The Executive Secretary of the National Health Insurance Scheme (NHIS), Prof. Mohammed Sambo, has announced that the agency has developed a framework to extend health insurance to members of the National Youth Service Corps (NYSC).

This follows a presidential directive on the enrollment of NYSC members into the NHIS scheme, with both government agencies collaborating to ensure that funding for the initiative is obtained so that it can commence.

The disclosure was made by Sambo while speaking at a forum of the News Agency of Nigeria (NAN) in Abuja, where he said that the gesture was to boost the Universal Health Coverage (UHC).

He revealed that NHIS had been working with the management of the NYSC on the implementation of the scheme.

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What the NHIS Executive Secretary is saying

Sambo in his statement said, “What I can say is that within the NYSC programme, we have developed a comprehensive framework. We are waiting for the disbursement of the fund to begin to cover them.”

While pointing out to NAN that the NHIS had been working toward addressing the complaints of health service providers that Health Maintenance Organisations (HMOs) were owing them, he, however, said that some of the complaints sent to the management of the NHIS against healthcare providers and HMOs were without evidence, noting: “when complaints have evidence and can be quantified, then the scientific value can be attached to them.”

He said, “There have been lots of complaints but last year, in spite of COVID-19, we embarked on an aggressive exercise of reconciliation between the HMOs and the healthcare providers.

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“Before we embarked on the exercise, we said it in the media that healthcare companies being owed by HMOs should submit their complaints.

“We generated the complaints sent by the healthcare facilities that responded and set up a mechanism for reconciliation between the HMOs and the providers.

“Through the exercise, we were able to take stock of the total claims by the healthcare providers and by mutual agreement, N2.3 billion was assumed to be the uncontroverted money being owed by HMOs and we insisted that the HMOs must pay that money.”

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The NHIS boss said that as at the end of 2020, the scheme was able to recover N2 billion from the HMOs on behalf of the healthcare providers by virtue of agreement, they negotiated between themselves and decided on the time frame to pay the outstanding N3 million.

Sambo said that forensic auditors would dig deep and find out if certain claims by the service providers were verifiable in order to resolve some contentious issues that are still outstanding.

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What you should know

• The NHIS is a government agency established under Act 35 of the 1999 Constitution by the Federal Government of Nigeria to improve the health of all Nigerians at an affordable cost
• NHIS is to provide social health insurance in Nigeria where health care services of contributors are paid from the common pool of funds contributed by the participants of the Scheme.
• It is a pre-payment plan where participants pay a fixed regular amount. The amount/funds are pooled, allowing the Health Maintenance Organisations (HMOs) to pay for those needing medical attention. It is primarily a risk-sharing arrangement that can improve resource mobilisation and equity. It is indeed regarded as the most widely used form of health care financing worldwide.
• NHIS also regulate private health Insurance operated by HMOs.
• Health Insurance is a social security system that guarantees the provision of needed health services to persons on the payment of token contributions at regular intervals.
• The Executive Secretary of NHIS had said that the country needs about N3 trillion annually to provide health insurance for about 200 million Nigerians, with the agency hoping to expand its benefits package to include medical conditions like cancer, which is currently excluded.