HMCAN collaborates with NHIS to sanction operators who flout standards
Health and Managed Care Association of Nigeria (HMCAN), an umbrella body of the Health Management Organisations (HMOs), the statutory key drivers of health insurance in Nigeria, has agreed with the Nigeria Health Insurance Scheme (NHIS) to develop a ‘holistic code of ethics’ that will guide the operations of HMOs in Nigeria.
This is against the backdrop of constant accusation by hospitals that HMOs are failing to settle their obligations to healthcare organisations. To protect the reputation of the HMOs, its association, HMCAN says it will now act to enforce guidelines in the sector.
“With all these challenges, the leadership of the Association has decided to take ownership of the industry through the introduction, implementation and enforcement of compliance with a holistic code of Ethic by all Accredited Health Maintenance Organisations,” stated a letter signed by Tunde Ladele, chairman of HMCAN to all HMOs in Nigeria, seen by BusinessDay.
Ladele further said the enormous challenges and the systematic blackmail of all the HMOs by other critical stakeholders in the last couple of years required that strong measures were taken to sanitise the system.
“We want to embark on a strategic consultation, it is our responsibility for everyone to understand the scheme and we seek for their support and collaboration to work together with the set standards and begin to sanitise the industry,” said Ladele.
“To take full ownership of the industry, HMCAN (including HMOs and service providers) has sought for a legal advice and have realised that they needed the binding of the National Health Insurance Scheme (NHIS) as a regulator, because without the NHIS they do not have the capacity to sanction” said Lekan Ewenla, national publicity secretary of HMCAN in press briefing, last Wednesday, in Lagos.
Ewenla further said a four-man committee headed by Ladi Awosika, a retired managing director of Total Health Trust, would drive the committee for the association to be able to experience the desired change.
He explained that members of the committee are neither executive member of the association nor active members that they are their senior colleagues who had retired from the industry and the reason is to ensure fairness and objectivity. “So with their presence they can take informed decision. They can be seen being very objective and fair,” said Ewenla.
Ewenla added, “there is a need for the National Assembly to urgently review the law of the scheme, make the scheme mandatory in order for health insurance scheme to grow in Nigeria.”
HMCAN is advising for a change of name of the National Health Insurance Scheme (NHIS) to the National Health Insurance Commission (NHIC).
“The National Health Insurance Scheme (NHIS) is designed to be commissioned like the Securities and Exchange Commission of Nigeria (SEC), regulatory agency are tends to be commissioned and government should ensure that the council of the agency is inaugurated.
“The government council should ensure that the information and communication technologies (ICT) and the software that is needed to run this scheme on auto drives should urgently be implemented, because it is long overdue. Right now, the scheme is been driven manually and anybody that is found not to be playing the game according to the set goals should be taken out of the field of play.
“There should be meaningful and constructive observations on the enhancement of the newly introduced compliance framework,” said Ewenla.