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Tag: NHIS boss

  • Refusal to pay N975m was the beginning of my problem with Health Ministry, says NHIS boss

    The suspended Executive Secretary (ES) of the National Health Insurance Scheme  (NHIS), Professor  Usman Yusuf, claimed yesterday  that his refusal pay the Federal  Ministry of Health N975m for a job NHIS was not aware of was responsible for his current ordeal.

    He told  a House of Representatives  investigative public hearing on the crisis rocking NHIS that a  probe panel set up by the Health Ministry was meant to indict him.

    He alleged that the panel was  paid N19m from NHIS account.

    Yusuf, who made his presentation at the final day of the  Nicholas Ossai-led investigative  ad hoc panel  also regretted that Health Management Organizations  (HMOs) have not added value to the scheme despite drawing hugely from the funds.

    Health Minister  Isaac Adewole, in his submission through  the Permanent Secretary, Abdulaziz Abdullahi, said Yusuf was initially investigated and suspended on the strength  of petitions from workers and other stakeholders.

    He said the ES was accused of the unauthorised appointment of staff into the scheme,  incurring expenditures without due process, giving approval  above the threshold of the ES, flagrant disregard for due process in procurement matters, financial irregularities and award of contract with impunity.

    HMOs also accused Yusuf of blackmailing them into refunding monies that legally accrued to them back to  NHIS, in addition to the entire 59 HMOs being forced to patronise one insurance brokering firm.

    The HMOs also accused Yusuf of mismanaging  Information and Communications Technology  (ICT) fund meant to automate the activities of the organization.

    In his response, Yusuf said reference to the first investigation by the minister was an “ambush” because it had been dealt with.

    He, however, expressed  reservations over some of the allegations raised against him.

    Saying that his refusal  to release N975m to the Ministry of Health was the beginning of his problems with the ministry, the ES added, “This led to the setting up of a panel to probe me and the panel delivered as the panelists were given N19m and even the security too were given money.

    “My suspension was a preemptive coup against transparency. Why was I suspended on October 18 and not  October 19?   October 18 was the day I was going to present a result of the forensic audit of the activities of HMOs.

    “October 18 was nothing but preemptive coup at the NHIS. It was a gang-up to stop my fight against corruption”.

    He also refuted HMOs’ allegation of being blackmailed into making a refund to NHIS that was tied to accreditation as well as being forced to patronise a single brokering firm.

    According to him, the Department of State Services (DSS) had been investigating NHIS for corruption due to payments made in 2012 and that by 2017, he was sent a letter by DSS that the money should be recouped and should no more be paid to the HMOs and the ICT Department fixed to prevent future occurrence.

    “That’s what informed my vigour in collecting that money, ” he added.

    The suspended ES also explained that some tough measures adopted against HMOs were necessitated by the manipulation of the funds whereby the HMOs, since inception, have failed to bring in more people on board other than civil servants.

    He also said the policy of patronising a brokering firm was not his idea, adding that it was initiated before his assumption of duty in 2016.

    He said: “Why are the health providers not being paid by HMOs despite accessing money from NHIS?

    “I saw a huge number of insurance firms and I asked how come we have HMOs presenting to us advanced payment guarantee that will insure what we gave them.

    “How come they are not paying hospitals and we are having debts, N400m, an HMO is not paid, N300m in some cases?

    “I was curious, if you present me an advanced payment guarantee and I give you money, if you don’t pay, my problem is not with you but with the insurance company that gives that.

    “We have not been activating the advanced payment guarantee. So we looked at the consortium and what they used to do is to give the HMOs a N100m for an insurance of N10.00. Worthless.

    “On the ones we picked, there was a due process and a new consortium was put in place.

    “It was done in 2016 and a management deceit before I came”.

    He also refuted allegation of disregard for due process on financial management and procurement,  saying after the organization’s funds were swept into the Treasury Single Account (TSA), he had to open five sub accounts for the organisation for transparency.

    To further throw light on the issue, the  panel has summoned  the Secretary to the Government of the Federation (SGF), Boss Mustapha, and the Central Bank of Nigeria (CBN) governor, Mr. Godwin Emefiele, to give account of all they know about the agency.

    Chairman of the investigation panel, Ossai,  pledged  that the report of the exercise would be fair to all concerned.

  • HMCAN urges NHIS boss to identify defaulting organs

    The Health and Managed Care Association of Nigeria (HMCAN) has called on the executive secretary of National Health Insurance Scheme (NHIS), Usman Yusuf to name  those health maintenance organisations (HMOs)  that are breaching standards, or engaged in sharp practices.

    HMCAN is the umbrella interest-organisation for all HMOs in Nigeria.

    According to the Chairman, Tunde Ladele speaking in Lagos yesterday, it is not possible that all HMOs are operating with total defaults, “as being advanced to the public by the NHIS’s Executive Secretary. As regulators, we believe NHIS has the statutory authority, the operational mandate, and instruments to enforce compliance in the industry”.

    Ladele said it is good to put the records straight on the refund of backlog of N2.1b, to NHIS, saying, “On his assumption of duty at the Scheme in 2016, Prof Yusuf without once consulting with the HMOs, till this moment, insisted vehemently that the 50 percent of this payment of this backlog to HMOs must be refunded, threatening to shut down the industry otherwise.

    “As critical investors with huge investments in the Nigerian healthcare space, the HMOs unanimously agreed to make the refund to avoid dislocations in the industry,” said Ladele, adding, “it was therefore a business decision by the HMOs to make the refund, and not necessarily because the payment was not properly earned, an impression Prof Yusuf has laboured to sell to the public”.

    Ladele added that the refunds HMOs are making to the NHIS is a sacrifice by them to save the industry and the circumstances surrounding this need a clear understanding.

    Giving the background, Ladele said: “It was an actuarial recommendation that payments of capitation, fee-for-service and admin fee be reviewed on the average of every two years, in view of inflationary trends in the economy. However, no such review had taken place between 2005 and 2012”.

    He added, “In response to pressure from critical stakeholders, such as healthcare facilities who are risk bearers at the primary level, the review finally occurred in 2012. Consequently, capitation was increased from N550.00 to N750.00, fee-for-service from N89.00 to N112.50, while administrative fee went up from N91.00 to N129.00”.

    Ladele said NHIS implemented this review, except for fee-for-service outstanding from 2012 to 2015, amounting to N2.1b, adding, “HMOs, being risk bearers at secondary and tertiary levels are expected to pay for services authorised at these two levels for fee-for-service as denominated and defined by NHIS. After a very long wait, 50 percent of the backlog of N2.1b was paid by NHIS to the HMOs in 2016, leaving a balance of 50 percent to date, and on his resumption at the scheme in 2016, Prof Yusuf insisted that the 50 percent of this backlog to HMOs must be refunded, and we did,”.

    As of today, according to Ladele, all the 59 HMOs were deactivated without concrete cause, as “majorities were compliant with set criteria. We see this move as a betrayal of leadership inadequacies, poverty of administration and management skills, weak knowledge of technical issues, gross deficiencies in understanding of corporate governance and a sorry state of inability to relate well with higher authorities by Prof Yusuf,”.

    Ladele said the current bitterness and acrimony in the young industry is unnecessary and avoidable, saying, “Prof Yusuf should make himself available to answer to charges of procurement law breaches, abuse of office, and financial brigandage that are pilling against him, rather than stifle himself with this phobia for HMOs’.

     

  • Buhari sets up panel to probe alleged scam against suspended NHIS boss

    PRESIDENT Muhammadu Buhari yesterday approved a fact-finding committee on the alleged infractions committed by suspended Executive Secretary of National Health Insurance Scheme (NHIS) Usman Yusuf.

    Yusuf was suspended from office over alleged fraud by the NHIS Governing Council.

    A statement by Permanent Secretary (General Services Office) Olusegun A. Adekunle on behalf of the Secretary to the Government of the Federation, Boss Mustapha, said the committee is to report back within two weeks.

    He said: “The Federal Government has found it necessary to restate that the objective for establishing parastatals is in fulfillment of the need to deliver services to Nigerians faster and better. It has also considered it necessary to restate that the roles of   Governing Boards/Councils are as prescribed by the statutes, guidelines and extant circulars and that the position of chief executives of parastatals is to ensure that policies of government as enunciated by boards and councils are implemented in accordance with their mandate.

    “It has, however, observed with deep concern the growing tension between boards and chief executives and their attendant implications for governance.  For the avoidance of doubt, government will neither tolerate acts of indiscipline from any appointee nor will it habour any acts of corruption.  Government will, however, ensure that due process is followed strictly in trying to maintain discipline and probity in public service.

    “With specific reference to recent developments at the National Health Insurance Scheme, Mr. President has after due consideration approved the establishment of an independent fact-finding panel to investigate the alleged infractions by the Executive Secretary and report back within two weeks.”

    The membership of the panel, he said, included Dr. Hassan Bukar as chairman. Members are Dr. Emmanuel Meribole, Director, HPRS, FMH, Mr. Adewale Owolo, Director, Audit, (AuGF), Mr. Shamsuddeen Bello, Deputy Director Expenditure (OAGF) and Mr. Ishaq Yahaya, Director, Certification & Compliance, BPP.

    Others are Dr. Ekanem John Udoh, Director of Science (FMS&T) and Mrs. Jummai Idakwo, Director, Administration (OSGF) to serve as member/secretary.

    According to the statement, the terms of reference included:

    “•To investigate the alleged infractions listed by the NHIS Governing Council in letter dated October 18, 2018 and determine the extent of culpability or otherwise of the Executive Secretary with regards to the allegations;

    “•To make appropriate recommendations based on the findings from TOR I above;

    “•To identify, investigate and make recommendations with regards to issues that led to the unhealthy relationship between the board and the CEO;

    “•Investigate and make recommendations on the extent of involvement of staff unions’ within the institution as to the current impasse between the Governing Board and Executive Secretary; and

    “•To examine all governance challenges in the NHIS and make appropriate recommendations.”

    The panel, which is headed by a retired Permanent Secretary, will be inaugurated by the SGF tomorrow at 3.00p.m. in the conference Room of the OSGF.

    “With the establishment of this panel, the earlier body set up by the Governing Council stands dissolved.

    “In order to create room for an unfettered investigation, Mr. President has approved that the NHIS Executive Secretary should proceed on administrative leave immediately.”

    In Yusuf’s absence, Mr. Ben Omogo, a director of Administration in the Office of the Head of the Civil Service of the Federation, has been deployed to oversee the scheme’s affairs.

    “Government recognises the importance of the scheme as a strong mechanism for the delivery of public healthcare and wishes to re-assure all Nigerians of its determination to place high premium on public interest.” the statement said.

  • Embarrassing moments for FG and NHIS boss

    IT is hard to explain why the federal government is not embarrassed by the controversy swirling around the Executive Secretary of the National Health Insurance Scheme (NHIS), Usman Yusuf, a professor of medicine. The government is unreasonably sustaining him in office to the irritation of most Nigerians. Last Thursday, about eight months after his first suspension in June 2017 was unbelievably overruled by President Muhammadu Buhari, he has again been suspended, this time by the agency’s governing council. When he was suspended last year, it was alleged that he misappropriated about N900m. He at first defied the suspension order, but after investigations by a panel comprising senior Health ministry officials, men of the Department of State Service (DSS), and officials of the Independent Corrupt Practices and other related offences Commission (ICPC), Prof Yusuf stayed away from the agency until his reinstatement in February 2018.

    But the controversies have refused to go away. Citing an avalanche of petitions against the professor and an investigation conducted in-house, the NHIS Governing Council led by Enyantu Ifenne has again placed the NHIS boss on suspension. He was not recalled by the Health ministry in February, but by the president, despite ongoing probes by both EFCC and ICPC. When he was recalled, the presidency made no reference to the Health minister, Isaac Adewole, also a professor of medicine, except to copy him the reinstatement letter. And when he was first suspended, Prof Yusuf reserved expletives for the minister, insisting that he was answerable only to the presidency. It is not clear how he would take this new suspension or how the presidency would react. But already, there are signs he would love to remain defiant and insubordinate, with the presidency in February insinuating that the NHIS boss suffered biases at the hands of his detractors.

    In announcing last Thursday’s suspension, Dr Ifenne said: “Let those who hide under cover of the Presidency to protect corruption know that Nigerians are keenly watching. I am convinced that if President Buhari is fully briefed about a tenth of Yusuf’s atrocities, he would throw him out! The truth, like health, has no colour, no tribe and no religion and no social class. The council stands by its decision.” The presidency will now have to determine whether to defy both the Health ministry and the NHIS Governing Council in favour of an official who has shown no regard for his supervisors and colleagues.

    It was atrocious and insensitive in the first instance to recall Prof Yusuf in February, when the allegations against him were still being investigated by the EFCC and ICPC. Believing that he had high-level support, Prof Yusuf neither mended his ways nor found the humility to work with the Health ministry, as counselled by the presidency. Now, he has attracted the fury of the board of the agency. The presidency has defied many things in the past three years, including common sense, and has shown little or no inclination to appropriately weigh negative public opinion. It will, however, be interesting to find out how they will handle this unfortunate little matter concerning an official who has proved without a shadow of doubt that he is not worth defending, let alone risking the credibility of an entire presidency.

  • My suspension was a gang-up, says NHIS boss

    The Executive Secretary of National Health Insurance Scheme (NHIS), Professor Usman Yusuf, yesterday in Kano, accused the NHIS, the HMOs, hospitals, insurance companies, as the institutions that ganged up to mastermind his suspension for six months, with the intent  to defraud Nigerians.

    Yusuf, who spoke to reporters, on why he was suspended from office, lamented that the rot perpetrated in those institutions was not only disturbing and alarming but meant to deny 180 million Nigerians from benefitting from the scheme, thereby placing their lives in danger.

    According to him:’’I came in 1st of August, 2016 and I saw all these mess, with NHIS, HMOs, hospitals, insurance companies, with our money in banks and I said this is not acceptable, for corruption will fight you back, you have to fight it, if you want to do the right thing, this cannot continue, as it has been.

    ‘’I asked myself questions, we are supposed to cover 180 million on the provision of healthcare, we only cover 3 million, why?, who has been taking the money?, We all know that, I say, this not acceptable and anywhere you hear that people are after a chief executive, it’s because we are not allowing things to happen as before.

    ‘’So, they took me to court to make sure that the judge makes me to maintain the status quo! What is status quo? To continue to give them money blindly and then not delivering to hospitals. They took me to the National Assembly. They have been writing all sorts of things in the paper and the social media. They just want to distract me. They said I was a thief and stole N900 million, with unsubstantiated allegation.

    ‘’But I have told Nigerians time and time again. I have a promise, not to any human being in life but to my creator that I am going to be  a good custodian to this money, the day I will not do that, I will walk away. Number one, if I want to steal money, NHIS money is a blood money! This money is meant to pay for the sick.

    ‘’And people have been feasting on this blood money and I said no! That is the reason why they have been fighting me. Only in Nigeria that people look  at  you in the face and say, you are a thief. Where I came from, the onus of proof is from the accuser, not the accused.

    ‘’If you say I stole N900 million, then prove to me or you take me to EFCC or ICPC. The president knows better. We are all serving at the pleasure of President Buhari, we’re presidential appointees. The president can fire you any time, without reason but I have said it time and time again, nobody gave me my honour and integrity, I have earned it, all of us over our life time, all of us. And if anyone is trying to impinge  upon my integrity, I will fight them.

    ‘’This is the problem. Calling me, thief, thief, they want to destabilize me. They want to push me out. They want to bring out this nonsense but the President has seen the truth, he is a man of honour and integrity.

    ‘’Way back, the battle continues, where we stopped, we would not stop fighting. We know that corruption will fight you by proxy and fight you frontally, so, it is never an ending fight. If they want to continue, we are ready to do that, the day, I am not ready to do it, I will just pack my things and go,” he said.

  • Revoke NHIS boss recall, says Falana

    Revoke NHIS boss recall, says Falana

    Lagos lawyer Femi Falana (SAN) has urged the Federal Government to stop the reinstatement of Executive Secretary of National Health Insurance Scheme (NHIS), Prof. Usman Yusuf.

    Yusuf resumed work yesterday, according to Head of Media and Public Relations of NHIS, Mr Ayo Osinlu.

    Osinlu said: “NHIS Executive Secretary, Prof. Usman Yusuf, resumed office today (February 8) after his reinstatement by the Federal Government on February 6.”

    Yusuf was suspended last June by Minister of Health, Prof. Isaac Adewole, following allegations of gross misconduct.

    Security agents were seen keeping vigil on the premises of the organization in Abuja.

    In a statement yesterday in Lagos, Falana said: “In line with the provisions of the Public Service Rules, the former Secretary to the Government of the Federation (SGF) and former Director-General of the National Intelligence Agency, Messers Babachir Lawal and Ayo Oke, were suspended pending the conclusion of investigations into allegations of corrupt practices and money laundering levelled against them.

    “But the established principle has just been set aside by President Muhammadu Buhari in this case.

    “In a bid to play on the intelligence of Nigerians, the Federal Government has said the allegation of the criminal diversion of the over N900 million involving the Executive Secretary has not been swept under the carpet and that his purported reinstatement will not stop the investigation being conducted by the Economic and Financial Crimes Commission (EFCC).

    “The Federal Government should be advised to stop insulting the intelligence of Nigerians. Since Section 42 of the Constitution bans the Federal Government from according preferential treatment to any citizen, the reinstatement of Prof Yusuf cannot be justified in law. It should be withdrawn by President Buhari without delay.”

  • ‘Health minister, NHIS boss cold war threatens scheme’

    ‘Health minister, NHIS boss cold war threatens scheme’

    The Minister of Health, Prof. Isaac Adewole and Executive Secretary of the National Health Insurance Scheme (NHIS), Prof. Usman Yusuf, may have been locked in a supremacy battle, it was learnt yesterday.

    The Ministry of Health supervises the NHIS, but has denied any rift between the two professors of medicine. But there are signs of a frosty relationship between the duo.

    The Nation gathered that Yusuf was quick to say that he was appointed by President Muhammadu Buhari to salvage the scheme which had been riddled with fraud and, therefore, responsible to the president alone.

    In carrying out his duties, it was learnt, the NHIS boss boycotted the Ministry of Health, which did not go down well with Adewole.

    A source cited a recent instruction from the minister, which the ES refused to carry out. He was told to restore Ilorin as one of the two regional offices for North Central but he refused.

    Also, there is the issue of the 15 people on secondment to the agency at Yusuf’s instance. The Executive Secretary brought in the 15 people from outside to occupy vacant positions after a redeployment.

    Some NHIS workers kicked against the action and petitioned the minister who in turn directed Yusuf to reverse his action as it did not follow laid down rules.

    The alleged tension between Adewole and Yusuf is reportedly fuelled by corrupt officials who do not want sanity restored in the NHIS.

    The Convener of Governance with Responsibility Project, an NGO, Mr. Funsho Tajudeen, in a statement, warned that the sour relationship between Adewole and Yusuf could threaten the President Muhammadu Buhari-led Federal Government’s agenda on healthcare.

    While acknowledging that both professors are men of integrity, Tajudeen said some corrupt elements in the health insurance industry were desperately trying to create a wedge between Adewole and Yusuf by leveraging on primordial sentiments.

    But a ministry source denied any rift between the Minister and the NHIS boss.

    “Prof. Yusuf, on Tuesday, complied with Prof. Adewole’s directive to remove the 15 workers he brought into the scheme, which was part of the issues in the petition raised against him by protesting workers.

    “Besides, he has also reversed to the old arrangement of two zonal offices for North Central zone,” the source said.

    But this may not be the end of the disquiet in the scheme as other issues are being raised.

    Tajudeen raised other salient issues, amongst which was the alleged diversion of huge funds meant for the agency’s operation.

    Among the sharp practices raging in NHIS, according to him, are unauthorised/unbudgeted and illegal payment of N1.05 billion to Health Management Organisations (HMOs), under the guise of arrears, as reported by the 2015 Auditor-General of the federation’s report.

    On December 22, 2014 N193.3 billion was  paid into a fixed deposits on one day with 11 banks at 2 per cent interest rate, at the time when the CBN’s prevailing interest rate was 9.2 per cent, it was alleged.

    As at March 31, 2015, more than 70 per cent  of HMO’s refused to pay hospitals that rendered services to enrollees – N2,442,891,628.95 for capitation and N298,334,233.01 for service in 19 northern states and N318,428,275.75 for  capitation and N49,936,529.29 for service in 17 southern states.

    This is all despite that all HMO’s collected billions of Naira in 2015 and 2016. Thus, the total amount due to hospitals and being held illegally by some HMO’s, from the verification conducted in March 2017, stands at N3,109, 590,667.00.

    An undeveloped land adjacent to NHIS head office in Utako, Abuja was purchased at N990 million (N90 million) vide a voucher, dated January 12, 2015, when the amount in the 2015 NHIS budget was N500 million. Even then, there was neither ministerial nor FEC approval for the purchase, it was alleged.

    All decisions were approved by the management committee who are unauthorised for that volume of expenditure. ICPC interim report, dated November 15, 2015, reference No: ICPC/P/NC557/2015, captured the scenario aptly. N10.085 billion of NHIS money with Heritage Bank (account 5900000386) is still being held by the bank more than 14 months after the start of the Treasury Single Account (TSA). This is despite a written undertaking by the bank to transfer the money to the TSA.

    Not less than N11.297 billion is being withheld by a bank. The money is neither transferred to TSA nor accessible to NHIS, according to the document .