NHIS: HMOs owes National Hospital over N600m, others ranging between N500 and N300m

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NHIS: HMOs owes National Hospital over N600m, others ranging between N500 and N300m

THE Chairman, Committee of Chief Medical Directors (CCMDs), Dr Jafaru Momoh, revealed on Thursday that the Health Management Organisations (HMO) under the National Health Insurance Scheme (NHIS), are owing the National Hospital, Abuja over N600 million Naira.

Dr Momoh, who is also the Chief Medical Director (CMD) of National Hospital, Abuja said there are other teaching hospitals that are owed within the range of N300 million to N500 million by the HMOs.

He also called for a review of tariff, saying that the present tariff payable under the scheme has been decided many years ago.

Dr Momoh, who spoke in an interview with journalists at a strategic stakeholders’ engagement with healthcare providers organised by the National Health Insurance Scheme (NHIS) in Abuja, blamed the HMOs for using excuses and technicality to delay and sometimes deny payment of bills incurred by NHIS enrollees in hospitals.

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When informed that the HMO was accusing the healthcare providers of delay in making their papers available for payment on time and this causes delay in the payment, the Chairman, CCMDs said: “Let them pay the one we have submitted, forget about the bills we have not yet submitted, the one we have submitted already, six hundred and something million, they have not yet paid, let them pay that one first.

“There is a time period for submission, but there are delays in payment, which means even if there is a time period for payment, they are not complying. They are using delay tactics by giving so many excuses and talking about technicalities.”

In his presentation, Dr Momoh said the healthcare providers are major stakeholders and added that the engagement will provide an opportunity to resolve some issues that have been troubling this scheme.

He said: “In order to achieve universal health coverage, we must promptly look at increasing the enrollees, we must look at burning issues such as prompt payment of bills, we must look at issues such as the current service vis-a-vis the economy atmosphere we are operating in, and the current tariff, the capitation which we have decided many years ago. We must look at whether this scheme is supposed to be saving money or spending money or whether HMOs are supposed to be paying money or delaying bills.”

He warned that the debt and continuous delay in their bills have affected the internally generated revenue of the hospitals, saying that this may also affect them from performing their responsibilities.

He said: “This attitude of HMOs of using a technicality to deny or delay payment of bills can jeopardize the scheme. These are the problems bedevilling the scheme.

“I would appreciate where standing bills currently as at today will be cleared. I know teaching hospitals that are being owed more than N300 million, some N500 million as at today by HMOs, and the issue is on technicalities. Did you receive this particular vote, did you use it for the wrong thing. And I have said particularly for me who is a CMD of a Federal Tertiary Institution, I have no reason to submit false bills. So, if you keep delaying, it means we may not be able to release the drugs to treat the next patient.

“Is it possible to look at the proper audit of this system, so that we can clear all the outstanding bills. Is it possible, to quickly review this tariff?”

NHIS: HMOs owes National Hospital over N600m, others ranging between N500 and N300m
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