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 of 2020 to curb the spread of Coronavirus (COVID-19).
NHIS disclosed this in a statement signed by its Head, Media and Public Relations, Mr Ayo Osinlu on Tuesday in Abuja.
According to Osinlu, the release of the funds from April to June is one of many corporate initiatives of the NHIS to curb the spread of COVID-19 in the country.
“This is to guarantee uninterrupted access to healthcare services by enrolees of the Scheme in these challenging times.
“By this timely action, NHIS has ensured that no enrolee will be turned back from any facility for non-payment of appropriate fees by any Health Maintenance Organisations (HMOs).
“The Scheme took the step to ensure that the looming threat of COVID-19 is not compounded for the enrolees by inability to access healthcare services at the points of need.’’
Responding further to the situation, the official said NHIS had issued guidelines to the HealthCare Facilities (HCFs) and the Health Maintenance Organisations (HMOs) on certain actions to be taken towards protecting the interests of the enrollees in the current situation.
“These guidelines contain concrete provisions to prevent service failure, and also ensure that enrolees enjoy prompt and effective healthcare services inspite of general restrictions and outright lockdown in certain parts of the country.
“The guidelines gave clear order to healthcare providers to ensure the safety and protection of their personnel against COVID-19 infection.
“It provides timely and appropriate level of care for all NHIS enrolees as may be required, and ensure that no NHIS enrollee is denied access to care.
“It directed the providers to note that all NHIS and HMO Call Centres are open 24hours daily.
“They are also to ensure the issuance of authorisation codes and resolution of all other issues and ensure prompt report of all cases of denial of authorisation codes by HMOs.
“Also, the health providers should maintain high index of suspicion and promptly report suspected cases to Nigeria Centre for Disease Control or State Ministries of Health.’’
On the other hand, he said the guidelines for the HMOs instructed them to also ensure the safety and protection of their personnel against COVID-19 infection.
“The guideline instructs that HMOs should ensure prompt payment of capitation and fee-for-service to all healthcare facilities.
“It instructs that HMOS should ensure the provision of timely and appropriate level of care for all NHIS enrolees by the healthcare facilities.’’
In addition, Osinlu said, the HMOs were required to ensure that no NHIS enrollee would be denied access to care.
He said that their call centres should to be open 24 hours daily, for prompt issuance of authorisation codes and to resolve all other issues that may arise.
“They are equally directed to log all cases of issued or denied requests for authorisation code by healthcare facilities.’’
Meanwhile, he said NHIS would continue to closely monitor the situation, and might revise the guidelines in the light of new developments.
“The 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 country,’’ he added.
