Doctors in NHI programme impacted by payment delays

Doctors in NHI programme impacted by payment delays

By KEILE CAMPBELL

Tribune Staff Reporter

kcampbell@tribunemedia.net

THE National Health Insurance Authority (NHIA) has yet to issue a definitive payment schedule for outstanding balances owed to healthcare providers for May, and potentially June, raising alarms among clinics that rely on timely reimbursements to operate.

In a letter addressed to participating general practitioners and clinics, the NHIA assured providers it would keep lines of communication open but offered no clear answers.

Several healthcare providers, speaking anonymously due to fear of reprisal, told The Tribune that they have not received full payments since mid-May. Some were paid partially, while others were not paid at all. One clinic reported it received only half of what it was owed.

A general practitioner said their clinic has had to tap into credit lines to stay operational, with some even preparing for potential layoffs if the delays continue. 鈥淭hey say they鈥檙e communicating, but all we hear is that they鈥檙e working on it. That does not pay rent or payroll,鈥 the physician said.

Others echoed similar frustrations, saying they were left in limbo without clarity on when payments would resume. One clinic manager noted they鈥檝e begun prioritising urgent care only and warned that prolonged delays could force them to close their doors.

Adding to the burden are unexplained patient delistings from NHI rosters. Multiple providers said patients who had visited their clinics within the past year were removed from the system, some without any prior notice. One doctor noted they had proof of recent visits despite NHIA claims that the patients had been inactive for two years.

Another provider explained that these unexplained adjustments are reducing capitation payments, directly impacting their monthly revenue streams. Some patients are now experiencing longer wait times or being diverted to private care, often unaware they鈥檝e been removed from the NHI registry.

This is not the first time the NHIA has been criticised for delayed payments. In April 2023, providers raised concerns after payments scheduled for the 15th of the month were only partially disbursed five days late, with the remainder paid even later. At the time, NHIA offered no explanation for the delay, prompting providers to question the authority鈥檚 financial stability. 鈥淚f you can鈥檛 pay your bills on the day you鈥檙e supposed to pay them, then that鈥檚 a problem,鈥 one doctor said in 2023, describing it as the first instance of such a significant delay.

While officials then insisted that NHI remained financially stable, the recurrence of delayed payments is likely to renew concerns about the programme鈥檚 reliability and the strain it places on the healthcare network.

Former Health Minister and FNM chairman Dr Duane Sands said the government remains 鈥渋n massive arrears鈥 and criticised what he described as expecting providers to work without pay.

鈥淚t is surreal for the minister to make these promises when the PHA and Ministry of Health are in such a serious cash crunch,鈥 he said. 鈥淵ou cannot expand benefits when you are not paying for the ones you already offer.鈥

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