NHIS resolves dispute between healthcare providers, HMOs

The National Health Insurance Scheme (NHIS), has resolved the dispute between Health Care Providers Association of Nigeria (HCPAN), and Health Maintenance Organisations (HMOs).

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

Hospitals, under the aegis of HCPAN and other associate bodies, had announced plans to drop HMOs and impose a new tariff structure for private health insurance.

Ononokpono said that the action was to commence from Feb. 1, a development which created anxiety within the health insurance ecosystem.

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

Similarly, it was to ensure that persons operating health insurance on a private basis were not stranded, Sambo had explained.

He said that NHIS was the only legally recognised body that had the authority to come up with services tariffs for health insurance in the country.

Sambo added that the primary objectives of social health insurance was to limit the rising cost of health care services and protect people from financial hardships of huge medical bills.

He however indicated reservations that the system had tolerated HMOs to run “private health Insurance”, which brought distortion to social health insurance implementation.

Sambo expressed optimism that the expected passage of the NHIS bill making health insurance mandatory would permanently resolve all such distortions.

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

“Therefore any element that will threaten the smooth operations of social health insurance scheme in Nigeria must be eliminated,” he said.

Sambo noted that taking the issue to the public space in the manner which the stakeholders did; left much to be desired.

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

Speaking on behalf of Health Care Providers, Dr Jimmy Arigbabuwo said that HMOs had foisted their own tariffs on providers without regard for inflationary realities.

Arigbabuwo said that HMCAN had not acted in good faith even as they provided services to clients.

The spokesman for HMCAN Dr Leke Oshuniyi, said that members of the association were open to negotiations with the view to bringing the dispute to a close.

At the end of the meeting, representatives of Health and Managed Care Association of Nigeria (HMCAN), (HCPAN), Guild of Medical Directors, AGPMPN, and other stakeholders agreed to propositions presented by Sambo.

The parties agreed that a reconciliation would be conducted by NHIS to ascertain the level of indebtedness by HMOs to providers and media advertorial would precede this activity.

“Rapid assessment of HMOs’ private plans will be conducted to ascertain their level of conformity with the NHIS prescribed arrangements.

“HCPAN will immediately withdraw its announced tariffs, while other stakeholders who had their own tariffs will withdraw same.

“HCPAN and HMCAN are given two weeks to negotiate and agree on a mutually accepted tariff structure,” he added.

Sambo said that a follow-up meeting had been scheduled for Feb. 7, to evaluate progress on the matter.

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