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Tag: NHIS

State House Clinic to be repositioned for efficient service

The Permanent Secretary, of the State House, Mr. Jalal Arabi, on Wednesday said that State House Medical Centre (SHMC), will be repositioned to offer qualitative and efficient services.

Reacting to a recent media report on the state of the Medical Centre, the Permanent Secretary said the management will among other things seek the commercialisation of the Centre to boost its revenue and augment the appropriation it receives from the government in the quest for a better qualitative service.

In a statement by Deputy Director (Information) State House, Attah Esa, he said ‘‘The Centre is the only health centre in Abuja where patients are not required to pay any dime before consultation.

‘‘In other government hospitals in Abuja, patients are required to pay for consultation, treatment, laboratory tests and others but that has not been the case with the State House Medical Centre.

‘‘The Centre offers free services, nobody pays a kobo for hospital card, consultations or prescriptions and this has taken a toll on the subvention the Centre receives from the government.

‘‘We have some of the best equipment in the country. For instance, to maintain the MRI and other scan machines, we spend close to N2 million monthly. Yet we do not charge a dime for those who require MRI scans in the clinic,’’ the Permanent Secretary said.

Arabi said the proposed reforms will ensure that those eligible to use the Centre are NHIS complaint with their Health Maintenance Organisations (HMOs) or primary health provider domiciled in the clinic.

‘‘We have already created a NHIS desk at the clinic where patients will be required to authentic their profile. If their HMOs are registered in other hospitals they will be required to transfer to the Centre.

‘‘This is another way through which we can boost revenue generation at the hospital and this has started yielding results because the stark reality is there is no free lunch anywhere,’’ he said.

The Permanent Secretary also dismissed allegations of misappropriation and withholding of funds meant for medical supplies in the Centre.

‘‘I know people will insinuate and give all sorts of reasons because they don’t ask but it will be foolhardy and madness for anybody in his senses to defraud a Medical Centre of a kobo and toying with people’s lives.

‘‘No sane person will do that, so the truth of the matter is the hospital is being run on subvention and appropriation; if it comes we pile the drugs; but the truth is the drugs are always overwhelmed by the number of people who use the Centre, because it is not controlled,’’ he said.

October 4, 2017
‘Only two per cent of Nigerians have enrolled for NHIS’

The Guild of Medical Directors (GMD) has expressed worry about the low coverage of the National Health Insurance Scheme (NHIS) across the country.

It regretted that less than two per cent of Nigeria’s population has enrolled in the scheme, saying this is against what obtains in other African countries, particularly Ghana and Kenya, which it said have enrolled up to 69 per cent of their populations.

The GMD announced this after an emergency meeting of its national executive, presided over by its National President, Prof. Femi Dokun-Babalola.

The guild called for a speedy resolution of the face-off between the Ministry of Health and the National Health Insurance Scheme (NHIS).

It assured Nigerians that it would ensure the delivery of quality health care across the country.

The Federal Government, through the Minister of Health, Prof Isaac Adewole, ordered the suspension of NHIS Chief Executive Officer, Prof Usman Yusuf, for three months with immediate effect.

Advocating the introduction of mandatory enrolment by eligible Nigerian families, GMD also called for the implementation of the National Health Act and its domestications at the state level.

The guild expressed dissatisfaction at the current situation, which it said “tends to affect the smooth running of the scheme and thus leads to negative consequences for enrolees of the scheme”.

Although GMD said it had no objection to the current structure of the scheme involving the NHIS, the Health Management Organisations (HMOs), the service providers (hospitals) and the enrolees, but it said there is need to fine-tune the relationship between the affected organisations to achieve high quality service to enrolees.

It advised government to rectify the anomalies hindering the smooth functioning of the scheme.

In anticipation of the increased load of enrolees, GMD said there is a need to accredit more private institutions, adding that a patient should not be made to travel over five kilometres from his home to access primary care.

GMD hospitals, which Dokun-Babalola said account for about 60 per cent of health care in the country, “is unfortunately not even in the national or state health council”.

It said: “Primary health care should be left to the primary health care centres and private hospitals and taken away from the secondary (general hospitals) and tertiary care providers (teaching hospitals, specialist hospitals and Federal Medical Centres).”

August 16, 2017
How to save NHIS, by HMOs

Why did the National Health Insurance Scheme (NHIS) run into troubled water?

It is because it transformed from being a regulator to a fund manager, Health Maintainance Organisations (HMOs), under the aegis of Health and Managed Care Association of Nigeria (HMCAN), have said.

HMCAN Chairman Dr Tunde Ladele and Publicity Secretary Lekan Ewenla spoke at a media roundtable in Lagos that the scheme’s problems had affected its performance and stalled enrolling. Ladele said: “The mismanagement started when NHIS was told to warehouse the health insurance fund. Since then, NHIS’ objective has changed from regulating the scheme to marketing and managing the fund. But this is not right according to the role of NHIS as stipulated by NHIS Act 35 of 1999.

‘’The Act says HMOs are drivers of the scheme. They are the risk bearers while the NHIS is the regulator. It is because of this that the NHIS has lost its focus and a lot of things went wrong. No regulator should market what it is meant to control.

“According to the rules, the capitation fee is meant to be prepaid, but now it is postpaid. This is another distortion. Money meant to be paid at the beginning of the month now comes as a postpayment which is why the quality of care given to enrollees is affected.

“We are suggesting that all premiums paid by enrollees should be warehoused with a National Health Fund possibly with the Central Bank to avoid undue interference and abuse by insurance administrators,” he said.

Another hole picked by Ladele in the scheme is the lack of equity in the distribution of enrollees from secondary and tertiary health care to the primary health care. ‘’The scheme as a social health scheme can only work if the volume of enrollees is much and it is the role of the NHIS to ensure that this is achieved,” he said.

He said the appointment of executive secretary of NHIS should not be political because it needs a technocrat to head same, “for the success of the scheme for all stakeholders. This is because health insurance requires a professional. Somebody who understands the nitty-gritty of healthcare delivery. A person that knows his onions when it comes to health financing.”

Another problem Ladele identified is the non-existence of a Governing Council, which made it easy for anyone occupying of the position of Executive Secretary (ES) to be a boss not answerable to anyone.

“We are faced with a situation that was not created by law in which an ES has becomes the sole authority to determine who is an HMO or care provider and even disburses more than what the law stipulates.

“The situation has become an aberration in which even the excesses of some HMOs could not be punished because there is no collaboration between the regulator and the HMO managers. We call on the public to forward to us any HMO that defaults and we will ensure discipline is enforced and the affected get redress. We recommend that the Federal Ministry of Health should constitute a Council for the NHIS to restore the confidence of enrollees in the beleaguered scheme.

HMCAN also supported the suspension of the ES and probe of the NHIS. ‘’It is time Nigerians knew how well their funds are managed by the regulators. Nigerians should not to lose hope in the scheme. It is the only means to get universal health coverage to every citizen. It is barbaric and archaic for the country to regress into the former situation where Nigerians were paying hospital providers mostly for services not rendered under the health retainership method,” it said.

It suggested a six-point agenda that could pull the scheme back on track, Ewenla said: “These proposals have been in the burner since 2005. It includes a short, medium and long term. It is long overdue that the National Assembly should consider upgrading the scheme to a full-fledged National Health Insurance Commission that will give room for better regulations, as well as make the scheme mandatory for all Nigerians to buy into and operate, rather than the voluntary exercise. It is only when every Nigerian regardless of status, creed or zone can be covered in the Universal Health Insurance that its maximum benefits can be felt by the large population of the country.

“If the law makes it compulsory for every employer whether in public or private to enrol their employees, and government also obeys the National Health Act of contributing the one per cent consolidated fund for those who are not covered by the formal or informal sectors, health insurance coverage would have gone a long way to reach several millions of Nigerians.

“There is need for retirees to benefit from the scheme, as well as more coverage of diseases, especially the non-communicable, which is increasing daily.

‘’The long-abandoned ICT platform should be activated. It will ensure proper documentation and enable the NHIS, as well as the HMOs, follow and monitor the fund activities by the HMO. It will guarantee transparency. All the running around for paper works and the feeling of embezzling will be taken care of. This is because all stakeholders and interested parties will be able to monitor via the internet how money is being pooled, disbursed and returned.”

“Technology has made it simple to regulate a system and monitor same by removing encumbrances, hence, it is only ideal to embrace online administration of the nation’s health insurance scheme as soon as possible,” Ewenla added.

August 4, 2017
Senate moves to review NHIS Act

The Senate on Monday initiated moves to review the National Health Insurance Scheme (NHIS) Act, with the view to strengthening the legislation for affordable healthcare delivery in the country.

Speaking at a two-day public hearing in Abuja, the chairman, Senate committee on Health Sen. Lanre Tejuosho, said the scope of the NHIS would also be widened through Universal Health Coverage.

Tejuosho added that lawmakers the world over, play important role in the design, implementation, financing as well as raising accountability bar for social policy thrusts.

He said: “The legislature’s statutory functions of appropriation, accountability, oversight and representation are needed to create necessary legal frameworks, mobilise additional public fund and hold the system accountable to ensure high quality design and effective implementation of UHC mechanisms.

“While there are ongoing pockets of health related efforts by national and state lawmakers, the Senate Committee on Health in collaboration with development partners had resolved to institute a legislative network on UHC.

“This is to harness and align the roles of lawmakers towards advancing UHC course and serve as a veritable tool for coordination and learning among federal and state lawmakers.

“The objectives of setting up the network, among other things, include improved appropriation to health sector by deepening the knowledge of law makers on economic, social, health and political benefits of improved health funding towards UHC.

“Also, it is to ensure prompt and adequate release of allocated funds by working with the lawmakers to make relevant central budget agencies accountable for funds released.”

While declaring the hearing open, President of the Senate Dr. Bukola Saraki, said the summit was a platform seeking to strengthen institutional cooperation to advance legislative activities in the health sector.

Saraki said: “The importance of this framework cannot be overstated, as our major role as legislators is to promote the welfare of our citizens; to ensure that effective healthcare systems are available to all Nigerians.

“This informed the desire to draw in the cooperative efforts of both the National and State Assemblies targeted at developing health strategies that would work effectively for all.

“This for me is another rare opportunity for us to ensure that the legislative effort in both the National and State Assemblies are moving towards the same direction.”

Also speaking at the occasion, the Minister of Health, Prof. Isaac Adewole, charged every Nigerian to rise to the responsibility for the development of the healthcare system.

“We are changing the narrative that health is not an item of expenditure. It is a critical factor for socio-economic development.

“When we invest one dollar in infrastructure the return on investment is three dollars. When we invest one dollar in immunisation, the return on investment is 16 dollars,” Adewole said

July 24, 2017
‘N351b NHIS fraud’: HMOs get deadline on audited accounts

The House of Representatives Committee on Healthcare Services has issued a two-day deadline to 35 Health Maintenance Organisations (HMOs) to present their audited accounts.

Chairman of the committee Chike Okafor, in a chat with reporters at the weekend, said the directive was part of the committee’s investigation into the alleged mismanagement of N351 billion paid to the HMOs between 2005 and 2016.

He said of the 59 HMOs paid from the National Health Insurance Scheme (NHIS) in the last 11years, only 24 of them made their accounts available to auditing consultants appointed by his committee to ascertain amounts paid to them.

According to the lawmaker, the committee decided to give defaulting HMOs till Wednesday to make their books available to the auditors.

This, he said, is to allow HMOs present their own side of the matter.

Okafor said: “As we announced on the final day of the public hearing on the allegations of fraud in health insurance administration and the maltreatment on enrollees on NHIS, the committee sent auditors to Lagos State to thoroughly scrutinise the books of HMOs.

“This was done to compare the figures the NHIS said it paid HMOs overtime to what they actually received. So far, the auditors have gone through the accounts of 24 of them, with 35 of these companies yet to meet with those we sent.

“The NHIS provided us with all the documents to show how much they paid. But we cannot conclude the investigation without checking what the HMOs received and this is why we have given them till Wednesday to allow for a checking of their account.”

On the three-month suspension of the NHIS Executive-Secretary, Prof. Usman Yusuf and the mandate given to the committee to interrogate the Health Minister, Prof. Isaac Adewole, on the issue, Okafor confirmed that the minister will appear before his committee on Thursday.

July 24, 2017
Suspension: NHIS boss defies minister

The Executive Secretary of the National Health Insurance Scheme, NHIS, Usman Yusuf, has told Health Minister Isaac Adewole that he is not proceeding on suspension as directed by the minister.

Yusuf says the minister lacks the power to discipline him and that only the president “by virtue of the NHIS Act particularly section 4 and 8 thereof” can remove him from office “whether by way of suspension or otherwise.”

The minister had, through a July 6, 2017 memo, asked the ES to proceed on a three- month suspension to allow for an uninterrupted investigation of petitions against him in accordance with the Public Service Rules.

But Yusuf, responding in a letter dated July 12,2017, said : “Except removed from office by the president under circumstances specified in the NHIS Act, my appointment is for a period of five years subject to further term of the same period at the discretion of the president.”

He said that although section 47 of the NHIS Act empowers the minister to “give directives of a general nature to the Governing Council of the scheme and in the absence of the council, you have presidential mandate to exercise the powers and functions of the council,” the powers and functions of the council do not include discipline, suspension or removal of the Executive Secretary of the scheme from office.

Besides, he said the suspension letter “is not in accordance with the Public Service Rules as no prima facie case has been established against me in respect of the petitions referred to in the letter. The mere fact that there are pending petitions against a public officer which is yet to be substantiated does not constitute a ground for suspension under the Public Service Rules. Otherwise, with over 18,000 petitions pending against public officer holders before the EFCC and ICPC as at the end of June 2017, the total number of public officers who would have been on suspension by now, including honourable ministers is left to be imagined.”

He added: “As you are aware, the petitions referred to in your letter are currently being investigated by the ICPC which is yet to submit its report. In view of the criminal nature of most of the allegations in the petitions, security/investigative agencies like the ICPC are the appropriate agencies for the investigation contemplated in your letter; not a Ministerial Committee. I have cooperated fully with the investigations so far and will continue to do so.”

He asked the minister to allow “investigations of these petitions to follow due process.”

But in a swift response last night, spokesperson for the ministry, Boade Akinola, said Yusuf, being a public officer, is bound by the regulations governing the Public Service.

Akinola, in a statement, said:”The NHIS is an agency supervised by the Federal Ministry of Health and the Administrative Panel of Inquiry raised by the ministry to investigate activities of the agency has commenced its assignment with specific terms of reference.”

The minister had directed the setting up of an investigative committee to look in the various allegations in accordance with the Public Service Rules.

July 15, 2017
Northern groups ask Osinbajo to suspend minister over alleged corruption

Northern based groups under the aegis of Northern Youth Rights Protection and Northern Youth Development Association have asked the Acting President Yemi Osibajo to immediately suspend the Minister of Health, Prof. Isaac Adewole, over alleged corruption.

The groups also asked the acting President to reinstate the NHIS Executive Secretary, Prof. Usman Yusuf, who was suspended by the minister.

The groups at their respective press conferences said at no time was the suspended NHIS chief queried or given room to respond to any petition while the minister had several petitions against him for alleged corruption.

“If there is anyone who should be suspended from office, it is the Health Minister and not Prof. Yusuf who so far has breached no law,” they said.

The Chairman of Northern Youth Rights Protection, Comrade Haruna Abdullahi Maikano, said: “Does Prof. Adewole possess the power to fire when he has no power to hire? The answer is assertive NO.”

According to him, the minister acted in contradiction to extant laws and civil service rules.

“Where did the minister obtain his power to remove the President’s appointee? So, it is a systematic plan to paint northerners black, and get rid of them from this administration,” Maikano stated.

He urged Osinbajo to suspend the minister and reinstate the NHIS chief to his position immediately.

July 13, 2017
Reps urge Health Minister to reinstate suspended NHIS boss

Minister of Health Isaac Adewole has been ordered by the House of Representatives to reinstate the suspended Executive Secretary of National Health Insurance Scheme (NHIS) Usman Yusuf within seven day.

He was accused of contempt of the Legislative House Powers and Privileges Act and attempt to frustrate ongoing investigation into the allegations bothering on fraudulent activities of Health Management Organisations (HMOs).

The allegations came during the debate of a motion sponsored by Chairman, House Committee on Healthcare Services Chike Okafor.

Minister was accused of suspending the NHIS helmsman through a memo over alleged petitions sent to the Ministry of Health.

According to the allegation by the lawmakers, the refusal of the suspended Executive Secretary of NHIS to accommodate a number of demands like the payment of N197.073 million; $37,383 for oversea travelling to World Health Organisation conference and his unearthing of fraudulent activities of the HMOs led to his suspension.

Members of the House were of the opinion that the minister, who was an appointee of the President, has no power to suspend another appointee of the President.

The minister, who was not suspended by the President despite series of documentary petitions against him, has no moral justification to suspend the NHIS boss for 90 days, the lawmakers said.

The House requested the Minister and the acting NHIS Executive Secretary to stop henceforth every process of HMOs reaccreditation pending the outcome of the ongoing investigation mandated by the House.

July 13, 2017
NHIS: Reps accuse minister of corruption

The Minister of Health, Isaac Adewole, was on Wednesday accused of corruption by the House of Representatives over his roles in the National Health Insurance Scheme (NHIS) scandal.

He was also accused of contempt of the Legislative Houses Powers and Privileges Act and tried to frustrate ongoing investigation into the allegations bothering on fraudulent activities of Health Management Organisations (HMOs).

The allegations came during the debate of a motion sponsored by Chairman, House Committee on Healthcare Services, Hon. Chike Okafor.

At the end of the deliberation, the minister was ordered to reinstate the suspended Executive Secretary of NHIS, Usman Yusuf, within seven days.

The minister suspended the NHIS chief over alleged poor handling of the agency.

The lawmakers alleged that the refusal of the suspended NHIS chief to accommodate several demands like the payment of N197.073 million and $37,383 for trip to a World Health Organization (WHO) conference, and his unearthing of fraudulent activities of the HMOs led to his suspension.

Members of the House were of the opinion that the minister, who was a President appointee, has no power to suspend another appointee of the President.

July 12, 2017
NHIS gets acting Executive Secretary

The Federal Government on Tuesday appointed Mallam Attahiru Ibrahim as Acting Executive Secretary of National Health Insurance Scheme (NHIS).

Ibrahim’s appointment followed the suspension of the Executive Secretary of NHIS, Prof. Usman Yusuf, over his alleged poor handling of the scheme.

The new acting executive secretary, until his appointment, was the General Manager in charge of Contributions Management Department at NHIS Headquarters in Abuja.

Ibrahim, according to a statement issued by the Head of Media and Public Relations at NHIS, Odoh Onuh, promised to sustain the re-accreditation process of Health Management Organisations (HMOs) and the monthly payment for capitation to HMOs.

The Minister of Health, Prof. Isaac Adewole, on Friday suspended Yusuf over his poor handling of the agency.

The statement reads: “The Minister of Health, Prof. Isaac Adewole, has directed the Executive Secretary of Chief Executive Officer of National Health Insurance Scheme, Prof. Usman Yusuf, to proceed on three months suspension with immediate effect.

“According to the directive, the suspension was a result of various allegations and petitions against him. The minister also said he had directed the setting up of an investigative committee to look into the various allegations in accordance with the public service rules.

“The suspension was to allow for an uninterrupted investigation. Prof. Usman Yusuf has been directed to hand over to the next most senior general manager in the agency.”

July 11, 2017