• Monday, February 26, 2024
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BusinessDay

Investor funds stuck as door slams on HMOs

health-insurance

Investor funds running into billions of naira are stuck as the doors have been slammed on 55 Health Maintenance Organisations (HMOs) which were unable to meet the National Health Insurance Scheme (NHIS) requirements for recapitalisation and re-accreditation.

HMOs are private or public incorporated companies registered by the NHIS to manage the provision of health care services through health care facilities accredited by the scheme. NHIS is the regulator of HMOs in the country.

The NHIS had instructed the 77 HMOs in the country to raise their minimum capital requirements to N400 million by August 31. On Wednesday, September 2, the NHIS said only 15 HMOs were able to meet the deadline.

What this means is that 55 HMOs were de-listed, while seven were placed on provisional accreditation.

Some of the HMOs that were re-registered include Maayoit Healthcare, Health Partners, InvestCorp Medical Limited, Pre-paid Medicare, Total

Health Trust, Healthcare International, United Healthcare International and Managed Health Care Services.

Others include Premium Health, Defence Health Maintenance, Royal Health Prepaid Medicare, Oceanic Health, Princeton, Royal Exchange Healthcare and Salus Trust.

Those that were placed on provisional accreditation include Bupar Healthcare, Redcare Health, Doma Healthcare, Avon HMO, Reginix Healthcare, Well Health Network and Police HMO.

Incidentally, some HMOs that were de-listed were the big industry players that control over N1 billion. Marina Medical Services HMO limited, which was said not to have met the requirements, is a big industry player which controls MTN and UBA accounts.

Hygea HMO controls over N2 billion in public and private accounts, while Clearline International HMO and Expert Care HMO, which could not be cleared, also control over N1 billion.

By implication, several billions of naira belonging to these 55 HMOs appear to be hanging in the balance as many of them are yet to know their fate. 

“I fear that almost all HMOs did not even meet the requirements,” an industry source told BusinessDay.

“I think what some of them did was to quote fresh monetary investments in their businesses as recapitalisation fund,” the source added. As of yesterday, the list of the 77 HMOs was still on the website of the NHIS, BusinessDay checks showed.

Among other requirements, the NHIS said, “Any group of persons or organisation of proven and impeccable character may be eligible to form a company (private or public) and apply for registration as an HMO under the scheme.”

Other informed sources told BusInessDay that the NHIS hired PricewaterhouseCoopers (PwC) to assess the status of the HMOs and see if they are healthy.

Sources close to Femi Thomas, a medical doctor and executive secretary, NHIS, said unhealthy HMOs were given six months to do the right thing but had failed to do so.

ODINAKA ANUDU