NHIS to review tariff as some hospitals rip-off patients upon HMOs’ payment
Indications have emerged that the National Health Insurance Scheme (NHIS) is set to review capitation rates paid by the Health Maintenance Organisations (HMOs) to hospitals and other service providers approved for the programme.
Already, some hospitals in Lagos are now in the secret habit of going at the back to collect more money from patients whose bills had been cleared by HMOs.
Whereas some experts described the act as criminal and against the agreement had with participating hospitals, operators of the NHIS said sanctions await hospitals involved in charging extra from patients whose place of work are covered under the NHIS.
Business Hilights gathered that a hospital in Festac Town (name with held) is currently in trouble after collecting extra N200,000 from a patient when HMO had paid an official bill of N180,000.
Explaining more at a seminar in Lagos, the Zonal Coordinator of NHIS, Mr. Akingbade Olufemi, said “The tariff is due for review. There is a review going on which we expect that it should be out by 2018. A lot of bodies are involved in the review process.”
While noting that “what the HMOs were currently paying their service providers was based on the rate reviewed in 2013,” Olufemi commended Healthcare International for its qualitative services to the enrolees and for its good relationship with the hospitals.
It would be recalled that key stakeholders under the NHIS are the HMOs, which are insurance companies; the health care providers, comprising hospitals and related service providers; and the enrolees who are the registered beneficiaries of the scheme.
