Stella Dimoko Korkus.com: MOTION BY HON CHIKE JOHN OKAFOR

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Friday, December 09, 2016

MOTION BY HON CHIKE JOHN OKAFOR



URGENT NEED TO INVESTIGATE THE COMPLIANCE RATE OF HEALTH MAINTENANCE ORGANIZATIONS (HMO’s) TO NHIS CONTRIBUTIONS AND UTILIZATION OF FUNDS BY THE HEALTHCARE PROVIDERS AND INHUMANE TREATMENT OF ENROLLEES:

Notes that the National Health Insurance Scheme (NHIS) was set up to provide health care for all Nigerians at an affordable cost through various pre-payment systems and also to ensure the availability of funds to the health sector for improved service delivery;



Also Notes that globally, health is regarded as a social security measure that guarantees the provision of healthcare services to persons on the payment of a token at regular intervals;


Further notes that one of the cardinal responsibilities of the scheme is maintenance of the highest standards with the regards to quality of care that is accorded to beneficiaries;


Equally notes that the Federal Government pays 3.5% while its employee pays 1.7% amounting to 5.25% of the monthly salary of a Federal Government worker, while the state Government, Local Government and organized private sector employers pay 10% and the employees pay 5% amounting to 15% of their monthly salary even when the services for which these premium deductions are made, are not rendered satisfactorily;




Aware that the enrollees are being short changed and used as conduit pipes to funnel revenue to the HMO’s and healthcare providers as the enrollees are treated like leprous people while trying to access the services that many strategies have been adopted by the Healthcare Providers and the HMO’s to deprive the enrollees their right to qualitative treatment and attention;




Also aware that the HMOs have received over three hundred and fifty one billion naira (351,000,000,000) from the scheme since inception in 2005 and it is regrettable to realize that the services cover less than 4% of Nigerians which is the current coverage of the scheme, and there are reports of alleged diversion of contributions amounting to billions of naira.




Further aware that the scheme pays the HMOs three months upfront to enable them provide timely, standard and qualitative health care services to the enrollees through timely and regular payment to the health care providers, but the reverse is the case;




Cognizant that the scheme’s benefit packages have many mouthwatering provisions from the primary, secondary and tertiary healthcare levels, but eleven years since its establishment, there have not been much difference because the beneficiaries/enrollees are being shortchanged, services denied, confidence in the scheme eroded and above all the core mandate of the scheme has not been achieved;




Resolves to:

Urge the National Health Insurance to put on hold further quarterly release of funds to the Health Maintenance Organizations pending the outcome of investigation by the House;
Mandate the Committee on Health Care Services to conduct an investigation on the activities of the (HMOs) and the Health care providers for the past eight (8) years with a view to identify Health Maintenance Organizations, their level of compliance with the relevant provisions of the Act and determine the reasons for the poor state of services to the enrollees and report back to the House within four (4) weeks for further legislative action.

I so move.





10 comments:

  1. Seriously there is need to checkmate the activities of the HMOs, one in particular is owing us from June till date and they are even telling us they don't know when they would pay. Another one is owing us from 2015 till date. We providers on the other hand are trying buh some of these HMOs encourage us to use cheaper medicaments on their enrollees.

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  2. I have nothing to say on this issue!

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  3. NHIS is one of the best things Obj did during his tenure, 10% Only for all medical bills, Xray nd some are Exams free and only 4% of Nigerians are on it?? Big lie

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  4. Thank God! Someone decided to do something about the shabby treatments from HMOs. These people know that most consumer health failures are emergencies, yet their emergency phone line never work. In some cases, it rings on end. Then they give one a great tussle whenever you want to recover out-of-pocket expenditures. Main culprits are Hygeia and Zenith Medicare. For Hygeiae, they will insist that they must write officially to the hospital before a patient will undergo surgery (imagine that in the case of emergency). And when the hospital renders services without the authorizing letter, they will refuse to pay them. I have been a victim severally. And my hand are tied by government policy. May God expose them for their treachery! Amen

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  5. People with NHIS are treated shabbily and it's no fair.

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  6. Thank God! Someone decided to do something about the shabby treatments from HMOs. These people know that most consumer health failures are emergencies, yet their emergency phone line never work. In some cases, it rings on end. Then they give one a great tussle whenever you want to recover out-of-pocket expenditures. Main culprits are Hygeia and Zenith Medicare. For Hygeiae, they will insist that they must write officially to the hospital before a patient will undergo surgery (imagine that in the case of emergency). And when the hospital renders services without the authorizing letter, they will refuse to pay them. I have been a victim severally. And my hand are tied by government policy. May God expose them for their treachery! Amen

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  7. Right step in the right direction. Its about time someone did something about this HMO's and their attitude to consumers, not fair at all

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  8. Even the drugs are not available to patients. Apart from the normal OTC drugs, they just tell you that the scheme doesn't cover ur treatment plan. Good job barr.

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