On Thursday, June 22, 2017 most national dailies had headlines such as: NHIS: FG Wants Health Management Organisations Scrapped Over Mismanagement of N351bn - Daily Times; Health Insurance: FG Wants To Scrap HMOs For Mismanaging N351bn – Independent; and Health Insurance: FG may scrap HMOs over N351bn fraud – Authority.

In reaction, many comments hit the social media, asking why the Ministry of Health and the National Health Insurance Scheme (NHIS) support the scrapping of the health management organisations.

It will be recalled that the House Committee on Health Services has requested the Minister of Health to attend a public hearing on “Investigation on compliance rate of Health Maintenance Organisations (HMOs) to the NHIS contributions and utilisation of funds by the health-care providers (HCPs) and inhumane treatment of enrollees.”

The hearing was scheduled for June 21 and 22, 2017.

The Minister of Health, Prof Isaac Adewole, was represented at the public hearing by the Director of Hospital Services in the ministry, Mr Wapanda Balami.

From the submission of the minister, he never called for the scrapping of the HMOs, but rather he called on the House to amend the NHIS Act in the area of inclusion of representatives of HMOs on the board of NHIS, and the weak punitive measures under the NHIS Act.

To set the record straight, following are the minister’s position at the public hearing:

1. Access to affordable and good quality health-care is a key element in the actualisation of our Universal Health Coverage (UHC) goal

2. Efforts by the House committee to address the challenges faced by Nigerians under the National Health Insurance Scheme is a step in the right direction

3. The minister noted the issues raised by the House committee and looks forward to a resolution that reduces inefficiency within the system, improves service delivery and elevates patient-centred care

4. The minister also noted that the issues raised under the votes and proceedings, appears to suggest that states and LGs employers and employees currently pay 10 per cent and 5 per cent respectively, as contributions to the health scheme. This is inconsistent with information available to my office.

5. The minister also noted that the document appears to suggest that the N351 billion premium paid to HMOs was geared towards the expansion of the scheme. This assumption appears incorrect

6. Federal Government pays between 5 per cent and 5.25 per cent of consolidated salary as premiums for federal civil servants

7. These funds are deducted at source and paid into the NHIS account

8. HMOs are paid by the NHIS to provide care for registered beneficiaries under their portfolio

9. 70 per cent of the fund paid to HMOs is expected to be transferred to HCPs immediately as capitation

10. A default by HMOs to transfer the funds as at when due is a punishable offence under the NHIS Act

11. The NHIS needs to perform better in its regulatory and oversight functions and ensure funds are transferred by HMOs within stipulated periods

12. Equally important is that the role of expanding the coverage is the mandate of the NHIS, and not that of the HMOs.

The minister also noted that the document stated that the funds (premiums) were being diverted. He further said that the House committee reserves the right to review the allegations of diversion of funds. That said, the NHIS’ role, as a regulator could be better. In line with its powers, it could do more to ensure errant HMOs are appropriately sanctioned.

In his submission, the minister suggested that the House committee may wish to empower the NHIS in its regulatory and oversight functions, particularly as it relates to sanctioning errant HMOs.

I want to use this opportunity to call on editors to scrutinise news reports submitted to them by their reporters before publishing, to avoid embarrassment and unnecessary rejoinder.

•Adewole Kehinde is the Publisher of Swift Reporters, based in Abuja. He can be reached via kennyadewole@gmail.com

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