To corroborate efforts around the country in curbing the menacing effect of the coronavirus (COVID-19), the National Health Insurance Scheme (NHIS) has effected the immediate release of funds for the payment of capitation and fee-for-service for its enrollees for the second quarter (April to June).
This is to guarantee uninterrupted access to healthcare services by enrollees of the Scheme in these challenging times.
By this action, NHIS has ensured that no enrollee will be turned back from any facility for non-payment of appropriate fees by any Health Maintenance Organization (HMO).
The Head of Media and Public Relations of the NHIS, Ayo Osinlu, made this known in a statement on Tuesday in Abuja.
According to him, โThe Scheme took the step to ensure that the looming threat of COVID-19 is not compounded for the enrollees by inability to access healthcare services at the points of need.
โResponding further to the situation, NHIS has issued guidelines to the HealthCare Facilities (HCFs) and the Health Maintenance Organizations (HMOs) on certain actions to be taken towards protecting the interests of the enrollees in the current situation.
โThese guidelines contain concrete provisions to prevent service failure, and also ensure that they enjoy prompt and effective healthcare services inspite of general restrictions and outright lockdown in certain parts of the country.
โThe guidelines gave clear order to healthcare providers to ensure the safety and protection of their personnel against COVID-19 infection, provide timely and appropriate level of care for all NHIS enrollees as may be required, and ensure that no NHIS enrollee is denied access to care.
โIt also directed the providers to note that all NHIS and HMO call centres are open 24 hours daily. They are also to ensure the issuance of authorization codes and resolution of all other issues, ensure prompt report of all cases of denial of authorization codes by HMOs, as well as maintain high index of suspicion and promptly report suspected cases to NCDC or State Ministries of Healthโ.
He further added: โOn the other hand, the guidelines for the HMOs instructed them to also ensure the safety and protection of their personnel against COVID-19 infection, ensure prompt payment of capitation and fee-for-service to all healthcare facilities, while also ensuring the provision of timely and appropriate level of care for all NHIS enrollees by the healthcare facilities.
โThe HMOs are, by the guidelines, required to ensure that no NHIS enrollee is denied access to care, while their call centres are to be open 24 hours daily, for prompt issuance of authorization codes and to resolve all other issues that may arise.
โThey are equally directed to log all cases of issued or denied requests for authorization code by healthcare facilities.
โMeanwhile, NHIS will continue to closely monitor the situation, and may revise the guidelines in the light of new developments.
โThe Scheme has in the meantime advised all its stakeholders to adhere strictly to Local, State and Federal Public Health recommendations to curb the spread of COVID-19 in the countryโ.
