Reps, NHIS differ on fate of HMOs

From Kemi Yesufu, Abuja

The decision to retain health maintenance organisations (HMOs) as part of the country’s health insurance programme caused a major disagreement between the House of Representatives Committee on Health Services and the executive secretary of the National Health Insurance Scheme (NHIS), Prof. Yusuf Usman.

Usman, at the just concluded two-day investigative hearing of the committee on the compliance rate of HMOs to the NHIS contributions and utilisation of funds by the health care services providers (HCPs), said that he would maintain the newly introduced  regime of paying HMOs monthly, jettisoning their quarterly payment. 

The NHIS boss also vowed that he would only re-accredit HMOS, some of whose accreditation had expired since 2013, when they cleared the debts  owed hospitals.

Usman, who suggested that hospitals be paid directly and not through HMOs, equally expressed regret that with about N60 billion paid them from 2005 to 2016 just for administration fee, majority of enrollees have reports of disrespect and poor treatment meted out to them at health facilities. 

“We are fixing the mistakes and you (pointing at HMOs representatives) are the big mistake we are going to fix.

“There is corruption, the number of enrollees was padded with 23,000 names. We will pay hospitals straight from our office. This we will do to save Nigerians money,” Usman said.

However, in his ruling, the chairman of the committee, Chike Okafor, stated that any action to be taken by Usman must conform with the NHIS  Act.

“I will look at the NHIS Act again and if it says you have to pay the HMOs every three months, you will have to keep to the law.

“If the law stays you must pay hospitals through HMOs, you have to comply until the relevant section of the (NHIS) law is amended. We are lawmakers, not law-breakers and we have to ensure that the right thing is done,” he said. 

Okafor assured the parties of the neutrality of the committee, adding that improving the quality of care provided Nigerians should be the ultimate goal of all stakeholders.

The lawmaker further stated that the committee would back the debt recovery effort of the NHIS as patients are often denied treatment at facilities where HMOs are not up-to-date with payment.

He expressed confidence that the committee would come up with workable recommendations to assist in reforming health insurance in the country.

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