By Olukayode Babalola
The National Health Insurance Authority (NHIA) has vowed to tackle late payments to Health Care Facilities (HCFs) especially fee-for-service due to them from Health Maintenance Organisations (HMOs).
Mrs Mary Aliu, the Coordinator of the Authority in Nasarawa State, made this known on the sidelines of a one-day stakeholders forum held in Karu Local Government Area of the state on thursday.
The News Agency of Nigeria (NAN) reports that HMOs are expected to pay HCFs promptly to provide healthcare services to enrollees.
During the Question and Answer segment of the forum, some of the representatives of the HCFs or healthcare providers decried the late or non-payment of fee-for-service owed them by HMOs.
Reacting to that development, Aliu said the late payment of fee-for-service to HCFs was becoming a concern for the NHIA.
According to her, this is why the Authority resolved to find a lasting solution to the situation to enable HCFs get their payments on time for prompt service provision to enrollees.
“We are doing all we can because we take the matter seriously. Our enforcement department is doing much concerning that.
“Right now we just finished reconciliation exercise and we have been able to see those HMOs that are owing and letters have been issued and so on.
“Just to make sure that all the healthcare providers that are complaining are sorted out as soon as possible,” she said.
She affirmed that some HMOs deliberately give one reason or the other so as not to make prompt payment.
Aliu added that the Authority has been up and doing by calling and speaking to them to make these payments promptly especially the fee-for-service to the HCFs so as not to affect provision of healthcare services to enrollees.
“Through our efforts, we thank God that some healthcare providers have notified us they have begin to receive alerts.
“Nevertheless, we will intensity efforts to continue to ensure the needful is done so the whole process of health insurance for enrollees is not adversely affected.
“But if it gets to a level that the Authority can no longer tolerate their non payment to HCFs, of course, those culpable will have to be delisted,” she added.
Aliu said the stakeholders forum was aimed at enlightening the public, especially those in Karu LGA, on the importance of health insurance and the efforts put in place by the federal government to make health insurance accessible to all Nigerians.
“We have the Group, Individual, Family Social Health Insurance Programme called GIFSHIP which makes sure that everybody is covered with nobody left behind.
“Even the private sector, artisans and so on are all covered by health insurance as long as they can afford it,” she said.
Aliu lauded both President Muhammadu Buhari for signing into law the new NHIA Act 2022 and the the Director General/CEO of NHIA, Prof Mohammed Nasir Sambo for the swift commencement of the implementation of the new act.
According to her, the new law is an upgrade to the former Act with provisions for sanctions for Health Maintenance Organisations (HMOs) and also enrollees that are not doing the right thing.
She explained that the essence of the stakeholders forum was to bring together all stakeholders to brainstorm and engage with them with a view to finding out if NHIA is going in the right direction, complaints and where corrections are needed.
Responding, Mr Shagel Tersoo, the Branch Head, Regenix Healthcare Services, an HMO based in Lafia, Nasarawa state, said late provision of bills from the HCFs is one of the reasons for the delay in making such payments.
“On our part, we have instructed the HCFs, they are the healthcare providers, to be sending the bills or claims on time.
“If they send the bills on time, we will look at them properly and pay them on time. That is what we do,” he said.
NAN reports that the stakeholders forum had in attendance NHIA officials, representatives of HMOs, enrollees and representatives of HCFs, among others. (NAN)