The National Health Insurance Authority (NHIA) has introduced a series of changes aimed at improving healthcare access and patient care.
NHIA’s Acting Director, Media and Public Relations, Mr Emmanuel Ononokpono made this known in a statement on Sunday in Abuja.
Ononokpono said that the new measures were in response to persistent delays in treatment authorisation and the issuance of codes, adding that they took effect on April 1.
He said that they were designed to enhance service efficiency and ensure that enrollees of the National Health Insurance Scheme (NHIS) received timely and quality healthcare services.
According to him, stakeholders were informed of the new guidelines, which will help eliminate bottlenecks in the healthcare process.
Ononokpono highlighted one of the most significant updates: Health Maintenance Organisations (HMOs) must now issue treatment authorisation codes within one hour of receiving requests from healthcare providers.
“This change aims to ensure that delays, which have been a major source of frustration for patients, are drastically reduced,” he said.
He said that the NHIA also emphasised the importance of transparent communication during the process.
“In cases where HMOs cannot meet the one-hour deadline, they are now required to inform healthcare providers and enrollees promptly, providing justifiable reasons for the delay,” he said.
He said that healthcare providers had been urged to proceed with necessary treatments if delays exceed the one-hour window, with the NHIA committing to verify that services were delivered.
He said the move was crucial in ensuring that the rights of enrollees are upheld and that delays in receiving medical care are minimised.
“Further provisions in the new directive include the requirement for enrollees to report any delays exceeding the one-hour limit directly to the NHIA.
“Emergency cases, as always, will not require prior authorisation codes before treatment is administered but must obtain the codes within 48 hours of initiating care,” he said.
Ononokpono also said that the NHIA would enforce strict sanctions against entities responsible for intentionally causing delays in the authorisation process, underlining its commitment to improving healthcare delivery.
“This move is part of the NHIA’s ongoing efforts to ensure better health outcomes for Nigerians and foster a more efficient healthcare system under the NHIA Act 2022.
“Stakeholders, including healthcare providers, HMOs, and enrollees, are expected to comply with these changes as the NHIA plans regular reviews to monitor the effectiveness of the new timelines,” he said.
The reforms are expected to significantly improve patient experiences and ensure timely care delivery across Nigeria’s health sector.
This is with a particular focus on the goal of Universal Health Coverage.
The new measures aim to improve the efficiency of healthcare access and enhance patient care through quicker and more transparent authorisation processes.
NAN
