‘It’s exploitation’ — private hospitals to drop HMOs Feb 1 over ‘poor’ tariffs, debts

The Association of Nigerian Private Medical Practitioners (ANPMP) says it will stop rendering services to patients with insurance cover under Health Maintenance Organisation (HMO).

In a statement on Saturday, Iyke Odo, ANPMP national president, said this would take effect from February 1, 2022, if HMOs failed to increase their tariffs and renegotiate their service agreements with health providers.

Odo said despite the high cost of goods and services in Nigeria, the public is yet to adapt to the fact that hospitals and clinics are also affected and thus, cannot charge the same.

He also faulted the National Health Insurance Scheme (NHIS), stating that “health providers have become burden bearers of the nation’s insurance project” as “due process, standards and accountability have been negated”.

“Health insurance is managed care but the only way its principles can stand is when the conditions necessary to drive a successful health insurance scheme are met and they include appropriate premium pricing, appropriate service tariff pricing amongst others,” Odo said.

“Change in price occurs almost daily. Nigeria has not witnessed price summersault as it has done in the last two years. No cost of medication, medical consumables, medical devices, medical equipment, food items and general cost of living has remained the same.

“Nigerians are adapting and adjusting to spending more for everything else in the environment but hospitals and clinics are rather expected to charge less than they were charging despite the obvious course of inflation.

“We appreciate the few HMOs that have yielded to calls from providers for tariff review as part of encouraging quality care at all times. For the wide majority which has not, I implore to embrace the moment.”

Odo referred to a joint strategic meeting held in 2020 between the Health and Managed Care Association of Nigeria (HMCAN), Healthcare Providers Association of Nigeria (HCPAN), and the ANPMP where a call was made “for the establishment of a national minimum tariff to help stabilize and sanitize the crisis in our private health insurance scheme arising from the “price war” amongst HMOs”.

According to him, “HMOs in negotiating premiums for the different insurance plans undercut one another, accept extremely ridiculous premiums they know will not pay for the providers’ services, just to secure the “business”.

“Such HMOs end up delaying claims payment, some fail to pay, others pay whatever they feel like paying and dare the providers. And yet, others have liquidated with the providers’ claims unpaid.

“This is why today, well over N15 Billions of providers claims across the country is trapped with the HMOs under various guises. Following that outing, the HCPAN constituted a joint tariff review committee to actualise the proposed minimum service tariff, and today, here we are.

“The NHIIS is not favouring up to 10% of private providers on account of poor enrollment. The state support health insurance schemes have shortchanged you and I across the country.

“Private health insurance has made many of the providers’ mere labour workers, an inch away from slave labour. This is not health insurance. This is exploitation.

“This is an open war on the Nigerian healthcare system and a sure path to the poverty of providers. Much as we desire health insurance, our government should give us health insurance, not make beliefs or look-alikes. If we cannot have health insurance the way it is known to be productive and equitably beneficial, then it should be abolished until we are ready.

“This is a clarion call to all members and to all private providers across the country to use the recommended tariff and renegotiate their services agreements with their HMOs effective 1/2/22. The tariff is the minimum. You can go above it, but you should not come below it.”