HRM,CHPS,NHIs Flashcards

Question

What is the purpose of audit procedures? Who develops the audit procedures and who approves it? What happens if a decision is made not to perform one or more of the procedures?

Answer 1

The purpose of audit procedures is to provide detailed audit steps to be performed to achieve the specific audit objectives. The audit procedures are developed by the auditor and approved by the MDA management prior to performance of the audit procedures. •If prior to the approval by MDA management, a decision is made not to perform one or more of the procedures, a note documenting the reasons for the decision is included in the audit procedures.

Answer 2

The specific objectives of any audit will address one or more of the following general management objectives: •Risks are appropriately identified and managed. •Interaction with the various governance groups occurs as needed •Financial, managerial, and operating information is accurate, reliable, and timely •Resources are acquired economically, used efficiently, and adequately protected. •During the course of the audit, conditions may arise which warrant revising the audit procedures, scope, or budgeted hours. The auditor should evaluate the situation, make timely recommendations to audit management, and obtain approval before incorporating any changes.

Answer 3

``` Common pitfalls and their implications •Misappropriation/embezzlement of funds. •Misapplication of funds. •Non-acquittal of P.Vs. •Un-presented /missing P.Vs. •Un-retired Programme/Project funds. •Mis-procurements. •Deficiencies in Store Records. •Undue retention of W/holding Tax. •Personnel/Payroll irregularities. •Refusal/failure to pay-back Staff Advances. ```

Answer 4

Procurement policies and procedures follow a logical pattern and are designed to ensure that the procurement process adheres to the financial regulations and procurement law. (Procurement Act 2003, Act 663) for Ghana •The main processes common to all procurements include supplier selection, requesting information, tender submission, tender evaluation, contract award and inspection.

Answer 5

Supplier Selection •Most companies will keep a list of preferred suppliers that the procurement department manages and updates. Suppliers on a preferred list will have undergone some form of selection process to evaluate them against criteria such as cost, quality and compliance Requesting Information •This is a core function of the procurement department. When there is a need to purchase something, the procurement department finds wholesalers or retailers that can effectively deliver the requirement. •Once suppliers have been identified, the team will develop a specification, which details the description of the requirement and sends it to the suppliers who will be asked to return quotes on prices for needed goods and services.

Answer 6

Tender Returns •Tenders usually have to be returned to the procurement on a specific day and time. The returned tenders will include the description and price for the service/ product required, financial information detailing the suppliers accounts, etc. Tender evaluation •Returned tenders are distributed to internal specialists who evaluate the different parts of the tender. The Procurement department will usually assess the pricing schedules and collate and prepare a recommendations report within a time line. 5. Contract Award •The procurement department will inform all suppliers of their decision. It is best practice to offer all unsuccessful suppliers a debrief to help them understand where their bid failed. Successful suppliers are notified in writing of their success

Answer 7

Contract Conclusion •A post-contract meeting offers both supplier and buyer improvement opportunities. •At the end of the contract, when the service or product has been delivered, the procurement team will check that all of the terms of the contract have been met and they are happy with the performance of the suppliers. •After this has been satisfactorily completed, the buying organization will typically authorize payment to be made.

Answer 8

From the late 1950s up to 1966, when the Convention Peoples’ Party government was overthrown, healthcare financing in Ghana was virtually free. •Ghanaians were asked to pay for their healthcare during subsequent regimes. Drugs and consumables were highly subsidized. •In the 1980’s the poor economic situation of the country led to low staff morale and poor hospital attendance. Cash and Carry’ the system of healthcare financing introduced by the PNDC survived until 2004 when the present health insurance system came into being. •Under Cash and Carry’, patients were required to pay for drugs and some medical consumables while the state bore all other costs including consultation, salaries and emoluments of health workers in state hospitals. •Experimentation of various insurance schemes-CHAG (Nkoranza, Techiman schemes) and private schemes like nationwide mutual, Medex etc acted as precursors The New Patriotic Party (NPP) enacted, the National Health Insurance Act 650 in 2003, which led to the establishment of a National Health Insurance Scheme(NHIS) in 2004 under a National Health Insurance Authority(NHIA). •Funding for the NHIS are from two main sources:- the NHI Levy, a 2.5% top up of the Value Added Tax (VAT), and a 2.5% transfer from the existing Social Security and National Insurance Trust. For those not on SSNIT, paying an annual premium

Answer 9

arrangement with a company or an institution in which regular amounts of money are paid so that the company/institution pays the cost of some service as and when needed. •It is a security •It serves as a guarantor for bank loans Examples of Insurance coverage: •Death, •Ilness, •Loss of a material (car, building, ship, shop, factory etc) through accident, theft or fire.

Answer 10

Premium: •The regular contributions paid by the clients towards the scheme. Solidarity: •The strength of a scheme is based on the number of contributors. The larger the number of contributors the stronger the scheme. “Consider the Broom”. •There is risk sharing and risk equalization Morale Hazard: • Providers continue to prescribe more drugs and expensive diagnostics. And clients also abuse the system by accessing health care even when they could avoid visits to health facilities. Benefit Package: •Minimum services that members can receive.

Answer 11

``` DESIGN OF A BASIC HEALTH INSURANCE SCHEME: Also referred to as the pillars are:- •Scheme administration •Clients of the Scheme •Providers of health services to the Scheme ```

Answer 12

Fee for service: • payment to a provider is based on each service rendered. * Ensures high quality service to clients since providers will undertake all services required by the patient without worry * It is subject to abuse by providers through request of sometimes unnecessary tests. This could raise the cost of insurance payment if a proper costing system and monitoring is not adopted due to the excessive drug prescriptions and diagnostics. 2. Co payment 3. capitation 4. diagnostic related grouping

Answer 13

Co-payment * The client is made to pay a certain amount of money any time he/she receives a service. The amount he/she pays is a proportion of the actual cost of services. * It helps checks abuse of services as the client always has to pay some part of the medical bill * It can affect access to health care by the insured because of the payment demanded. Capitation •an agreement on the payment of a fixed amount of money to providers irrespective of whether services have been rendered or not * May be cheaper for the management unit since providers do not charge per service. * Quality of service may be compromised when funds approved by scheme do not meet the cost of services rendered by providers. Diagnostic related grouping (DRG) •an agreement on the payment of a fixed amount of money to providers based on diagnosis related groupings. Eg. OPD, PAED 36C, MED 128A, ZOOM, OBGY06A •May be cheaper for the management unit since providers do not charge per service but based on diagnosis. •Quality of service may be compromised when funds approved by scheme do not meet the cost of services rendered by providers.