The National Health Insurance Authority (NHIA) has inaugurated its first-ever Adjudication Committee to strengthen the fair, impartial and timely resolution of disputes arising from the administration of the National Health Insurance Scheme (NHIS).
The establishment of the committee, under Section 106 of the National Health Insurance Act, 2012 (Act 852), marks the first practical implementation of the adjudicatory mechanism envisaged by the law since its passage.
The 10-member committee was inaugurated by the Chairman of the NHIA Governing Board, Lawrence Nii Okantey Adjetey, at the Authority’s Head Office in Accra on Monday.
The committee is chaired by retired Justice of the Superior Courts of Judicature, Justice Abdul Yusif Asibey. Other members include Dr Alex Peasah Koduah of the Medical and Dental Council, Professor Vida Yakong of the Health Facilities Regulatory Agency, Joyce Adu of the Institute of Chartered Accountants, Pharm. Samuel Antwi Kwakwa of the Pharmacy Council, Nelly Bernice Wallace of the Department of Social Welfare, Mrs Sophia Gifty Wiredu of the Nurses and Midwives Council, and Dr Senanu Kwesi Djokoto, Deputy Chief Executive Officer in charge of Operations at the NHIA.
Addressing the inauguration ceremony, Mr Adjetey described the event as a significant milestone in the implementation of the National Health Insurance Act.
“Today, we inaugurate the Adjudication Committee established under Section 106 of the National Health Insurance Act, 2012 (Act 852). For the first time since the Act was passed, the Authority is giving practical effect to the adjudicatory mechanism the law envisaged,” he said.
He expressed appreciation to the Minister of Health, Kwabena Mintah Akandoh, for constituting the committee and underscored the NHIA’s central role in Ghana’s healthcare financing system.
According to him, disputes and grievances were inevitable in the management of a nationwide health insurance scheme, making it necessary to establish a credible mechanism to ensure fair and transparent resolution of such matters.
Mr Adjetey stressed that the success of the committee would not be measured solely by the number of cases determined but by the fairness of its proceedings, the quality of its decisions and the confidence it inspires among stakeholders.
He urged members to discharge their duties with independence, impartiality, fairness and integrity while adhering strictly to due process.
The Board Chairman further called on members to uphold the highest ethical standards, avoid conflicts of interest and maintain strict confidentiality, noting that public trust in the adjudication process would depend largely on the committee’s professionalism and integrity.
“As the first committee constituted under the Act, members have a unique opportunity to establish procedures and institutional standards that will shape future adjudication within the Authority,” he stated.
In a speech delivered on his behalf by the Deputy CEO in charge of Human Resource and Administration, Raphael Segkpeb, the Chief Executive of the NHIA, Dr Victor Asare Bampoe, pledged Management’s full support and cooperation to the committee.
Dr Bampoe described the committee as an important independent forum for reviewing contested decisions concerning members’ benefits, claims processing, provider accreditation and entitlements under the NHIS.
He said the body would strengthen institutional accountability and provide a credible avenue for impartial review of decisions taken by the Authority.
“In the course of its work, the Authority takes decisions that bear directly on providers, beneficiaries and other stakeholders. While the majority of these decisions will be sound, some will inevitably be contested. An institution confident in the quality of its work should welcome a credible forum in which such decisions can be examined,” he noted.
The NHIA Chief Executive outlined three commitments by Management to support the committee. These include providing prompt access to records, information and officers required for its work, respecting and implementing its determinations without delay, and ensuring that no officer attempts to influence the outcome of matters before the committee.
Responding on behalf of the committee, Justice Asibey expressed gratitude to the Minister of Health and the NHIA Management for the confidence reposed in members.
He assured stakeholders that the committee would discharge its mandate diligently and ensure the fair, impartial and legally sound determination of disputes brought before it.
The inauguration is expected to strengthen governance, accountability and stakeholder confidence in the administration of the National Health Insurance Scheme while providing an independent framework for resolving disputes within the Authority.