The National Health Insurance Authority (NHIA) has begun on-the-spot compliance inspections at hospitals within the Federal Capital Territory (FCT).
This initiative aims to enforce a new policy requiring Health Maintenance Organisations (HMOs) to issue pre-authorisation codes within one hour of receiving a request.
The exercise, carried out on Saturday in Abuja and led by the NHIA’s enforcement team, is part of ongoing efforts to eliminate delays in access to care for enrollees under the national health insurance scheme.
The directive introduced by NHIA Director-General, Dr Kelechi Ohiri mandates healthcare facilities to proceed with treatment if pre-authorisation codes are not issued by HMOs within the stipulated one-hour timeframe.
During unannounced visits to the National Hospital Abuja and the Federal Medical Centre (FMC) Jabi, the NHIA team observed varying levels of compliance.
At the National Hospital, NHIA’s Acting Director of Enforcement, Dr Habib Abdulhamid, reported a 70 per cent compliance rate with the one-hour rule.
However, he noted that some personnel responsible for requesting authorisation codes were not fully acquainted with the new policy.
As a result, the NHIA team conducted an impromptu sensitisation session on site.
“Some HMOs found to have delayed authorisation were contacted immediately by the NHIA team during the visit,” he said.
He reaffirmed the authority’s commitment to investigating any irregularities and warned that sanctions would be imposed on any HMO or healthcare facility found to be in breach of the directive.
“The NHIA will not hesitate to sanction any non-compliant healthcare facility or HMO. Those failing to meet the guidelines must improve their performance,” he added.
The NHIA Desk Officer at the National Hospital, Mr Tony Osuji stated that the hospital has already implemented measures to reduce waiting times and resolve bottlenecks in service delivery for NHIA patients.
Meanwhile, at FMC Jabi, the NHIA team reported full compliance by HMOs.
However, in one instance, a delay in care was traced to the hospital’s failure to upload required data promptly, despite timely response from the HMO.
Commenting on the overall outcome of the monitoring visit, NHIA’s Director for the North-Central B Region, Dr Chris Okoh, acknowledged noticeable improvements in HMO response times.
He, however, emphasised the need for sustained vigilance and strict adherence to NHIA policies.
The NHIA plans to extend the compliance monitoring exercise to other parts of the country in the coming weeks as part of its efforts to strengthen accountability and enhance the patient experience under the health insurance scheme.
NAN
