NHIS resolves tariff dispute between healthcare providers & HMOs

Sharing Is Caring:

Individual health insurance policy and stethoscope.

NHIS resolves tariff dispute between healthcare providers & HMOs

THE National Health Insurance Scheme (NHIS) said it has amicably resolved the dispute between Health Care Providers (HCPs) and Health Maintenance Organizations (HMOs) in Nigeria.

The intervention of the agency, according to its Deputy General Manager, Press, Emmanuel Ononokpono – in a statement, was aimed at “avoiding possible service disruption.”

Recall that hospitals under the aegis of Health Care Providers Association of Nigeria (HCPAN) and other associate bodies had announced plans to drop Health Maintenance Organizations (HMOs) and imposed a new tariff structure for private health insurance from February 1, 2022.

The development, according to the statement, would have “created anxiety within the health insurance ecosystem.”

“At a meeting convened at the instance of the Executive Secretary of the National Health Insurance Scheme (NHIS), Prof Mohammed Sambo, the parties reached an interim but mutual understanding aimed at ensuring that a potential crisis is averted and persons operating health insurance on a private basis are not stranded,”the statement read.

Private health insurance is a practice  where HMOs buy health care for interested persons under pre-determined arrangements. Usually, it is outside NHIS system.

“In his remarks, Sambo stated that NHIS was the only legally recognized body that has the authority to come up with services tariffs for health insurance in the country, noting that the primary objectives of social health insurance was to limit the rising cost of health care services  and protect people from financial hardships of huge medical bills.

“Sambo, however indicated reservations that the system had tolerated HMOs to run “Private Health Insurance” which brought distortion to social health insurance implementation, expressing the optimism that the expected passage of the NHIS bill making health insurance mandatory will permanently resolve all such distortions. 

“Social health insurance is the only vehicle by which every Nigerian can access quality and affordable health care. Therefore any element that will threaten the smooth operations of social health insurance scheme in Nigeria must be eliminated”,the statement quoted Sambo as saying.

It added:”Sambo further noted that taking the issue to the public space in the manner which the stakeholders did left much to be desired, adding that disagreements can be resolved when parties  listen to each other’s positions and make effort to reach a compromise.

“Speaking on behalf of Health Care Providers, Dr Jimmy Arigbabuwo stated that HMOs had foisted their own tariffs on providers without regard for inflationary realities, insisting that HMCAN had not acted in good faith even as they provide services to their clients.

“For their part, the spokeman for HMCAN Dr Leke Oshuniyi said that members of the association were open to negotiations with the view to bringing the dispute to a close.

“At the end of the meeting, representatives of Health and Managed Care Association of Nigeria (HMCAN), Health Care Providers Association of Nigeria (HCPAN), Guild of Medical Directors, AGPMPN and other stakeholders agreed to propositions presented by the Executive Secretary of NHIS.”


Sharing Is Caring:

16 thoughts on “NHIS resolves tariff dispute between healthcare providers & HMOs

Leave a Reply

Your email address will not be published. Required fields are marked *

Previous post LASG Health Insurance Policy Sensitization Exercise
Next post How Can Government Curb Misdiagnosis
DISCLAIMER: Oshobaba Health Tunnel provides general information and discussions about health and related subjects. All of the content provided on the website, including but not limited to text, graphics, images, outcomes, charts, profiles, videos, advice, messages and other material contained on www.oshobaba.com.ng or in any linked materials, are for informational purposes only and should neither be construed as medical advice, nor is the information a substitute for independent professional medical judgment, advice, diagnosis, or treatment. If you or any other person has a medical concern, you should consult with your health care provider or seek other professional medical treatment. Never disregard professional medical advice or delay in seeking it because of something that have read on this blog or in any linked materials. Talk with your healthcare provider about any questions you may have regarding a medical condition. You understand and acknowledge that all users of this website are responsible for how they choose to use this information.