The Health & Managed Care Association of Nigeria (HMCAN), The Umbrella Association of Accredited Health Maintenance Organisations Position on the Various Accusation of Corruption in HNIS Operations.
Our attention has been drawn to various allegations of rot in NHIS by HMOs levelled by the new Executive Secretary of NHIS, DR. YUSUF USMAN, during his visits to some selected media houses (including Hausa BBC Service), stakeholders and public fora like National Assembly, State Governments etc; the cumulation of what appeared in the Leadership and Daily Trust Newspapers of Friday 3rd February, 2017.
We say unequivocally as follows:
• The Health Maintenance Organisations have been in business of Prepaid Healthcare Scheme before the law establishing the National Health Insurance Scheme was passed in 1999.
• It is important to clarify that only about 30% of HMOs are involved in the running of the Public Sector Social Health Insurance Scheme for the federal civil servants.
• The NHIS from inception in 2005 was mandated by the critical stakeholders to collect and warehouse the premium for all the federal MDAs directly from the office of the Accountant General of the Federation on behalf of HMOs for operational convenience and to avoid Rent-Seeking and Moral Hazards; which would have been unhealthy for the emerging industry.
• For the umpteenth time that the HMOs, though recognised by Act 35 of 1999 as Contribution collector etc are not the Fund Keeper in this particular instance.
• The facts here are that for the smooth and seamless activation of the Public Sector Social Health Insurance Scheme for the Federal Civil servants in 2005, the key Stakeholders including the NHIS unanimously agreed that the Federal Civil servants in the MDAs should be allocated on equal basis to all the existing HMOs with a proviso that any established case(s) of poor Quality Assurance and Relationship Management on the part of any HMO should translate to the MDA switching to a better one.
• For clarification purpose, a fraction of total sum collected by NH IS is paid out as PREMIUM to HMOs after the confirmation of payment of Advance Payment Guarantee (APG) Bond to an Insurance Underwriter appointed by NHIS.
• So, where is this money that is being claimed diverted? By whom & to whom? Diverted as "medical subsidy" and "HEIST fostered" on Enrollees? using the words of the Executive Secretary.
• Since July 2016 when the Executive secretary started his campaign of calumny, the HMCAN at different fora had asked that the NHIS should name and shame offenders. Throw the books at them. One or two that defaulted in payment were sanctioned by the previous acting Executive Secretary. The larger majority are ethical players.
• "Nothing can be further from the truth that HMOs have taken over the function of NH1S regulatory functions". This is scandalous to say the least. It is unfortunate that the Executive Secretary literarily claimed he himself has been put under an HMO without his knowledge. The truth is, he is a new employee in NHIS and has to use the HMO that all staff of NHIS are using but to make use of his own choice hospital. We are at pain to be painted black warts and all for no apparentreason than bias and hearsay.
• If 98% of refunds have been made by HMOs, how much does this represent in Federal Government fund on behalf of Federal Ministries, Departments and Agencies yearly payment to NHIS and the amount paid to HMOs till date? How many are these HMOs out of almost 59 at the last count.
• "HMOs have collected huge amount of money and nothing to show for it", which money are we talking about? A Contract, a Subsidy? Haba! The truth is that for this particular Prepaid Scheme, our Federal Government, some Organised Private Sector players, Families & Individuals are in the net. What is this percentage in the whole population?
• We are not involved in the current face-off with his staff/union. This is calling a dog a bad name to hang it. These were the staff that booed the HMOs in Kaduna Retreat at his prompting. Let him come to judgement with equity. HMCAN is not involved in any "proxy war".
• In conclusion, our appeal to the Helms-man is to be temperate in his utterances and check the facts on the ground. We want to operate under his leadership without fear or favour. His hostile posture and campaign of calumny will not help the gains that have been made so far with this PPP programme that is now recognised internationally. This unholylibellous campaign should stop forthwith.
â–ª We implore his cronies in the mass media to operate within the ethics of the profession by cross checking and balancing their stories before going to bed. Ourlines are opened 24/7 across the country.
DR. TUNDE LADELE CHAIRMAN HEALTH AND MANAGED CARE ASSOCIATION OF NIGERIA