Three pharmacies suspended by NHIA over suspected fraudulent NHIS claims

The National Health Insurance Authority (NHIA) has suspended three pharmacies from operating under the National Health Insurance Scheme (NHIS) over suspected fraudulent claims and irregularities in service transactions.

In a public notice issued on Thursday, May 14, 2026, the Authority announced the immediate temporary suspension of the three pharmacies [names withheld] following what the NHIA said was a routine claim verification exercise.

According to the NHIA, investigations uncovered “material irregularities in claims and service transactions associated with these facilities,” raising “reasonable suspicion of fraud and abuse under the NHIS Provider Service Agreement.”

The suspension took effect on May 14, 2026, and bars the affected pharmacies from providing services or dispensing medicines under the NHIS until further notice.

The statement, signed by NHIA Chief Executive, Victor Asare Bampoe, said the Authority was commitment to transparency, accountability and the prudent use of public funds in delivering quality healthcare services across Ghana.

“The pharmacies are not permitted to provide services or dispense medicines under the NHIS during the suspension,” the Authority stated.

The NHIA advised NHIS subscribers seeking pharmaceutical services to visit other accredited providers nationwide while investigations continue.

“NHIS members who require pharmaceutical services are encouraged to seek care from other credentialed NHIS providers nationwide,” the statement read.

The Authority further warned all accredited healthcare providers against engaging in practices that threaten the sustainability of the Scheme.

“The Authority will not tolerate fraudulent or abusive practices that undermine the sustainability of the NHIS, which may deprive members of quality healthcare services,” the statement said.

The NHIA also reminded service providers of the legal implications of defrauding the Scheme, stressing that offenders could face fines, imprisonment of up to 10 years, or both upon conviction.