FCTA to sanction Health Management Organisations over unpaid healthcare fees
The Federal Capital Territory Administration (FCTA) has issued a stern warning to Health Maintenance Organisations (HMOs) under the FCT Health Insurance Scheme (FHIS), over failure to remit payments to healthcare providers.
In a statement issued Tuesday by Lere Olayinka, Senior Special Assistant to the FCT Minister on Public Communications and Social Media, the administration said erring HMOs risk sanctions for delays in settling capitation and service fees owed to hospitals and clinics.
The FHIS is a social health insurance programme providing financial protection and access to healthcare for FCT residents.
While enrollment is free for FCTA staff, area council employees, and vulnerable groups such as pregnant women, other members of the public can join the scheme by paying a premium of N22,500 annually.
HMO is a network or organisation that provides health insurance coverage for a monthly or annual fee.
An HMO typically limits member coverage to medical care provided by doctors, hospitals, and other healthcare providers within its network, except for emergencies and out-of-area urgent care.
4billion released to cover backlog
The statement indicates that the FCT Minister, Nyesom Wike had approved the release of N4 billion to clear a backlog of payments dating from 2022 to 2024.
It said this is part of efforts to improve healthcare delivery under the scheme.
The funds, according to the statement were disbursed between last year and this year to address delayed capitation and service fees.
“The Benefit Package of the FHIS includes the Basic Minimum Package of Health Care services (BMPHS) ranging from promotive, preventive, curative and some rehabilitative care services.
“The services include primary preventive care, screening, primary emergency services, and secondary level care such as dental, mental, eye, ear, nose and throat care, physiotherapy, surgeries, laboratory investigations, radiological investigations such as ultrasound scan, x-rays,” the statement reads
Despite this intervention, some healthcare providers have reported that certain HMOs continue to withhold payments, citing lack of bank details from hospitals, a justification the administration has described as unacceptable.
Source: Premium Times
