OrderPaperToday – The Senate has urged the National Health Insurance Scheme to direct Health Maintenance Organization (HMOs) to within three month settle all outstanding debt owned health care providers across the country.
NHIS was established by the National Health Insurance Scheme Act No 35 of 1999, Cap N42 LFN 2004, Vol. 11 and is a beneficiary of 50% of Basic Heaith Care Provision Funds by virtue of Section 11 of the National Health Act 2014 to ensure that every Nigerian has access to quality and affordable health care services through the provision of affordable health insurance.
The resolution by the chamber is sequel to a motion on the need to make the NHIS work for Nigerians following the crisis bedevilling it.
The motion was moved by Senator Oloriegbe Yahaya Ibrahim (APC, Kwara) and co-sponsored by Senators Chimaroke O. Nnamani (Enugu East), lsah Iibrin (Kogi East), Ewhrudjakpo Lawrence (Bayelsa West), Oluremi Tinubu (Lagos Central), Umar Suleiman Sadiq (Kwara North), Yusuf A. Yusuf (Taraba Central), Odebiyi T. Akinremi (Ogun West) and Kwari Suleiman Abdu (Kaduna North).
While moving his motion on Thursday during plenary, Oloriegbe noted that the scheme was conceived to achieve Universal Health Coverage by 2015 but “it has failed in this regard as available information shows that it currently boasts of a little above 6 million enrollees even as at the middle of 2019.”
According him, in spite of the provision of regular budgetary allocation and release, the availability of 50% of the Basic Health Care Provision Fund, (1% of Consolidated Revenue Fund of Federal Government) 6.1.Billion naira which was released to the Scheme in May 2019, it has fallen short of the attainment of its objectives.
He indicated that the NHIS has been without a substantive Chief Executive Secretary since October 2018 and that a new Secretary was only just appointed on the 1st of July, 2019.
He further noted that the Scheme has been under the management of an ‘Overseeing Director’ appointed from the Office of the Head of Civil Service of the Federation which he believes has affected many critical and important operations of the Scheme.
The operations include: “Non-approval of the 2017/2018 HMOs reaccreditation exercise report which has allowed or those HMOs not fit for operation to still continue to provide service despite their deficiencies, non-approval of the 2018 Staff promotion exercise with the likely consequent delay in the conduct of the 2019 exercise and imperative staff dissatisfaction
“The approach to dealing with contentious issues with the various stakeholders has been rather not pragmatic. The uncertainties surrounding a lack of substantive CEO has caused a delay in approval and release of revised guidelines, drug and professional service price lists which have been long overdue for review;
“Certain operations of the Scheme such as Quality Assurance and improvement exercises conducted periodically on Health Care Providers and Health Maintenance Organizations have not been done as expected.”
He equally lamented that the dyfunctionality on the organization has resulted to various complaints of dissatisfaction by the health care providers and beneficiaries of the scheme.
The dissatisfaction borders on “enrollees complaint of being frequently told to purchase drugs outside of the hospital (under the guise of either the drug being out-of-stock or not covered under the Scheme),
“Prolonged waiting time and discrimination in accessing health services by enrollees and discrimination against NHIS enrollees in the hospitals compared to fee paying patients;
“Failure to convene regular meetings with the various stakeholders (including capacity building workshops and HMO Standing Committee meetings); Failure to review Fees and charges paid by the NHIS to meet the current economic realities in the country;
“NHIS accredited HMOS owe debts of several months due to unpaid capitation and fee for service and have resorted to unethical means to avoid payments. The National Hospital Abuja is owned more than 500 million naira while other Teaching Hospital and federal medical centre are owned huge sum of money
“Poor regulation and supervision of State Social Health Insurance Agencies. Several of the States that have established their own Agencies introduced Benefit Packages, capitation fees and fee for service tariffs that are not viable.”
The chamber in other resolutions promised to investigate the activities of NHIS once a standing committee on Health is constituted and urged CBN, Customs, NNPC and other government agencies to key into the scheme.