The Federal Capital Territory Health Insurance Scheme (FHIS) says it will delist health maintenance organisations not delivering quality healthcare services to enrollees.
FHIS director Ahmed Danfulani stated this in his address at the one-day interactive session with HMOs, FHIS and National Union of Local Government Employees (NULGE) officials on Tuesday in Abuja.
Mr Danfulani said one of the ways to ensure that enrollees in the FHIS get quality healthcare service was to engage in an interactive session and get feedback on issues and challenges.
“The sheme has some challenges. Some healthcare providers do not give regular drugs to the enrollees. However, we are looking at alternative to have private pharmacies near the healthcare facilities so that people can access those private pharmacies for drugs,” the FHIS boss explained. “There is another issue of delay in the transition code. With all the HMOs here, we are going to resolve the issues here.”
He added, “To those HMOs or healthcare providers who are not meeting up on delivery of quality service to our enrolees, you will be delisted or suspended from the scheme. Some of the challenges are not one-way traffic. The Area Councils are supposed to pay at the right time and volume to HIS so that we can also service the healthcare service providers to carry out the programmes. Some councils are doing well in terms of payment, but others are not, and it is not encouraging.”
NULGE president Zubiru-Abdullahi Kabir said there was a need to improve healthcare delivery under the FHIS, stating that the healthcare facilities “don’t attend to our members promptly,” asking HMOs to do more “and put in their best so that our members can get better healthcare delivery system.”
The care coordinator of Zuma HMO, Arimoro-Yusuf Inuwa, said HMOs work to ensure enrollees get the service from the healthcare facilities.
“However, some staff of healthcare facilities that prepare bills are incompetent, and as such, ineffectiveness leads to delay in payments, and the enrollee suffers. There is a need for frequent sensitisation of enrollees because most don’t know what they are expected to do at every level of the healthcare delivery system,” explained Mr Inuwa.