The Proprietor of Health Frontiers Laboratory Limited at Amansie in the Ashanti Region, Dr Dennis Osei, has been arrested for allegedly defrauding the National Health Insurance Authority (NHIA) of GH¢140,858.45.
The alleged fraud was detected after an audit by the NHIA covering the period January to December 2013.
Dr Osei is currently in custody at the Criminal Investigations Department (CID) Headquarters in Accra assisting the Fraud Unit in investigations.
The medical practitioner, who is also the owner of some clinics and laboratories in the Amansie District in the Ashanti Region, is alleged to have forged medical folders and particulars for claims of non-existing NHIS card holders who were referred to Health Frontiers Laboratory by some hospitals within the stated period.
He is also alleged to have forged the signatures and the stamps of the said hospitals on the cards of the non-existing users to facilitate his operations. However, all the referral hospitals denied having treated any such patients or referred them to Dr Osei’s laboratory.
The suspect is currently in police custody for conspiracy to defraud and forging of documents and will soon be processed for court.
Similar case last week
A similar operation was carried out by the audit team of the NHIA which led to the arrest of the Medical Superintendent of the Essikado District Hospital in the Western Region, Dr N.K. Ametewee, and his younger brother, Francis Ametewee, on January 27.
Dr Ametewee was also alleged to have duped the authority to the tune of GH¢415,439.15.
He is currently on bail, while investigations are still ongoing.
The NHIA has recently come under attack for its inability to pay service providers across the country.
Media brief
Briefing the media in Accra yesterday, the Head of the Fraud Unit of the CID Chief Superintendent Felix Koku Mawusi said the Chief Executive Officer of the NHIA, Mr Sylvester Mensah, made a report to the CID about fraud perpetrated by a medical officer in the Ashanti Region, which led to Dr Osei’s arrest.
He explained that the clinical audit team of the NHIA usually organised audits after claims had been submitted by both private and public hospitals, as well as clinics and laboratories, from all the 10 regions of the country.
It was in the period January to December 2013, that the audit team realised that Dr Osei had submitted fraudulent claims of NHIS card users for claims for his private laboratory, Health Frontiers, an NHIS service provider.
According to Chief Supt Mawusi, Dr Osei also made claims for services which were not available under the scheme at his health facility.
The other facilities owned by the suspect, namely the Asumaja Clinic, the Denmida Laboratory and Health Frontiers laboratories at Manhyia, Abuakwa and Goaso, are also being investigated.
