Minister Wants HMOs Scrapped over Alleged Mismanagement of N531bn

NHIS boss: Health managers operating without licence

James Emejo in Abuja

The Minister of Health, Prof. Isaac Adewole, wednesday called for the scrapping of Health Management Organisations (HMOs) operating under National Health Insurance Scheme (NHIS) for among other things, failing to deliver on their healthcare mandate.

He said a total sum of over N351 billion had been paid to the HMOs by the federal government within the past 12 years without measurable improvement in health care delivery for Nigerians.

Speaking at a two-day investigative hearing organised by the House of Representatives Committee on Health Care Services, into the “compliance rate of the HMOs to the NHIS contributions and utilisation of funds by the health care providers and inhumane treatment of enrollees,” he said there was need for the National Assembly to amend the NHIS Act with a view to repositioning and strengthening the scheme.

Represented by the Director, Hospital Services, Federal Ministry of Health, Dr. Wapanda Balami, Adewole, said it may be necessary to eliminate HMOS from the scheme.

The minister’s position came as the Executive Secretary, NHIS, Prof. Yusuf Usman, also said about 59 HMOs currently do not have operating licenses since December last year, adding that reaccreditation was supposed to commence next month.

He regretted that the HMOs had never been called to account for their stewardship in the past 12 years.
He said: “More than 70 new born babies and over a 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 are 1.5 percent 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 signed 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’m here to rock the boat. We must sink this boat of corruption that has killed the health care sector of our country.”

He, further urged members of the committee to audit the HMOs with a view to finding out how many Nigerians have been deprived of their rights to quality health care.

He said: “Honourable members, these people are your constituents, and these guys operating the HMOs are owing them huge money. The NHIS is suppose to enhance the standard of health care delivery and crash the cost of health care in Nigeria, but covering just 1.5 per cent of Nigerians in 12 years, have we achieved the objective?

“Now, I went round and demanded that HMOs pay back monies collected without service delivered, or I delist them, and as I speak to you right now, over 95% of the debt has been recouped by the NHIS, and as we speak, there are no HMOs in Nigeria.

“And we are going to re- accredit all the HMOs in July and when you apply to manage a hospital, I must get a letter of non- indebtedness from the chief medical director of that hospital before you are hired.

“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. What should be the status quo, when you hold on to administrative fees and capitation”? He added.

Nevertheless, Chairman of the committee, Hon. Chike John Okafor (APC, Imo) acting on Usman’s submission, directed that further reaccreditation of HMOs be suspended pending the conclusion of comprehensive investigation on the defaulting HMOs.

He also indicated that the committee could call for prosecution of both the NHIS for releasing funds to HMOs whose licenses had expired and considered to have been operating illegally as well as the latter themselves.
However, President of Nigeria Labour Congress (NLC), Ayuba Wabba, also called for the scrapping of middlemen in the scheme, adding that apart from the enrollees, other stakeholders were just “parasite.”

He urged the federal government to improve funding to the scheme and strengthen compliance.
Earlier, House Speaker, Yakubu Dogara, had decried the poor rate of coverage by the scheme and urged stakeholders to demonstrate patriotic spirit in their deliberation.

Represented by the Deputy Minority Leader, Hon. Chukwuka Onyema Wilfred, the speaker said the task of making the nation’s health sector work for the benefit of all rested on all Nigerians.

He also supported the expansion of investigations into the activities of HMOs to have a clear cut picture of the situation.

However, Chairman of the Health and Managed Care Association, Dr. Tunde Ladele, had tried to counter the position of the NHIS boss, accusing him of hatred towards the HMOs.

He said the NHIS should rather account for the deductible from HMOs which had never been utilised.
Among other things, he said the health insurance programme should be made mandatory for all Nigerians.
But the association failed to substantially counter the allegations levelled against it.

Rather, he said: “All the actions of the Executive Secretary since July, 2016 pointed to a clear case of open hatred for the operators of health maintenance organisations, direct victimisation, deliberate attempt to stifle, disrupt and destroy the health insurance scheme and poor knowledge of the workings of health insurance.”