By Philip Yatai

The Federal Capital Territory Administration (FCTA) says it will sanction any Health Maintenance Organisations under the FCT Health Insurance Scheme (FHIS), who failed to remit payments to healthcare providers promptly.

Mr Lere Olayinka, Senior Special Assistant to the FCT Minister on Public Communications and Social Media gave the warning in a statement in Abuja on Tuesday.

Olayinka explained that the FHIS was a social health
Insurance programme, offering financial protection through access to quality, affordable and equitable healthcare services by all FCT residents.

He added that staff of the FCTA and Area Councils, including vulnerable persons and pregnant women were being enrolled for free, while other members of the public could enroll upon payment of N22,500 as premium per annum.

He added that about N4 billion, outstanding payments for capitation and fee for service from 2022 to 2024 was approved by the FCT Minister, Nyesom Wike and paid between 2024 and 2025.

This, according to him, is to improve the quality of healthcare services provided to the FHIS enrollees.

He said that one of the benefit packages of the FHIS was the Basic Minimum Package of Health Care services (BMPHS), ranging from promotive, preventive, curative and some rehabilitative care services.

Other services, he said, included  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, and radiological investigations such as ultrasound scan, and x-rays.

The spokesman, however, said that complaints have been received from some healthcare providers concerning non-remittance of their payments by some of the HMOs.

According to him, the HMOs blamed the non-payment on nonavailability of bank details of the affected hospitals.

“This excuse is not acceptable to the FCT Administration government.”

He said that henceforth, compliance of the HMOs to the prompt remittance of payments to healthcare providers and the commitment of the healthcare providers to the FHIS enrollees would be closely monitored.

He stressed that all defaulters
would be sanctioned accordingly.

On implementation of the FHIS in the last one year, Olayinka said that outstanding payment for capitations and fee for service from 2022 to the end of 2024 had been paid.

He identified other successes as improved timeliness in the payment of capitation to HMOs, upward review of capitation to healthcare providers, free enrolment of vulnerable persons, especially pregnant women, children under-five years and indigent residents.

“Others include accreditation visits to 100 Primary Health Care (PHC) facilities to expand the number of PHC providing FHIS services and in the long run, improve access to healthcare services in communities.

“Also, all pregnant women who enrolled through the Basic Health Care Provision Fund (BHCPF) PHCs across the six area councils in the FCT will continue to enjoy free health education, medical consultation and treatment.

“Other services include routine antenatal drugs, laboratory investigations and delivery.

“Referral for secondary care, including caesarean section, blood transfusion and treatment of other obstetric complications such as eclampsia in all the 14 General Hospitals in the FCT is also provided at no cost to the patient through the BHCPF,” he said. (NAN)

Edited by Abiemwense Moru