By Sola Ogundipe
In the wake of the controversy trailing the National Health Insurance Scheme, NHIS, the Health and Managed Care Association of Nigeria, HMCAN, has urged the Federal government to investigate activities of Health Maintenance Organizations, HMOs, in the country.
The HMCAN, which is the umbrella body for all HMOs in the country, said the government should wade into the current impasse between the HMOs and the Executive Secretary of the Scheme saying such investigation would put to rest once and for all the allegations of sharp practices and misdemeanour.
The President of the HMCAN, Dr Tunde Ladele, who made the call in Lagos, said the normal process of re-accreditation of the HMOs should be restored in good faith.
“We are investors in the business and cannot just let our investments go to waste. We want the government to invite the HMOs and listen to our own side. We have been to the Council of the NHIS and submitted memoranda. Other stakeholders also submitted, thereafter the House of Representatives sent consultants to look at our papers, and we were given a clean bill of health, so we are still surprised that the allegations persist.”
Among other issues he raised were, non-payment of fee – for – service to health care providers as and when due as well as the total removal of HMOs in the operations of the NHIS.
Ladele who lamented the series of wrangling in recent times between the headship of the Scheme and the HMOs, said they (HMOs) were operating within the ambit of the law, while calling on the leadership of the NHIS to “name and shame “those who breached standards or engaged in sharp practices rather than persistent blanket condemnation of all HMOs.
“We will not get tired of talking about these things. The NHIS is to regulate and must know what to do about it.”
On the issue of re-accreditation, he said it had been done successfully a number of times in the history of the Scheme without much pressure and high hurdles such as was set in the latest experience.
“Letter of non-indebtedness was introduced, while HCFs were inaugurated against HMOs amidst threats of deactivation of HMOs without reasonable justifications.”
According to Ladele: “At the submission of the first report of the exercise to the Governing Council in April 2018, 23 of the 59 HMOs were deactivated without concrete cause as the majority were compliant with set criteria.
“The Governing Council, in its wisdom, felt differently and directed that the exercise must be to enforce compliance with standards set by the regulators (NHIS), and not to kill business especially in a circumstance where government was working assiduously to encourage the growth of private sector content of the national economy.
“HMCAN will like to reiterate at this juncture that it is not possible that all HMOs are operating with total defaults. To this end, it has consistently challenged the leadership of NHIS to name and shame those who are breaching standards, or engaged in sharp practices, instead of persistent global condemnation of all HMOs.”