Green Party leader, Sinkamba, urges govt to resolve challenges facing health insurance scheme

Green Party president, Peter Sinkamba, says government should quickly move in and resolve challenges facing the National Health Insurance Authority (NHIMA) members countrywide.

Sinkamba in a statement issued in Lusaka on Monday said it was regrettable and inconveniencing to NHIMA clients when private pharmacies turn them away.

He said this defeats the objective for establishment of NHIMA.

Sinkamba said government should ensure timely payments from NHIMA to healthcare providers so as to create financial stability and enable the provision of quality services.

“Delays in payments has led to pharmacies prioritizing cash sales over providing medicines to NHIMA clients. Healthcare providers, including pharmacies, experience a significant rate of claim rejections from NHIMA,” he said.

He noted that this had resulted in frustration and financial losses, hence literarily y all pharmacies, including top notch ones prioritize cash sales to mitigate the risk of non-payment.

Sinkamba noted that NHIMA’s pricing structure for medications differs from market values, posing financial challenges for pharmacies.

“Furthermore, low reimbursement rates lead to incentivize pharmacies to focus on cash sales at market prices to maintain profitability,” he said.

Sinkamba said the cumbersome administrative requirements and manual claims submission processes contribute to a higher rate of rejections for pharmacies.

He added that the manual nature of paper claims increases the risk of errors, incomplete information, and discrepancies, leading to rejections and delays in reimbursement processing.

“Overall, NHIMA is well intended and many pharmacies are ready to support its success, especially if these issues are sorted out with relevant stakeholders,” Sinkamba said.

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