NHIS Recovers N2bn Debts From HMO’s

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NHIS Recovers N2bn Debts From HMO’s

 

The National Health Insurance Scheme, NHIS on Tuesday says it has recovered the sum of N2 billion debts from Health Maintenance Organizations, HMOs and unpaid bills to Health care facilities.

 NHIS General Manager, Enforcement Department, Pharmacist Mohammad Ghali disclosed this during a stakeholders sensitization workshop held in Kano to strengthen effective operations of the scheme.

Ghali said it received complaints from the health care providers over HMO’s non-payment of services rendered to enrollees and to that effect, the scheme came up with a principle of reconciliation between the HMO’s and healthcare facilities leading to the recovery of the monies, N2 billion, which was later paid to the healthcare facilities.

According to him, “over some period, what the NHIS witnessed before the coming of the new management led by Prof. Nasiru Sambo, there are lots of complaint coming from the healthcare providers. And part of the complaint is that they are subjecting our enrollees to sometimes hardship. When you ask, they would say some other services that they rendered to the enrollees, the HMO did not pay. And this is coming to an unbearable level.

“So he now directed that the management through the department that action must be taken. And that is why we came up with this principle of reconciliation whereby we collected all debts due to the health care facilities period of 2019.

“We invited the HMO to meet with the healthcare facilities that are alleging that they are indebted to them. And they did the reconciliation between June and July 2020.

As of September 2020, from our report from the state, about N2 billion have been recovered from the HMOs as payment that has now been done to the health care facilities. A letter of non-indebtedness is issued to HMO that finishes clearing its debt.

“The exercise is still ongoing across the 36 states and FCT. Because there are some HMOs that are yet to complete the payment,” Pharmacist Ghali stated.

The NHIS General Manager, Enforcement Department, Pharmacist Mohammad Ghali, however, highlighted some benefits of a new package, Groups, Individuals and Families Social Health Insurance Programme, GIFSHIP introduced by the scheme to cater for a large number of persons and the needy among others.