Healthcare providers refute allegations of enrolee abuse by HOR

Healthcare providers in the country have expressed reservations over the insinuations by the federal House of Representatives that Health Maintenance Organisations (HMOs) and Healthcare providers have been colluding to short-change enrolees.

The House of Representatives recently mandated its Committee on Health Care Services to commence investigation into the activities of the HMOs and healthcare providers for the past eight years, with the view to identifying their level of compliance with the relevant provisions of the NHIS Act 35 of 1999 and determine the reasons for the poor state of services to their enrolees.

“There is no such thing as connivance with the HMOs to short change enrolees. All monies paid to providers so far have been for the various services rendered to the registered enrolee over the past 9 to 11 years of the Scheme. National Health Insurance Scheme (NHIS) should be able to accurately account for fund used for the service procurement thus far when they render its audited account over the past years,” said Umar Sanda, National President, Healthcare Providers Association of Nigeria (HCPAN) at a press briefing in Lagos.

 

Sanda further explained that “pertaining to the treatment of enrolees as lepers by providers, we wish to state categorically that this cannot be the experience of enrolees with our providers.

“The distribution of enrolees has been about 80 per cent in public facilities and 20 per cent in the private facilities. Public providers consist of government owned facilities such as Teaching Hospitals, FMCs, Specialist hospital, General hospitals. Private providers are fully privately owned facilities.

“There is no discrimination in attending to enrolees by healthcare providers, and while it does not mean there aren’t one or two culprits which cannot be entirely ruled out, generally, our member don’t short changed enrolees” noted Sanda.

Banbo Oyekan on his part said “There is need to be educated what health insurance is all about. By taking insurance, you are pulling resources, premium from so many (people) to be accessed by the few [that may be in need of attention], and to maximize that, there are certain guidelines.

In the same vain Adeyeye Arigbabuwo, deputy national President, HCPAN, said there no respect being given to the time value for money.

“As we are talking today, the capitation has only been reviewed once in 2012. It was initially 550 naira and later 750 naira, the same month it was made 750, oil subsidy was removed and so the 200 hundred naira increment had no meaning.”

“Most of the time emphasis has always been made on quality and we all know that quality is not cheap’’, he noted.