Ghana National Health Insurance Authority operations

The National Health Insurance Authority (NHIA) in Ghana has reported significant developments in insurance coverage and provider reimbursements. In the Ahafo Region, coverage reached 87% in 2025, exceeding targets and marking a second year of achieving what the NHIA defines as “Universal Health Coverage” within its scope. This region was also the first to utilize the One-Time Attendance Code (OTAC) system to prevent identity fraud.

Nationally, the NHIA disbursed GH¢382.85 million in claims during September 2026, contributing to a cumulative yearly total of GH¢2.115 billion. In the latter half of 2026, the Authority paid GH₵83.1 million in claims, a notable increase from the GH₵27.8 million recorded throughout 2025. By October 2026, monthly disbursements reached GH¢210.36 million, bringing the total yearly claims payments to GH¢2.325 billion.

While Parliament’s Health Committee commended the Authority for prompt disbursements that reduce out-of-pocket costs for patients, the NHIA acknowledged that “leakages persist within its claims payment system.” The Authority is working to identify and close these loopholes to improve efficiency.

Additionally, the NHIA has issued a warning to healthcare facilities against charging members unauthorized fees for services covered under the National Health Insurance Scheme (NHIS) benefit package. The Authority reported that some facilities have been compelling patients to pay extra for medicines and procedures. To address provider concerns, the NHIA implemented upward tariff adjustments of approximately 50 percent. Facilities found imposing unauthorized charges face sanctions, including fund recovery, suspension of credentialing, or referral to law enforcement.