the
end of each financial year, a
scheme shall prepare accounts
containing,
(a) a statement of the assets and
liabilities of the scheme at the
end of the preceding financial
year;
(b) a statement of the revenue and
expenditure of the scheme during
the financial year;
(c) proper and adequate
explanatory notes to the financial
statements; and
(d) such other matters as the
Council may in writing direct.
Regulation 49—Audit
(1) The board of a scheme shall
annually appoint the auditors for
the scheme and agree on the fee
payable to the auditor.
(2) An auditor shall not be an
employee, manager, director or
principal officer of the scheme.
Regulation 50—Duties and power of
auditors
(1) The auditor of a scheme shall
(a) audit the scheme's accounts
and report on its balance sheet
and income and expenditure
account;
(b) scrutinise and carry out audit
procedures designed to detect
irregularities and illegal acts in
the conduct of the activities or
business of the scheme;
(c) communicate to the board of
the scheme any evidence of
irregularities or illegal acts
committed in the course of the
scheme's business or activities
whether or not they may have led
to material misstatements in the
scheme's account or records, and
(d) communicate to the Council any
evidence the auditor may have that
irregularities or illegal acts
have been committed by
(i)
any officer or employee of the
scheme; or
(ii) any other person, if there is
a reasonable possibility that they
may significantly damage the
scheme's financial stability.
(2) In every report referred to in
paragraph (a) of subregulation (1)
the auditor shall state whether
the accounts of the scheme fairly
present the state of affairs and
the activities or affairs of the
scheme.
(3) The report of the auditor
shall record,
(a) any irregularity or illegal
act which the auditor has
ascertained, or which he or she
suspects, has occurred in relation
to the conduct of the business or
activities of the scheme;
(b) any other matter which, in the
auditor's opinion, requires
rectification or attention by the
scheme; and
(c) any recommendations for
improving the scheme's financial
administration,
and a copy of the report shall
immediately after the audit be
submitted to the Council.
(4) In addition to the report
required under this regulation,
the Council may request an auditor
of a scheme to submit such other
reports as the Council considers
necessary.
(5) The Council may appoint an
auditor for a scheme if the board
of that scheme fails to appoint an
auditor, and the auditor shall be
deemed to have been appointed by
the scheme.
(6) The auditor of a scheme shall
comply with his or her obligations
under this regulation
(a) to submit reports or to
include information in reports;
(b) to provide information
notwithstanding any duty of
confidentiality to the contrary,
and shall not be held liable in
any proceedings arising out of
compliance with any obligation
unless it is proved that he or she
acted in bad faith.
(7) An auditor of a scheme shall,
(a) have a right of access at all
reasonable times to the scheme's
books and accounts; and
(b) be entitled to require such
information and explanations from
any officer, employee or agent of
the scheme, as in his or her
opinion, is required in order to
enable him or her to perform his
or her duties as an auditor.
(8) Any person who fails without
just cause
(a) to permit an auditor to have
the access referred to in
paragraph (a) of subregulation
(7); or
(b) to comply with a requirement
to submit information or offer an
explanation under paragraph (b) of
subregulation (7)
commits an offence and is liable
on summary conviction to a fine
not exceeding 250 penalty units or
to a term of imprisonment not
exceeding six months or to both.
Regulation 51—Annual report to the
Council
(1) For the purposes of the Act
the Council shall determine the
form of the annual report required
to be submitted by a scheme under
section 57(2) of the Act.
(2) The annual report shall cover
the period starting from 1st
January and ending on 31st
December.
PART II—DISTRICT MUTUAL HEALTH
INSURANCE SCHEMES-ADDITIONAL
PROVISIONS
Regulation 52—Location of
Headquarters of District Schemes
The headquarters of a District
Mutual Health Insurance Scheme
shall as far as practicable be
located in a town in the district
that has at least electricity and
telephone facilities.
Regulation 53—Minimum membership
of a scheme
(1) A district mutual health
scheme shall have at least two
thousand members before it is
registered by the Council.
(2) Despite subregulation (1), a
proposed scheme with less than the
number of members provided under
subregulation (1) may be
registered on condition that the
membership will within two years
from the date of registration
increase to the minimum required
under subregulation (1).
(3) A scheme shall for the
purposes of subregulation (2)
render every six months, namely
30th June and 31st December of
each year, a return on its
membership to the Council.
(4) Where a scheme fails to make
the minimum membership by the end
of the two years, the Council may
revoke the licence of the scheme
and recommend appropriate
arrangement to meet the healthcare
needs of the members.
Regulation 54—Application for
membership of District Scheme
(1) The process of application for
membership of a District Mutual
Health Insurance Scheme shall be
as determined by the scheme.
(2) Notwithstanding subregulation
(1) an application may be as in
Form 11 in Schedule 1.
Regulation 55—Mode and time of
payment of contribution
(1) The mode and time of payment
of contribution shall be
determined by each scheme,
(2) The provisions in
subregulation (1) are subject to
section 34 subsections (4) and (5)
of the Act.
(3) A scheme may employ any method
it finds effective for the payment
of contribution by its members.
Regulation 56—Exemption from
payment of contribution on basis
of age
A
person who is
(a) under eighteen years of age
and both of whose parents or
guardians are contributors;
(b) under eighteen years of age
and whose parent or guardian has
been proven by the scheme to be a
single parent or guardian;
(c) a pensioner under the SSNIT
Scheme; or
(d) seventy years or over seventy
years of age
is not required to pay any
contribution to a District Mutual
Health Insurance Scheme but is
entitled in the case of a child to
enjoy the minimum benefits under
the scheme as a dependant, and in
the case of a person of seventy
years of age or above to enjoy the
minimum benefit under the scheme
in which the person is a member in
that person's own right.
Regulation 57—Participation in
District Scheme by a dependent
Notwithstanding Regulation 55 a
dependant of a contributor who is
(a) not a child;
(b) a pensioner under the SSNIT
Scheme; or
(c) a person of seventy years or
above seventy years
may in accordance with section 56
of the Act and in accordance with
the constitution of a District
scheme, participate in the
district scheme and receive the
same minimum benefits that are
available under the district
scheme subject to a reasonable
variation in the level of
contribution by the contributor.
Regulation 58—Means test for
indigent persons
(1) A person shall not be
classified as an indigent under a
district scheme unless that person
(a) is unemployed and has no
visible source of income;
(b) does not have a fixed place of
residence according to standards
determined by the scheme;
(c) does not live with a person
who is employed and who has a
fixed place of residence; and
(d) does not have any identifiable
consistent support from another
person.
(2) The conditions under
subregulation (1) for ascertaining
who is an indigent shall be
incorporated in the registration
form of a district scheme.
(3) A person assigned the duty by
a district scheme of registering
persons for the scheme, shall
elicit the information required
under the subregulation (1) for
the classification of indigents as
part of the registration process.
(4) Every district scheme shall
keep and publish a list of
indigents in its area of operation
and submit the list to the Council
for validation.
(5) Where the list of indigents
submitted by a district scheme
exceeds one-half percent of the
entire membership of the scheme,
the Council shall verify the list
by whatever means the Council
determines.
(6) Any member of a district
scheme who is dissatisfied with
the classification of a person as
an indigent under the scheme may
first complain to the scheme and
after that if the member is still
not satisfied, to the District
Health Complaint Committee.
(7) The District Health Complaint
Committee shall investigate any
complaint about the classification
of a person as an indigent.
Regulation 59—Suspension and
reinstatement of a defaulting
member
(1) A member of a district scheme
who, except as otherwise provided
by the scheme, defaults in the
payment of contribution to the
scheme for a period exceeding
three months shall be suspended
from the scheme,
(2) A member of a district scheme
whose membership of the scheme is
suspended because the member has
defaulted in the payment of
contributions to the scheme shall
be reinstated if that member pays
all the contributions in arrears
and in addition pays a penalty of
fifty per centum of the total
contribution that is due.
(2)sic A suspended member of a
district scheme who is reinstated
under subregulation (1) shall not
enjoy any benefits under the
scheme until the expiration of a
period of six months from the date
of re-instatement.
PART III—PRIVATE COMMERCIAL AND
PRIVATE MUTUAL HEALTH INSURANCE
SCHEMES-ADDITIONAL PROVISIONS
Regulation 60—Payment of
contribution to private commercial
and private mutual schemes.
The mode, time, quantum and
conditions for the payment of
contribution to private commercial
and private mutual health
insurance schemes shall be
determined by the boards of the
schemes.
Regulation 61—Security deposit for
private commercial schemes
Every private commercial health
insurance scheme, shall in
accordance with section 43 of the
Act, deposit with the Bank of
Ghana, ¢5.5 billion
PART IV—MISCELLANEOUS
Regulation 62—Use of forms and
variations in the forms
The following Forms provided in
Schedule I shall be used in
respect of district mutual health
insurance schemes and may be used
by other health insurance schemes
licensed under this Act with such
modifications as are considered
appropriate: Form 2 Form 3
Form 4 .. In-Patient
Treatment Costing Sheet
Form 5 .. Health Facility
Attendance Card
Form 6 .. Diagnostic Card
Form 7 .. Prescription Form
Form 8 .. Claims Form
Form 9 .. District Mutual
Health Membership/Household
Registration
Form 10 .. Complaint Form
Regulation 63—Interpretation
(1) In these Regulation unless the
context otherwise requires,
"Act" means the National Health
Insurance Act, 2003 (Act 650);
"accreditation" has the same
meaning it has in the Act;
"beneficiary" has the same meaning
it has in the Act;
"benefit package" means the
healthcare services that are
available to a contributor or
member of a health insurance
scheme;
"contribution" has the same
meaning it has in the Act;
"Community Health Insurance and
Planning Services" means an
arrangement by which members of a
community establish and manage
health care facilities for the
benefit of members of the
community and for the purpose of
improving the health status of the
members;
"Council" means the National
Health Insurance Council
established under section 1 of the
Act;
"fee-for-service” means in respect
of out-patient (OPD), consultation
fees, costs of drugs and cost of
management; and in respect of
admitted patients (in patients),
admission fees, costs of drugs,
cost of surgery and cost of
management;
"healthcare facility" includes a
hospital, a nursing home,
laboratory, maternity, dental
clinic, polyclinic, clinic,
pharmacy and any other facility
that the Council may determine;
"indigent" has the same meaning it
has in the Act;
“means test" has the same meaning
it has in the Act;
“monitoring performance" has the
same meaning as performance
monitoring in the Act;
“mutual health insurance scheme”
has the same meaning it has in the
Act;
“peer review” means the process by
which the treatment of a patient
or the performance of a healthcare
professional is reviewed by a
professional colleague either
within the professional
organisation or healthcare
facility;
“quality assurance" has the same
meaning it has in the Act;
"resident" means a person who
lives in this country for six
months or more in any period of
twelve months.
(2) The abbreviations found in
these Regulations have the
interpretation as set out in
Schedule III
Regulation 64—Transitional
provision
Notwithstanding any provision of
these Regulations to the contrary,
the Council is empowered to take
such administrative measures as it
considers necessary to enable
schemes to obtain healthcare
services from healthcare
facilities that are not yet
accredited by the Council for such
period as the Council finds
necessary.
Regulation 65—Revocation
The Hospital Fees Regulations 1985
(LI 1313) are hereby revoked.
SCHEDULES
SCHEDULE I
FORM 1
(Regulation 2)
NHIS
FORMS 1
PART I
APPLICATION FOR REGISTRATION AS A
HEALTH INSURANCE SCHEME
(regulation 2)
PART I—PARTICULARS OF APPLICANT
1. Name of applicant.........................................................................................................
2. Head office, postal address,
telephone, e-mail,
fax...................................................
................................................................................................................................................
................................................................................................................................................
3. Type of health insurance
scheme to be registered
(private/commercial, private
mutual, district mutual health
insurance scheme)
4. Name, address and occupation of
directors................................................................
................................................................................................................................................
................................................................................................................................................
................................................................................................................................................
5. Principal officer/manager.................................................................................................
6. Name, address and
qualifications of chief accounting
officer.........................................
................................................................................................................................................
................................................................................................................................................
7. Name, address of auditors.................................................................................................
................................................................................................................................................
................................................................................................................................................
Note:
* Attach annexures wherever
necessary.
* Do not leave any question
blank or unanswered: where
necessary, answer "Not applicable"
or "Not known".
* Upon completion, the original
of this Form and supporting
annexures should be submitted to:
The National Health Insurance
Council
P. O. Box MB44.
Accra.
8. Total number of all classes
of employees.......................................................................
.....................................................................................................................................................
9. Name and address of bankers.......................................................................................
................................................................................................................................................
................................................................................................................................................
10. Number of members of the
scheme and estimated dependants of
members as at the date of the
application
................................................................................................................................................
................................................................................................................................................
................................................................................................................................................
11. Provide details of applicant's
past and present membership of or
affiliation to any association
concerned with health insurance
schemes in Ghana or elsewhere,
including details of any refusal,
termination or lapsing of such
membership or affiliation and the
reason for it..........................................................................................................................
................................................................................................................................................
................................................................................................................................................
12. Is any director of the
applicant a director of another
scheme that carries on business in
Ghana? YES/NO. If yes, provide
details.....................................................................................................................................................................................................................................................................................................................................................................................................................................
13. The applicant or any director
of the applicant ever, under the
laws of this country or any other
country has—
(a) been adjudged or otherwise
declared insolvent or bankrupt and
has not been rehabilitated or
discharged? YES/NO.
(b) made an assignment to, or
arrangement or composition with,
his or her creditor which has not
been rescinded or set aside?
YES/NO.
(c) been convicted of theft,
fraud, forgery, uttering a forged
document or perjury or any other
offence, that is similar to any of
these offences? YES/NO.
(d) been convicted of any offence
and sentenced to a term of
imprisonment exceeding six months,
without the option of a fine, and
has not received a free pardon?
YES/NO.
If the answer to any of these
questions is yes, provide details.
Declaration
We, the undersigned principal
officer and board of directors of
the applicant, do hereby declare
that—
(a) the information given in
response to and in support of the
questions and matters in this Part
of this application is true and
correct to the best of our
knowledge and belief;
(b) this application is made in
good faith with the purpose and
intent that the affairs and
business of the applicant will at
all times be honestly conducted in
accordance with good and sound
principles and in full compliance
with all applicable laws.
Dated this..............................................................................................................................
Chairperson of the Board (print
name).................................................................................
Signature
Principal Officer/Manager (print
name)...............................................................................
Signature
Director (print name)............................................................................................................
Signature
Director (print name)............................................................................................................
Signature
Director (print name)............................................................................................................
Signature
Director (print name)............................................................................................................
Signature
PART II: PARTICULARS OF PRINCIPAL
OFFICER OR MANAGER
14. Name and address of principal
officer or manager (address of
head office in the case of a
corporate manager):
............................................................................................................................................................................................................................................................................................................................................................................................................................................................................
15. In the case of a corporate
independent manager, name and
address of the chief executive
................................................................................................................................................................................................................................................................................................................................................................................................................................................
16. Professional and academic
qualifications and employment
history (for the past 5 years,
listing, in reverse chronological
order, the name and address of the
employer, the nature or type of
business, job title and duties,
the date employed and reasons for
leaving) of the principal officer
and manager or, in the case of a
corporate independent manager, the
chief executive of the manager.
17. Does the principal officer or
manager act in the capacity of a
principal officer or independent
manager, or member of the
governing board, of any other
schemes? YES/NO. If yes, provide
details.
18. Has the principal officer or
manager or, in the case of a
corporate independent manager, any
director of the manager ever,
under the law of this country or
any other country
(a) been adjudged or otherwise
declared insolvent or bankrupt and
has not been rehabilitated or
discharged? YES/NO
(b) made an assignment to, or
arrangement or composition with,
his or her creditors which has not
be rescinded or set aside? YES/NO
(c) been convicted of theft,
fraud, forgery, uttering a forged
document or perjury or any other
offence, that is similar to any of
these offences? YES/NO
(d) been convicted of any offence
and sentenced to a term of
imprisonment exceeding six months,
without the option of a fine, and
has not received a free pardon?
YES/NO
If the answer to any of these
questions is yes, provided
details.
Declaration
by principal officer/manager or
chief executive of independent
manager I, the undersigned, do
hereby declare that all
information given in response to
and in support of the questions
and matters in Part II of this
application is true and correct to
the best of my knowledge and
belief.
Dated this.............................................................................................................................
................................................................................................................................................
Name and signature of principal
officer/manager or name and
signature of chief executive of
the independent manager.
Annexures to this application Form
provide as applicable to type of
scheme
1. List of branch offices,
address, telephone, e-mail, fax.
2. Certified copy of certificate
of incorporation under the
Companies Code 1963
(Act 179).
3. Constitution, bye-laws or
rules in the case of district
mutual or private mutual scheme.
4. Financial statement and cash
flow for the two years preceding
the date of the application for an
existing scheme.
5. In the case of a
private/commercial health
insurance company a feasibility
study and projection for the first
two years of operation containing
the following data:
(a) cash-flow analysis;
(b) gross premium income and
expenditure projections;
(c) assessment of the prospects
and profit potential for the next
five years.
6. Evidence of the ability to
pay security deposit required
where applicable.
NHIS
FORM 2
ACCREDITATION OF HEALTH CARE
FACILITY APPLICATION FORM
(Regulation 28(1))
Note: If any space is
insufficient for the information
required, please provide
additional information on a
separate sheet and where documents
are required, please attach
certified copies.
1. Name of healthcare facility.............................................................................................
................................................................................................................................................
......................................................................................................................................
2. Location (Street name, House
No)..............................................................................
........................................................................................................................................
3. Postal address and
Telephone/Fax/Email:...............................................................
................................................................................................................................................................................................................................................................................................
4.
Town........................................District.................................Region
................................................................
................................................................................................................................................
5. Name of Chief
Executive/Administrator/Proprietor:......................................................................................
........................................................................................................................................
6. Facilities:
1. Health care
available...............................................................................................
..........................................
................................................................................................................................................................................................................................................................................................
2.
Laboratory.............................................................................................................
............................................
................................................................................................................................................
3.
Surgery................................................................................................................
...............................................
................................................................................................................................................
4.
Maternity...................................................................................................................
5. Dental...........................................................................................................................
6.Physiotherapy...................................................................................................................................................................................................
7. Health personnel
1. Number of medical
practitioners:.........................................................................
....................................................................................................................................
2. Number of Nurses:..............................................................................................
....................................................................................................................................
3. Number of Dentists:............................................................................................
............................................................................................................................
4. Others...................................................................................................................
5. Evidence of qualifications of
healthcare
personnel............................................
...................................................................................................................
..............................................................................................................................
Declaration
I
......................................................................
Chief
Executive/Administrator/Proprietor
of............................................................................................................................................hereby
declare that to the best of my
knowledge and belief, the
information given on this
application form is correct.
Date:....................................................Signature:.................................................
NHIS
FORM 3
REPUBLIC
OF GHANA
(Ministry of Health)
CERTIFICATE OF ACCREDITATION
(Regulation 30(1))
Certificate No............................................................................................................
Grading.....................................................................................................................
This is to certify that the health
care facility known
as:....................................................
................................................................................................................................................
................................................................................................................................................
situated
at............................................................................................................................
has been granted accreditation in
terms of regulation 28 of the
National Health Insurance
Regulations 2004 (LI 1809) for a
period of
.......................................
year with effect from
......................................
to
...............................................
..................................................
...................................................
Chairperson
Executive Secretary
National Health Insurance Council
National
Health Insurance Council
Seal:
This certificate remains the
property of the National Health
Insurance Council and must be
surrended on demand.
DISTRICT MUTUAL HEALTH INSURANCE
SCHEME.
......................................SUB-METRO/DISTRICT
NHIS
FORM 4
IN-PATIENT TREATMENT COSTING SHEET
(Regulation 62)
..........................................................................................
HEALTH FACILITY
Patient
Name.....................................Admitted...........................Discharged.....................
ID No
............................................Insurance
No...........................................................
Patient
Number...............................
HFAC
..................................*Patient
Type...............
Hospital Ward..................
RFFC...................... Corp
Name................Debtor's
No.............
|
DATE |
DG
NO |
CODE |
DESCRIPTION |
QTY
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UNIT PRICE |
AMOUNT
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PROVIDER’S
SIGNATURE |
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PATIENT TYPE:
1-PAYING
2-FREE 3-HEALTH
INSURANCE
DISTRICT MUTUAL HEALTH INSURANCE
SCHEME
..................................
SUB-METRO/DISTRICT
NHIS
FORM 5
HEALTH FACILITY ATTENDANCE CARD
(Regulation 62)
Please check code for each episode
.
Episodes Codes
FD Code CCY Code MED
Code CONTRA
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
|
DT |
HFAC |
HFC |
Signature
(Scheme) |
Signature
(F. Desk) |
Signature (Diagnostic) |
Signature (Pharmacy) |
Signature (Med.Doctor) |
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DISTRICT MUTUAL HEALTH INSURANCE
SCHEME
..............................SUB-METRO/DISTRICT
NHIS
FORM 6
DIAGNOSTIC CARD
(Regulation 62)
HEALTH FACILITY
......................................Date.........................
Client's
Surname......................................First
Name
................................................
Unique No
.......................................
ID No............................
HI No. ........................
CONTRA
DF...................................
HFC
.............................
HFAC...................
D
Code(s)................................................
OPD
No...............................................
Prescriber's
Name...............................................................................................
Prescriber's ID No.
....................................................
Tel................................................
|
Date |
DF Code |
Diagnostic
Test |
Test Code |
Amount |
Signature |
Staff Code |
|
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Total Amount |
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(1)
...........................................
.............................
............................
Name (Professional
in-charge) Code
DFC
(2)
.............................................
..............................
..........................
Name (Professional
in-charge) Code
DFC
(3)
.........................................
...............................
.........................
Name (Professional in-charge)
Code
DFC
DISTRICT MUTUAL HEALTH INSURANCE
SCHEME
....................................................SUB-METRO/DISTRICT
NHIS
FORM 7
PRESCRIPTION CARD
(Regulation 62)
HEALTH FACILITY
................................................
Date.............................................................
Client's Surname
.........................................................
First Name
.................................................
Unique No.
........................................
ID No.
..........................
H/No............................................
CONTRA...........................................
HFC
...............................
HFAC..........................................
D
Code(s).........................................................
OPD
No....................................................................
Prescriber's Name
...............................................................................................................................
Prescriber's ID No.
.........................................................
Tel..........................................................
Date
Drug Code
Description Qty.
Amount Supplier
Code Supplier
Signature
Total
Amount
(1)
...........................................
......................................
.......................................................
Stamp (Health
Facility)
HCC
SCC
(2)
............................................
......................................
........................................................
Stamp (Health
Facility)
HCC
SCC
(3)
...........................................
......................................
.......................................................
Stamp (Health
Facility)
HCC
SCC
FOR OFFICE USE ONLY
DATE CLAIM
ACTIVITY CODE
OFFICER IN CHARGE
SIGNATURE
RECEIVED
VALIDATION
DATA
ENTRY
DATA
VALIDATION
CONTROL
PROCESSING
ACCEPTANCE
REJECTION
REVIEW
REVIEW
ACCEPTANCE
REVIEW
REJECTION
PAYMENT
REJECTED CLAIM
SENT BACK TO
HF
DISTRICT MUTUAL HEALTH INSURANCE
SCHEME
........................................
SUB-METRO/DISTRICT
NHIS
FORM 8
CLAIMS FORM
(Regulation 62)
Date
.......................................
Client's Surname
..................................................
First
Name.............................................................................
Unique No.
...........................................................
ID
No.............................
H/No.
...........................................
CONTRA ......................
REF..............................
RFT
...............................
HFC...............................................
GTS................................
HFAC............................
Review
Status................................................
........................
Status No. ......................
D No
.............................
PCD.......................................................................................
Doctor's
Name....................................................................................................................
...................................
Doctor's ID
No........................................................................................................................................................
Diagnosis
...............................................................
D.
Code..............................................................................
(Please complete if Client is
admitted)
Admission
(Date)..................................................
Authorized by (Name and
Code)............................................
Discharge(Date)....................................................
Authorized by (Name and
Code)............................................
Ward No
.............................................................
Bed
No...................................................................................
(Please complete the relevant
cells)
Activity
NON-DRUGS
DRUGS
HD Code HW Code
Amount Signature
Code Qty. Amount
Signature
Consultation
D.
Test
D.
Test
D.
Test
D.
Test
D.
Test
Blood
Bank
Dressing/Injection
Delivery
Admission
Theatre
Feeding
Others
SUB-TOTAL
GRAND
TOTAL
.....................................................
..........................................................
Signature
(Doctor)
Date
....................................................
..........................................................
Signature (Claims Dispatch
Officer)
Date
DISTRICT MUTUAL HEALTH INSURANCE
SCHEME
....................................
SUB-METRO/DISTRICT
DISTRICT MUTUAL HEALTH
NHIS
FORM 9
MEMBERSHIP/HOUSEHOLD REGISTRATION
COMPLETE ALL DETAILS REQUESTED
(PEASE PRINT CLEARLY)
SECTION 1 PERSONAL
DETAILS HOUSEHOLD HEAD
Family Name
...............................................
First Names (in
full)......................................................
Sex M F Date of
Birth
................................
Age
............................................................
Unique
No.............................
H/No.................................
WPC...........................................................
ID No.
................................
Marital
Status...........................................................................................
Nationality................................
N.
Code...............................................................................................
Educational
Attainment.........................
Habitation
Status....................................................................
Parent Status
........................................
Amount
Payable....................................................................
Occupation.............................................
Occupation
Code....................................................................
SECTION 2 CONTACT
DETAILS HOUSEHOLD HEAD
Residential Address
................................................
Address
Code.......................................................
Tel No
..................................................................
Cell Phone
No.....................................................
SECTION 3
EMPLOYMENT DETAILS HOUSEHOLD
HEAD
Name of
Company/Institution...................................................................................................................
Sector ID
........................................................
Company Unique
ID......................................................
Location Address
.............................................
Address
Code.................................................................
WPS
..............................
Activity Code
.................................
Size
Code.............................................
Tel. No
.................................................
Fax No
......................................................................................
E-Mail
.........................................................................................................
...........................................
SECTION
4
DEDUCTIONS
2.5% Deduction
............................................
Net Monthly
Income.....................................................
SSNIT Deductions
..........................................
SECTION
5
PERSONAL DETAILS HOUSEHOLD
HEAD
Family Name
.........................................
First Names (in
full).....................................................................
Sex M F Date of Birth
...................................................
Age...................................................
Unique No
..............................................
H/No
..............................
WPC................................................
ID No.
....................................................
Marital
Status..............................................................................
Nationality..............................................
N.
Code.......................................................................................
Educational
Attainment...........................
Habitation
Status.........................................................................
Parent
Status............................................
Amount
Payable.........................................................................
Occupation..............................................
Occupation
Code..........................................................................
SECTION 6 CONTRACT
DETAILS SPOUSE
Residential Address
.......................................................
Address
Code.............................................................
Tel. No
.......................................................................
Cell Phone
No............................................................
SECTION 7
EMPLOYMENT DETAILS SPOUSE
Name of
Company/Institution..........................................................................................................................
Sector
ID..........................................
Company Unique ID
........................
H/No........................................
Location
Address..............................
Address
Code.......................................................................................
WPS......................................
.......... Activity
Code.............................
Size
Code......................................
Tel. No
............................................
Fax
No................................................................................................
E-Mail
.......................................................
SECTION 8
DEDUCTIONS
2.5%
Deduction...................................................
Net Monthly
Income...........................
........................
SSNIT Deductions
..............................................
SECTION 9 PERSONAL
DETAILS (CHILDREN/DEPENDANTS)
Name Date of Birth Age
Sex Occ. Nat. WPC
Status Marital HHS
Code Relations
Signature/ Thumbprint
I/We hereby declare that the
content of the form have been
examined and certified as correct.
I/We also accept to join
....................................................
...................Health
Insurance scheme with my/our
family and pledge to adhere to the
tenets of the NHIS Act 650, the
Regulations made under the Act and
the Scheme's constitution.
...............................................................
.........................................................
Signature/Thumbprint
Signature/Thumbprint
(Head of Household)
(Spouse)
DISTRICT MUTUAL HEALTH INSURANCE
SCHEME
NHIS
FORM 10
COMPLAINT FORM
(Regulation 43 (3))
1. Name and address of
complainant...........................................................................................................................
.............................................................................................................................................................................
2. Name of
Scheme.....................................................................................................................................................
3.
District.........................................................................................................................
..........................................
4. Person/body against whom the
complaint is
made...........................................................
........................................
...................................................................................................................................
..........................................
5. Record of earlier submission
of the complaint to the
scheme...................................................................................
................................................................................................................................................
................................................................................................................................................
6. The nature of injustice, harm
or damage suffered arising from
the action, inaction or omission
of the person against whom the
complaint is
made....................................................................................................................................
................................................................................................................................................
7. The relief sought by the
complainant................................................................................
.......................................
................................................................................................................................................................................
8. Any other matter relevant to
the
complaint..............................................................................................................
................................................................................................................................................
Date:
...............................................................
Signature:......................................................................
SCHEDULE II
PART I
(Regulation 19(1))
MINIMUM HEALTHCARE BENEFITS
The healthcare services specified
in this Part are the minimum
healthcare benefits under the
national health insurance scheme
and shall be paid for by the
schemes.
1. Out-patient Services
(1) Consultations including
reviews: These include both
general and specialist
consultations.
(2) Requested Investigations
including laboratory
investigations, x-rays and
ultrasound scanning for general
and specialist out-patient
services.
(3) Medication, namely,
prescription drugs on National
Health Insurance Scheme Drugs
List, traditional medicines
approved by the Food and Drugs
Board and prescribed by accredited
medical and traditional medicine
practitioners.
(4) HIV/AIDS symptomatic
treatment for opportunistic
infection.
(5) Out-patient/Day Surgical
Operations including hernia
repairs, incision and drainage,
haemorrhoidectomy.
(6) Out-patient Physiotherapy.
2. In Patient services
(1) General and Specialist
in-patient care.
(2) Requested Investigations
including laboratory
investigations, x-rays and
ultrasound scanning for
in-patience care.
(3) Medication, namely,
prescription drugs on National
Health Insurance Scheme List,
traditional medicines approved by
the Food and Drugs Board and
prescribed by accredited medical
and traditional medicine
practitioners, blood and blood
products.
(4) Cervical and Breast Cancer
Treatment
(5) Surgical Operations.
(6) In-Patient Physiotherapy.
(7) Accommodation in general
ward.
(8) Feeding (where available)
3. Oral Health services
including
(a) Pain Relief which includes
incision and drainage, tooth
extraction and temporary relief;
(b) Dental Restoration which
includes Simple Amalgam Fillings
and Temporary Dressing.
4. Eye Care services including
(a) Refraction;
(b) Visual Fields;
(c) A- Scan;
(d) Keratometry;
(e) Cataract Removal;
(f) Eye Lid Surgery;
5. Maternity care including
(a) Antenatal Care;
(b) Deliveries, namely, normal and
assisted;
(c) Caesarian Section;
(d) Postnatal care.
6. Emergencies
All emergencies shall be covered.
These refer to crisis health
situation that demand urgent
intervention and include,
(a) Medical emergencies;
(b) Surgical emergencies
including brain surgery due to
accidents;
(c) Paediatric emergencies;
(d) Obstetric and Gynaecological
emergencies including Caeserian
Sections;
(e) Road Traffic Accidents;
(f) Industrial and workplace
Accidents;
(g) Dialysis for acute renal
failure.
7. Accessing Services Under the
Health Insurance Scheme
(1) The first point of
attendance, except in cases of
emergency, shall be a primary
healthcare facility, which
includes Community-based health
Planning and Services (CHIPS),
Health Centres, District
Hospitals, Polyclinics or
Sub-metro Hospitals, Quasi Public
Hospitals, Private Hospitals,
Clinics and Maternity Homes.
(2) In localities where the only
health facility is a Regional
Hospital, the General patient
department shall be considered a
primary healthcare facility.
(3) All health care services
provided in these facilities shall
be paid for by the District Mutual
health Insurance Schemes (DMHIS).
(4) In cases where the services
are not available, all referred
cases other than those in the
Exclusion List shall be paid for
by DMHIS.
(5) Emergencies shall be
attended to at any health
facility.
SHEDULE II—PART 2
(Regulation 20)
EXCLUSION LIST
1. The healthcare services
specified in this Part of this
Schedule are not covered under the
minimum benefits available under
the National Health Insurance
Scheme.
2. Health insurance schemes may
decide to offer any of these as
additional benefits to their
members.
Excluded are the healthcare
services that fall under any of
these groups;
(a) Rehabilitation other than
physiotherapy;
(b) Appliances and prostheses
including optical aid, hearing
aids, orthopedic aids, dentures;
(c) Cosmetic surgeries and
aesthetic treatments;
(d) HIV retroviral drugs
(e) Assisted Reproduction eg.
Artificial insemination and
gynaecological hormone replacement
therapy;
(f) Echocardiography;
(g) Photography
(h) Angiography;
(i) Orthoptics;
(j) Dialysis for chronic renal
failure;
(k) Heart and brain surgery other
than those resulting from
accidents;
(l) Cancer treatment other than
cervical and breast cancer;
(m) Organ transplantation;
(n) All drugs that are not listed
on the NHIS Drug List;
(o) Diagnosis and treatment
abroad;
(p) Medical examinations for
purposes of visa applications,
educational, institutional,
driving licence;
(q) VIP ward (Accommodation);
(r) Morturary Services.
PART 3
(Regulation 19(4))
FREE PUBLIC HEALTH SERVICES
The following healthcare services
are free:
(a) Immunization;
(b) Family planning;
(c) In-patient and Out-patient
treatment of mental illnesses;
(d) Treatment of Tuberculosis,
Onchocerciasis, Buruli Ulcer,
Trachoma;
and
(e) Confirmatory HIV test on
AIDS Patients.
SCHEDULE III
(Regulation 63 (2))
NATIONAL HEALTH INSURANCE SCHEME
(NHIS) OPERATIONAL ABBREVIATION
INTERPRETATIONS
1.
GTS
Gate
Keeper Status
2.
RFF
Referral Facility (from)
3.
RFT
Referral Facility (to)
4.
RS
Review Status
5. FD
Code
Front Desk Code
6.
CCY
Consultancy Code
7. PH
Code
Pharmacy Code
8. Contra DF
Diagnostic Facility Contra
9.
DT
Date
10.
HFAC
Health Facility Attendance
Control Code
11.
HFC
Health
Facility Code
12.
PSC
Patient Status Code
13.
DG
Diagnosis
14. OCC
Code
Occupation Code
15.
WPC
Work Place Code
16.
WPS
Work Place Status
17.
DFC
Diagnostic Facility Code
18. RC
Results Code
19.
T
Test
20.
R
Results
21.
PC
Patient Code
22.
CP
Co-payment
23.
ID
Identification
24.
HI
Health Insurance
25.
HD
Health Delivery
26.
HW
Health Worker
27.
PSN
Patient H.I. Scheme Number
28. SC
Supplier Control Code
29.
HFCC
Health Facility Control Code
30.
HF
Health Facility
31. RC
Relations Code
32.
HHS
Household Status
33.
HN
— Household Number
34. H
—
House Number
35.
T
— Town/Village/Community
36.
S
— Street/Road/Path
37.
AG
— Age
38.
BAL
— Balance
39.
FA
Facility Attendance
40. DST
Disease Status
41.
DS
Disease Code.
42.
D-TEST
— Diagnostic Tests
DR. KWEKU AFRIYIE
Minister Responsible for Health
Date of Gazette Notification: 24th
September, 2004.
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