NHIS resolves dispute between healthcare providers, HMOs

Mr. Emmanuel Ononokpono, Deputy General Manager of NHIS, said this in a statement in Abuja on Tuesday.

The Nigerian News Agency , reports that hospitals, under the aegis of HCPAN and other partner agencies, had announced plans to abandon HMOs and impose a new fee structure for private health insurance.

Ononokpono said the action would start from February 1, a development that created anxiety within the health insurance ecosystem.

Prof. Mohammed Sambo, Executive Secretary, NHIS, in a meeting with the parties, reached a provisional but mutual understanding, aimed at ensuring that a potential crisis was averted.

Similarly, it was to ensure that people who operate health insurance privately were not stranded, Sambo explained.

“Private health insurance is a practice in which HMOs purchase health care for interested individuals based on predetermined agreements. It is usually outside of the NHIS system,” he said.

He said that NHIS was the only legally recognized body that had the authority to set service fees for health insurance in the country.

Sambo added that the main goals of social health insurance were to limit the rising cost of health care services and to protect people from the official hardship of huge medical bills.

However, he indicated reservations that the system had tolerated HMOs administering “private health insurance”, which distorted the implementation of social health insurance.

Sambo expressed optimism that the long-awaited passage of the NHIS bill making health insurance compulsory would permanently resolve all such distortions.

“Social health insurance is the only vehicle through which Nigerians can access quality and affordable health care.

“Any element that threatens the smooth functioning of the social health insurance scheme in Nigeria should therefore be removed,” he said.

Sambo pointed out that bringing the issue to the public space in the way that the stakeholders did; left a lot to be desired.

According to him, disagreements can be resolved when the parties listen to each other’s positions and strive to reach a compromise.

Speaking on behalf of health care providers, Dr. Jimmy Arigbabuwo said that HMOs had imposed their own fees on providers without considering inflationary realities.

Arigbabuwo said that HMCAN had not acted in good faith even when providing services to clients.

HMCAN spokesman Dr. Leke Oshuniyi said the association’s members were open to negotiations with a view to ending the dispute.

At the end of the meeting, representatives from the Health and Managed Care Association of Nigeria (HMCAN), (HCPAN), the Guild of Medical Directors, AGPMPN and other stakeholders agreed on the proposals put forward by Sambo.

The parties agreed that a reconciliation would take place to determine the level of indebtedness of the suppliers and that the media advertorial would precede this activity.

“A rapid assessment of private HMO plans will be carried out to determine their level of compliance with the arrangements prescribed by the NHIS.

“HCPAN will immediately withdraw its advertised rates, while other stakeholders who had their own rates will withdraw them.

“HCPAN and HMCAN have two weeks to negotiate and agree on a mutually acceptable fee structure,” it added.

Sambo said a follow-up meeting had been scheduled for February 7 to assess progress on the matter.

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Source: NAN

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