We detected these findings through our Clinical Audits long ago

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The damning findings in the recently released Auditor-General?s report against the National Health Insurance Authority (NHIA) for the period January 2008 to December 2009 are legitimate and a true reflection of what happened at the time, the Authority?s Chief Executive, Sylvester Mensah has confirmed.

Mr Mensah said over 90 percent of the adverse findings in the report had already been detected by a comprehensive internal audit the Authority undertook immediately he became Chief Executive in June 2009. He added that pragmatic measures had since been put in place to prevent its recurrence.

?We detected these findings through our Clinical Audits long ago, but we decided to act on them rather than make the findings public issue for media discussion. Some culprits have been sent to court, some have been jailed, some have been interdicted, and several millions of the tax payer?s monies that went into wrong pockets have been retrieved and put to good use.

?The challenge is not with the report but rather the manner in which sections of the media deliberately pick and choose portions of the report and sensationalise them to make it look as though the Authority cannot account for some money and that is why payment to the service providers has delayed under my watch. This is wickedly misleading and preventable if the persons running with the report had taken time to study it properly,? Mr Mensah explained.

On the findings that monies from the Authority were diverted into a non-existent account, Mr Mensah said it was the Authority that uncovered the ploy to commit fraud, investigated the findings, handed the culprits to the police, who sent them to court.

He said the case proceeded for five years until just a few months ago that the culprits were jailed five years each.

The chief executive said the two were a scheme manager and an accountant of Samatek Hospital. He disclosed that the two had diverted an amount of GH?131,409.26 to an unknown account.

On a claim that the NHIA paid monies to some providers in 2008 even when their claims had not been vetted, Mr Mensah noted that though he was not at the NHIA at the time, in his view and in practice, there was nothing wrong with the advance payment made to those facilities prior to the vetting of their claims.

According to the chief executive, the NHIA usually agreed to requests from some facilities in distress to make about 40 to 50 percent advance payment on the face value of their claims when there is obvious delay in the vetting to allow for essential payments such as salaries for the facility while vetting continued and the rest topped up after vetting was concluded.

By Halifax Ansah-Addo (Twitter: @HalifaxAnsahAdd)

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