The National Health Insurance Scheme has sanctioned 39 Health Maintenance Organisations for failing to raise the N400m minimum capital base required of them to be in business.

The NHIS Executive Secretary, Dr. Femi Thomas, who announced the sanction at the meeting of the NHIS HMOs Standing Committee in Abuja, said the decision was part of its measures to strengthen the scheme.

An assessment report, Thomas said, found the affected HMOs “unhealthy.”

The NHIS had given 77 HMOs in the country till August 31, 2014 to raise the funds or be delisted from its transactions.

HMOs are organisations that provide group and self-funded health insurance package to subscribers. They act as intermediaries for the NHIS, hospital owners and the subscribers.

Only five million of over 160 million Nigerians have access to the health insurance policy inaugurated 15 years ago in the country.

Thomas said, “We have announced the results and the HMOs that didn’t meet up have been sanctioned so they will have to make up whatever deficiency they have before we register them. This decision is part of quality assurance that will ensure that only healthy HMOs will help us to drive our programmes. So it is going to add value to whatever we are doing and that is the way forward.”

The PUNCH, on September 1 and 2, had published a two-part investigative story, which revealed how some HMOS were short-changing the scheme by offering services not commensurate with premiums paid by enrollees.

The story highlighted unethical practices of some HMOs and complaints from disgruntled Nigerians who enrolled for the scheme.

Meanwhile, patients who subscribed to the affected HMOs have expressed fears that their hospitals may deny them treatment.

Efforts to reach the NHIS management to speak on how this would be resolved were not successful. But a source said the NHIS may take over the assets and liabilities of the affected HMOs and reassign their patients to functional HMOs if they fail to come up with the N400m minimum capital base by the end of September.

He said, “When a bank goes underground, it does not mean that the depositors’ fund in its custody is completely gone. The Nigerian Deposit Insurance Corporation comes to absorb the responsibilities of the bank, including its management, assets and liabilities and pay all the depositors.

“In this situation, the NHIS will absorb those assets and liabilities and take responsibilities for the payment of the depositors and later set up an interim management.”

Among firms that passed the HMOs re-accreditation exercise are InvestCorp Medical Limited, Total Health Trust, Healthcare International, United Healthcare International, Hygeia HMO Limited, Managed Health Care Services, Premium Health, Maayoit Healthcare and Defence Health Maintenance.

Others are Royal Health Prepaid Medicare, Prepaid Medicare, Health Partners, Oceanic Health, Princeton, Royal Exchange Healthcare and Salus Trust.

The HMOs, which received provisional accreditation, include Doma Healthcare, Avon, HMO, Reginix Healthcare, Redcare Health, Well Health Network, Bupar Healthcare and the Police HMO.

Thomas added that the NHIS was sensitising stakeholders on the enrollment of pupils in public primary schools nationwide as well as the repackaged tertiary institutions health insurance programme.

“All these are things we would begin to see later in the year”, he added.

Already, the NHIS said it had contracted Price waterhouseCoopers to audit the functional HMOs with a view to ascertaining their preparedness to drive the NHIS initiatives.