•2.4 million vulnerable persons funded under BHCPF
•N640 million paid by defaulting HMOs
CHIGOZIE AMADI
The Nigeria Health Insurance Authority (NHIA) said that enrollment in scheme has risen to 19.2 million as at Wednesday, December 11, 2024.
The Director General of the agency, Dr. Kelechi Ohiri, who spoke to journalists during the end of year get-together in Abuja on Wednesday said that out of the registered persons, 2.4 million are vulnerable Nigerians being sponsored with money from the Basic Healthcare Provisions Fund (BHCPF).
He said that NHIA has surpassed the presidential target in 2024, and is planning to add additional 20% in 2025, working with relevant stakeholders.
“In terms of coverage as you asked, there are 19.2 million people as of date that are covered. We expect those numbers to increase before the end of the year because we still have numbers coming in.
“For the Basic Healthcare Provision Fund, there are 2.4 million vulnerable Nigerians that are covered to date. We expect those numbers to also increase because of the reforms we’re making to the guidelines of the BHCPF, ” he said.
Regarding some of achievements made by the agency, Ohiri said the enrollment into the insurance scheme has increased by 14 percent in the last one year.
He said that as part of the objectives of this year’s World Universal Health Coverage Day, the president launched the Health Sector Renewal Investment Initiative.
“In doing this, one of the compacts he signed was that we should make sure that we increase coverage of health insurance by 20% by a certain deadline in 2027. We took this on board, and we ran with that vision. That’s why we have surpassed the trajectory that was set for us”.
Ohiri also explained that NHIA is striving hard to ensure steady improvement in the services rendered to patients by the various health facilities under the insurance scheme.
According to him, NHIA has expanded the disease treatment coverage to also include critical health challenges such as cancer care, diabetes and hypertension.
The DG further spoke on the efforts being made to enforce standard operational guidelines by Health Management Organisations.
He said that NHIA has a set of sanctions for defaulting HMOs and facilities, adding the agency has so far imposed penalties amounting to over N640 million on various HMOs found to be culpable.
While explaining the process, Ohiri said that some of patient’s complaints require our investigation.
His words: “We have had situations where patients had to pay out-of-pocket for drugs, and they’ve had to be reimbursed because this was covered. And we’re getting more and more aggressive and on top of that.
“Now, on the issue of codes, we’ve also developed a guideline that will be released, where within a certain time limit, if a code does not come, you’ll be able to get one from an HIA that will give you the permission to be seen for those under our plan, so that the delay in getting a code is not going to be a hindrance from getting good quality care.
“Now, in terms of sharp practices, whether it’s by health facilities or by HMOs or by the enrollees themselves, we’ve had instances where enrollees bring family members who are not covered to come and get care. We’ve had instances, yes, where providers act in ways that may not be optimal.
“We have also had stories where HMOs also do those things. It’s now a standing item on our management meeting monthly to review complaints, and I get an update on – how many complaints did we get? What were they about? And were they resolved?
“And so that is a big thing that we are doing. And the more we are on top of it and making sure that complaints get resolved, the less they’re likely to come up”
