From Kemi Yesufu, Abuja
Executive Secretary of the National Health Insurance Scheme (NHIS), Prof. Usman Yusuf, has accused Health Maintenance Organisations (HMOs) of mismanaging N351 billion paid them between 2005-2016 for the provision of health services to federal civil servants.
Speaking yesterday at an investigative hearing by the Chike Okafor-led House of Representatives Committee on Health Services on the compliance rate of HMOs to NHIS contributors and utilisation of funds by healthcare providers, Yusuf insisted that despite the huge sums paid HMOs in 12 years, they failed to pay hospitals as at when due, and this resulted in majority of enrollees being treated shabbily.
He vowed to recoup the N3.5 billion debt owed hospitals by HMOs, even as he revealed that the weeding out of ghost enrollees will save the Federal Government N288 million annual payment for these fictitious patients.
HMOs have been padding the number of enrollees they have with the complicity of NHIS staff in the ICT department, led by a former General Manager of the department, who later became Executive -Secretary of the NHIS.
“This is not hearsay. This has been investigated by the Independent Corrupt Practices Commission (ICPC) and the Department of State Services (DSS), and the reports are there,” Yusuf said.
In response, representatives of HMOs denied the allegations made against them by the NHIS boss and said he had often displayed “open hatred” towards them.
But a mild drama played out as HMOs were represented by two different associations.
Dr. Lekan Ewenla, who made a presentation on behalf of Health and Managed Care Association of Nigeria, stressed that Yusuf lacked proper understanding of the administration of health insurance.
“From day-one he (NHIS Executive-Secretary) has been displaying open hatred to HMOs. All the issues he raised are really about NHIS poor implementation of its regulatory role,” Enwela said. Dr. Ademola Aderibigbe, who spoke on behalf of 10 HMOs under the Association of Health Maintenance Organisation and Practitioners of Nigeria, argued that not all service providers have been fraudulent as members of his association have strived to be up to date with payments to hospitals.