The Federal Capital Territory Health Insurance Scheme (FHIS) is planning to delist Health Maintenance Organizations (HMO) that are failing to provide quality healthcare services to enrolled patients.
Dr Ahmed Danfulani, Director of FHIS, stated this in his welcome address to the one-day interactive session with officials from HMO, FHIS, and the National Union of Local Government Employees (NULGE) on Tuesday in Abuja.
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 scheme has some challenges. Some healthcare providers do not give regular drugs to the enrollees. However, we are looking at an alternative to have private pharmacies near the healthcare facilities so that people can access those private pharmacies for drugs.
“There is another issue of delay in transition code. With all the HMOs here, we are going to resolve the issues here. To those HMOs or healthcare provider who are not meeting up on delivery of quality service to our enrollees, you will be delisted or suspended from the scheme.
“Some of the challenges are not a 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.”
Also speaking, the President of FCT NULGE, Mr Zubiru-Abdullahi Kabir, said there was need to improve in healthcare delivery under the FHIS.
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“The healthcare facilities don’t attend to our members promptly. With this interactive session, I except HMOs to do more and put in their best so that our members can get better healthcare delivery system.”
Also speaking, the Care Coordinator of Zuma HMO, Dr Arimoro-Yusuf Inuwa, said HMOs work to ensure that enrollees get the service from the healthcare facilities. Inuwa admitted that enrollees sometimes encounter challenges while trying to access healthcare in the facilities to no fault of theirs.
“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 need for frequent sensitisation of enrollees, most of them don’t know what to do at every level of healthcare delivery system.”