NHIS, HMOs disagree over N381b for healthcare

The Executive Secretary of the National Health Insurance Scheme (NHIS), Prof. Yusuf Usman, has disagreed with Health Maintenance Organisations (HMOs) over the usage of N381 billion for the healthcare of Nigerians within the past 12 years.

Usman testified yesterday before the Chike Okafor-led House of Representatives panel probing into the compliance rate of HMOs to the NHIS contributions and utilisation of funds by the healthcare providers and inhuman treatment of enrollees. He described the HMOs as a bunch of cartel that had perpetrated a huge fraud to the detriment of the well-being of the citizenry.

He also lamented that Nigeria is far below less-endowed countries like Rwanda and Kenya in health coverage for its populace, saying that contrary to claims by the HMOs, only 1.5 per cent of Nigerians have access to healthcare under the NHIS scheme.

The NHIS chief, who accused the HMOs of dragging him to the anti-graft agencies like Economic and Financial Crimes Commission (EFCC) and the Independent Corrupt Practices and other related offences Commission (ICPC) as part of the agenda to frustrate him from repositioning the NHIS scheme, alleged that the HMOs actually “padded” the numbers of enrollees to achieve pecuniary benefits.

He alleged that his outfit uncovered how the HMOs pay a paltry 25 per cent of monies collected as capitation fees to provide healthcare service to beneficiaries of the scheme, claiming that the HMOs were indebted to the tune of N3.5 billion to the healthcare providers.

He vowed that he would not accredit any of the 57 HMOs that fail to show convincing evidence of non-indebtedness to accredited hospitals in the country by July this year.

Usman, who disclosed how he was able to weed out 23,000 ghost enrollees from the NHIS data system, noted that he would leave no stone unturned to ensure adequate coverage of Nigerians in the NHIS scheme.

He further stated that he would engage NHIS desk officers to checkmate the incidence of alleged fraud associated with the HMOs. Calling for the probe of the role played by the HMOs in sabotaging the NHIS scheme, he canvassed, among others, the immediate removal of the HMOs from the board of the NHIS.

HMOs, under the aegis of the Health and Managed Care Association of Nigeria (HMCAN), faulted claim that they got N381 billion, adding 70 per cent of the amount was paid to healthcare providers in the country within the period under review.

Meanwhile, HMCAN’s Chairman, Dr. Tunde Oladele, has described the scathingly attack on their activities as a clear case of open hatred for his members, adding: “It is a deliberate attempt to stifle, disrupt and destroy the health insurance scheme.”

Saying that the NHIS chief had a poor knowledge of the working of the health insurance scheme, he cited how he turned a pre-paid scheme to a post-paid scheme to substantiate their claim.

Insisting that the total number of enrollees on the public sector scheme ranges between 7.8 million to 7.9 million, which is less than five per cent of the 170 million population of Nigerians, he urged the lawmakers to direct the NHIS to account for all the deductible amount just as they canvassed a change in the name of NHIS to the National Health Insurance Commission to confine the agency to its regulatory role.

Director, Healthcare Services in the Health Ministry, Dr. Wapanda Balami, lauded the lawmakers for the probe, adding that it’s important to unearth those who sabotaged the implementation of the NHIS scheme over the years.