Health insurance: NHIS unites with HMOs against misconducts

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Lekan Ewenla

Having set up a committee to sanction offenders, health maintenance organisations (HMOs) under the aegis of the Health and Managed Care Association of Nigeria, (HMCAN), said they have united with the National Health Insurance Scheme (NHIS), to fight against misconduct in the industry.

The Publicity Secretary of the Health and Managed Care Association of Nigeria, (HMCAN) Mr Lekan Ewenla, made this known recently in Lagos.

It will be recalled that the HMCAN recently established a new committee- Joint Ethics or Standard Compliance Committee charged with the sanitisation of the industry.

It is in order to fulfil the mandate of the committee that the association chose to partner with the NHIS, Dr Ewenla explained.

Explaining further about the collaborate with the NHIS, he said; "In order to take full ownership of the industry and redeem the battered image that the recent crisis had caused, we sought for a legal advice. We were told that we need the legal binding of NHIS as a regulator to sanction offenders.

“So we meet with NHIS to seek its support and collaboration and the body has agreed. They know that it will take two of us to come together for us to set a standard and begin to sanitize the industry and whoever that is found culpable, whether HMOs or healthcare providers will be sanctioned. Once we investigate and write a report to NHIS, NHIS will sanction,” he said.

Mr Ewenla said that a four-man committee headed by Dr 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. Other members of the committee include Dr Gbenga Idowu, former managing director of Multi Shield HMO; Dr Bola Sunny, former managing director of Defense HMO, and Dr Ebun Sonaya who was the executive coordinator in Total Health Trust.

Mr Ewenla 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 for their selection is to ensure fairness and objectivity.

“So with their presence they can take an informed decision. They can be seen being very objective and fair,” he asserted.

In addition to that, he said: “We are equally going to be to consult more with other critical stakeholders so that we can have a binding of everybody. It is we Nigerians that will develop this country and as such we’ve decided to take the bull by the horn by setting the standards and the meeting we had today, despite the fact that we sent letters to all our members, we equally called this meeting to reemphasize the fact that whoever is not doing the right thing should change his ways because any moment from now we are going to start sanctioning. The committee will start sitting any moment from now,” he assured.

However, to make the health insurance scheme grow in Nigeria, Mr Ewenla advised that there is a need for the National Assembly to urgently review the law of the scheme and make it mandatory. He also advised that there should be a change in name of the National Health Scheme to National Health Commission and to ensure that governing council of that agency is inaugurated.

“In addition to that, the governing council should also ensure that the ICT and software that is needed to run this scheme on the auto drive should urgently be implemented, 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,” he advised.