The National Health Insurance Act 2022’s operating requirements should be revised, according to the Health and Managed Care Association of Nigeria, in order to promote an affordable and inclusive healthcare system in the nation.
According to The Punch, this was declared by the association during the recently conducted Annual General Meeting of HMCAN and the IHFM, which had as its theme “Pitfalls in the 2023 NHIA Operational Guidelines “Sustainability of HMOs as Strategic Stakeholders” and was held in Lagos.
The objective, according to HMCAN, is to increase the ability of Health Management Organisations to effectively fulfil their duties as essential players in the realization of the Universal Health Coverage Scheme.
The chairman of the association and CEO of AIICO Multishield HMO, Dr. Leke Oshunnyi, voiced reservations about the new standards, pointing out that they were in violation of the 2022 NHIA Act, especially with reference to state-determined contributions for Health Maintenance Organisations.
“There are discrepancies in the guidelines,” Oshunnyi stated, pointing out that the Act stipulates that 4% of all premiums received from commercial health insurance must be sent to the NHIA each quarter. “There is no insurance regulation that demands that operators give it 4% of their hard-earned money.
“Since the guidelines state that the NHIA will determine contribution amounts, non-compliant corporate organizations that choose not to purchase health insurance for their employees are not subject to penalties.”
He emphasized how important it is to match new regulations with the Act, pointing out that the existing regulations jeopardize HMOs’ financial standing and make it more difficult for them to deliver health insurance.
Additionally, the former CEO of the National Health Insurance Authority, Dr. Muhammad Mustafa, counseled HMOs to rethink their business models through cooperation in order to meet present and future problems.
He criticized the NHIA standards and urged the regulatory body to provide an explanation for the payments made by citing the value of the services provided.
Mustafa stated, “There is a need for dialogue between the NHIA and HMOs. They must work together to contact the NHIA as a group, highlighting their contributions and asking for clarification on the necessary funding.”
Speaking at the same event, the President of the Healthcare Federation of Nigeria, Dr. Pamela Ajayi, emphasized the critical role that public-private partnerships play in guaranteeing equal access to healthcare in Nigeria, particularly in developing the Universal Insurance Health Scheme.
“More needs to be done to create a more inclusive healthcare system that addresses the movement of medical professionals and acknowledges the enormous contribution of the private sector, which accounts for over 70% in some areas,” she added.
Ajayi advocated for greater investment in healthcare and a strategic partnership between the public and private sectors.
The Deputy Director at NHIA, Aisha Haruna, for her part, encouraged appropriate avenues for issues regarding new standards and reassured stakeholders of open conversation.
