The Executive Secretary of the National Health Insurance Scheme (NHIS), Prof. Mohammed Sambo, announced on Sunday that the company has developed a framework to extend health insurance to members of the National Youth Service Corps (NYSC).
Speaking at a forum of the News Agency of Nigeria (NAN) in Abuja, Sambo said that the gesture was to boost the Universal Health Coverage (UHC).
He said that NHIS had been working with the management of the NYSC to implement the scheme.
According to him, enrolment of NYSC members into NHIS is a presidential directive and we have been working in partnership with the NYSC to ensure that the fund for the coverage is obtained, so that national insurance scheme can begin to cover youth corps members.
“What I can say is that within the NYSC programme, we have developed a comprehensive framework. We are waiting for the disbursement of the fund to begin to cover them.”
Sambo also said that the NHIS had been working toward addressing the complaints of health service providers that Health Maintenance Organisations (HMOs) owed them.
He said, however, that some of the complaints sent to the management of the NHIS against healthcare providers and HMOs were without evidence, noting: “when complaints have evidence and can be quantified, then scientific value can be attached to them.
“There have been lots of complaints but last year, in spite of COVID-19, we embarked on aggressive exercise of reconciliation between the HMOs and the healthcare providers.
“Before we embarked on the exercise, we said it in the media that healthcare companies being owed by HMOs should submit their complaints.
“We generated the complaints sent by the healthcare facilities that responded and set up a mechanism for reconciliation between the HMOs and the providers.
“Through the exercise, we were able to take stock of the total claims by the healthcare providers and by mutual agreement, N2.3 billion was assumed to be the uncontroverted money being owed by HMOs and we insisted that the HMOs must pay that money.”
The NHIS boss said that as at the end of 2020, the scheme was able to retrieve N2 billion from the HMOs to the healthcare providers and by virtue of agreement, they negotiated between themselves and decided on the time frame to pay the remaining N3 million.”
On contentious issues that might not have been resolved, Sambo said that forensic auditors would dig deep and find out if certain claims by the service providers were verifiable.
“If we find them to be verifiable, we will insist that HMOs pay or we take punitive action against them but if we find out that they are not verifiable, there is nothing we can do.
“We try our best to reduce the strains of the contention. So now if you plot a graph and follow the trend of the complaints, you will see that the complaints from healthcare providers have drastically gone down,’’ he said.
NAN