By Admin:
The National Health Insurance Authority (NHIA) has sanctioned 49 healthcare facilities (HCFs) and 47 Health Maintenance Organizations (HMOs) for various breaches in 2024, as part of ongoing efforts to enhance service quality for enrollees under the Authority and the state health insurance schemes.
According to the NHIA 2024 Annual Complaints Report, a total of 3,507 complaints were received, with 2,929 (84%) resolved. Most of the complaints were against HCFs and focused on issues such as denial of services, unavailability of medicines, and demand for out-of-pocket payments for services already covered under the scheme.
Following investigations, 84 formal warnings were issued to healthcare providers, while 54 enrollees received refunds totaling ₦4,375,500 from 39 HCFs. Additionally, four facilities were suspended, six were delisted, 35 HMOs were issued warning letters, and 12 HMOs refunded ₦748,200 to 15 affected enrollees.
NHIA Director-General, Dr Kelechi Ohiri, said the complaints resolution process is essential to rebuilding trust and improving care quality. He emphasized that enrollees deserve the best, and the sanctions serve as a message that substandard service will not be tolerated.
Dr Ohiri also commended healthcare providers who are delivering high-quality services, describing them as partners in the journey toward Universal Health Coverage (UHC). He noted that with the recent increase in provider payments, the first in 12 years, patients should experience improved care and faster service delivery.
In a further policy move, the NHIA has mandated a one-hour deadline for HMOs to issue referral codes. If no response is received within that period, providers are authorized to begin treatment. These measures, the NHIA said, are part of its commitment to accountability, transparency, and President Bola Ahmed Tinubu’s vision to make UHC a reality for all Nigerians.
