NHIS Releases Pandemic Guidelines for HMOs

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The National Health Insurance Scheme (NHS) has developed guidelines to tackle the spread of

In a statement issued yesterday, NHIS said, as part of its response to the COVID-19 pandemic, the scheme had ensured the “immediate release of funds for payment of capitation and fee-for-service for April to June 2020 to accredited HMOs to guarantee uninterrupted access to healthcare services for enrollees”.

The scheme said, consequent upon the protocols of the Federal Government and similar directives by various state governments in order to curtail the spread of COVID-19, it had directed all NHIS accredited healthcare facilities to comply with its guidelines.

The guidelines read in part, “Ensure the safety and protection of their personnel against COVID-19 infection. Provide timely and appropriate level of care for all NHIS enrollees as may be required. Ensure that no NHIS enrollee is denied access to care.

“Note that all NHIS and HMO call centres are open 24 hours daily to ensure issuance of authorisation codes and resolution of all other issues. Ensure prompt report to NHIS of all cases of denial of authorisation codes by HMOs.

“Maintain high index of suspicion and promptly report suspected cases to Nigeria Centre for Disease Control and/or state ministries of health. NHIS will monitor the situation and may revise these guidelines as may be considered appropriate. We encourage all NHIS accredited healthcare facilities to adhere strictly to local, state, and federal public health recommendations.”

The NHIS added that, in line with the prescription of the Federal Ministry of Health, the Nigeria Centre for Disease Control and the World Health Organisation (WHO), it “highly recommends community approach to curtailing the spread of the disease.”