The National Health Insurance Authority (NHIA) has commenced on-the-spot compliance inspections at hospitals across the Federal Capital Territory (FCT) to enforce a new directive aimed at improving service delivery under the national health insurance scheme.
The initiative seeks to ensure that Health Maintenance Organisations (HMOs) issue pre-authorisation codes within one hour of receiving a request, as mandated by the NHIA.
The exercise, conducted on Saturday in Abuja by the NHIA’s enforcement team, is part of broader efforts to eliminate delays in accessing medical care for enrollees.
The directive issued by NHIA Director-General, Dr Kelechi Ohiri, stipulates that healthcare providers must proceed with treatment if an HMO fails to issue the required code within the designated one-hour window.
During unannounced visits to the National Hospital, Abuja and the Federal Medical Centre (FMC) Jabi, the NHIA team observed varying levels of compliance.
At the National Hospital, the Acting Director of Enforcement, Dr Habib Abdulhamid, reported a 70 per cent compliance rate. However, he noted that some staff responsible for initiating pre-authorisation requests were not yet fully familiar with the new policy.
To address this, the team conducted an impromptu sensitisation session at the facility.
“HMOs found to have delayed authorisation were contacted directly during the visit,” he said, reiterating NHIA’s commitment to investigating all breaches.
He warned that both HMOs and healthcare providers found to violate the directive would face sanctions.
“The NHIA will not hesitate to sanction non-compliant healthcare facilities or HMOs. Those falling short of expectations must take urgent steps to improve,” he added.
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Mr Tony Osuji, the NHIA Desk Officer at the National Hospital, confirmed that the hospital had already introduced measures to shorten waiting times and resolve service delivery challenges for NHIA patients.
At FMC Jabi, the NHIA team reported full compliance by HMOs. However, one case of delayed care was attributed to the hospital’s failure to upload necessary data on time, despite a prompt response from the HMO.
Commenting on the outcome of the visit, NHIA Director for the North-Central B Region, Dr Chris Okoh, acknowledged notable improvements in HMO response times but stressed the need for continuous monitoring and strict adherence to NHIA policies.
NHIA plans to expand the compliance inspections to other regions in the coming weeks, as part of its drive to strengthen accountability and improve patient experience across the health insurance scheme.
