NHIA begins 50% NHIS tariff increase, introduces digital claims verification

NHIA begins 50% NHIS tariff increase, introduces digital claims verification

The National Health Insurance Authority (NHIA) has commenced the phased implementation of revised service tariffs for credentialed healthcare providers, beginning with a 50 per cent increase in current NHIS tariffs.

Ernest Arhinful
Aug 13
NHIA begins 50% NHIS tariff increase, introduces digital claims verification

The National Health Insurance Authority (NHIA) has commenced the phased implementation of revised service tariffs for credentialed healthcare providers, beginning with a 50 per cent increase in current NHIS tariffs.

The first phase of the adjustment began in August 2026, with full implementation expected by October.

The NHIA says the move follows a nationwide stakeholder review and is aimed at improving provider reimbursement, strengthening healthcare delivery and ensuring the long-term sustainability of the National Health Insurance Scheme.

NHIA begins 50% NHIS tariff increase, introduces digital claims verification

The Authority says the phased implementation will allow it to strengthen financial and accountability controls before the full tariff adjustment takes effect.

It estimates that about 15 per cent of claims currently reimbursed may be ineligible, resulting in approximately GH¢400 million in annual losses. Without corrective measures, the losses could rise to nearly GH¢1 billion annually after the full tariff increase.

NHIA begins 50% NHIS tariff increase, introduces digital claims verification

To address claims leakages, the NHIA is introducing the One-Time Attendance Code (OTAC), a digital verification system designed to confirm that patients attended health facilities and received the services for which claims are submitted.

NHIA begins 50% NHIS tariff increase, introduces digital claims verification

The OTAC system is currently being piloted in the Ahafo and Western North Regions ahead of a nationwide rollout.

The NHIA says the system will improve transparency, minimise fraud and safeguard NHIS funds, while it continues working with providers to improve claims quality and ensure prompt payment of validated claims.

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