The National Health Insurance Scheme (NHIS) on Tuesday disclosed that it had recovered the sum of N2 billion debts from Health Maintenance Organizations (HMOs) being unpaid bills to healthcare facilities.
The NHIS General Manager, Enforcement Department, Mohammad Ghali, disclosed this during a stakeholders sensitization workshop held in Kano to strengthen effective operations of the scheme.
Ghali explained that the recovery was sequel to complaints by health care providers over HMOs’ non-payment of charges for services rendered to enrollees and subsequent adoption of a principle of reconciliation between the HMOs and healthcare facilities and payment to the latter their outstanding claims of about N2 billion.
The GM explained: “Over some period, what the NHIS witnessed before the coming of the new management led by Prof. Nasiru Sambo, there are lots of complaint coming from the healthcare providers. And part of the complaint is that they are subjecting our enrollees to sometimes hardship.
“When you ask, they would say some other services that they rendered to the enrollees, the HMOs did not pay. And this is coming to an unbearable level.
“So, he now directed that the management through the department that action must be taken. And that is why we came up with this principle of reconciliation whereby we collected all debts due to the health care facilities period of 2019.
“We invited the HMO to meet with the healthcare facilities that are alleging that they are indebted to them. And they did the reconciliation between June and July 2020. As of September 2020, from our report from the state, about N2 billion have been recovered from the HMOs as payment that has now been done to the health care facilities. A letter of non-indebtedness is issued to HMO that finishes clearing its debt.
“The exercise is still ongoing across the 36 states and FCT. Because there are some HMOs that are yet to complete the payment”, Ghali added.
He also gave some insights into the benefits of the new Groups, Individuals and Families Social Health Insurance Programme (GIFSHIP) package introduced by the NHIS to cater for a large number of persons and the needy, among others.