NHIS: FG wants HMOs scrapped over mismanagement of N351bn

The Federal Government is seeking the scrapping of the Health Management Organisations (HMOs) in the operation of the National Health Insurance Scheme (NHIS) over poor coverage and alleged mismanagement of over N351 billion contributed by subscribers.

Minister of Health, Prof. Isaac Adewole, made the position of the Federal Government known on Wednesday in Abuja, at the two-day investigative hearing organised by the House of Representatives Committee on Health Care Services on compliance rate of the Health Management Organisations (HMOs) to the NHIS contributions and utilisation of funds by health care providers and inhumane treatment of contributors.

Represented by the Director of Hospital Services in the ministry, Mr. Wapanda Balami, the minister said that the hearing would afford the House Committee the opportunity of knowing the desirability or otherwise of retaining HMOS under the health insurance scheme.

The government’s position is informed by the fact that while over N351 billion premium has been received from the NHIS by the HMOs, only four per cent of Nigerians have been covered since inception of the scheme 12 years ago.
Prof. Adewole therefore prayed the House to sanction the immediate stoppage of further disbursement of funds to the HMOs.
The minister, who described efforts by the National Assembly to reposition the health insurance scheme as a step in the right direction, added that the amount quoted as premium is incorrect as the Federal Government pays five per cent from its coffers to the NHIS aside the deduction from subscribers.
“The scheme needs to perform better if it must justify the huge sums being expended by government. The role of expanding coverage of enrollees is that of the NHIS and not HMOs,” he stated.
The minister also called for the expulsion of HMOs from the board of the NHIS, describing it as abnormal.
“There have been complaints by previous and present NHIS leadership of attempts to undermine their authority by representatives of HMOs who are on the board of the agency.
“Such a situation breeds conflict of interest. The presence of HMOs representatives on the board tends to challenge the powers of the NHIS to regulate and sanction erring organisations,” the minister said.
Earlier, Executive Secretary of the NHIS, Prof. Yusuf Usman, had descended heavily on the HMOs, saying that “for 12 years, the HMOs have never been called to account for their misdeeds.”
The NHIS chief executive disclosed further that “more than 70 new born babies and over 100 women die daily from avoidable mortality, even though they are on the scheme.
“Millions die across the states and there seemed not to be time to fight these anomalies until now. When I came to the agency, I saw the potential and I felt the NHIS should perform its duties of helping vulnerable Nigerians to access quality health care.
“The number of Nigerians covered by the NHIS after 12 years is 1.5 per cent of the population. Countries like Kenya and Rwanda have achieved better health care delivery without HMOs and health care financing in Nigeria is nothing but a huge fraud.
“I know all these things because I sign the cheques and nobody has been brought to book in the last 12 years. If you want to hear the truth, hear it from me today because my way of making the scheme work is to hold the HMOs accountable.
“We are told that they are powerful and untouchable because they are owned by some powerful Nigerians. But I have news for you, that I am here to rock the boat. We must sink this boat of corruption that has killed the health care sector of our country,” he declared.
He challenged House committee to audit the HMOs with a view to finding out how many Nigerians have been deprived of their rights to quality health care.
According to him, the NHIS has directed HMOs to pay back monies collected without service delivered, otherwise they will be delisted.
He disclosed that over 95 per cent of the debt has been recouped by the NHIS, adding also that the agency would re- accredit all HMOs in July.
“We gave them N37billion just for administrative fees; patients go to the hospitals and are treated like lepers because the HMOs have not paid the providers. I had to stop it, and they took me to court, EFCC and ICPC, saying that I must be made to reverse back to status quo,” he added.
Defending the HMOs, their representative, Dr. Tunde Ladele accused the new NHIS boss of open hatred for health management organisations.
“All the actions of the executive secretary since July, 2016, pointed to a clear case of open hatred for the operators of health management organisations, direct victimisation, deliberate attempt to stifle, disrupt and destroy the health insurance scheme and poor knowledge of the workings of health insurance,” he said.
Declaring the hearing open, House Speaker, Hon. Yakubu Dogara, represented by the Deputy Minority Leader, Rep. Chukwuka Onyema, decried the poor coverage rate of the health insurance scheme.
Rep. Dogara charged stakeholders to demonstrate the patriotic spirit that would make the nation’s health sector work for the benefit of all Nigerians.
The hearing continues today.