NHIA deploys compliance officers to tackle illegal charges in hospitals

n n

The National Health Insurance Authority has commenced the deployment of Compliance Officers to accredited healthcare facilities as part of efforts to strengthen regulatory oversight, improve service delivery and protect enrollees from illegal charges and denial of healthcare services.

n

The initiative, which begins with 18 accredited health facilities in the Federal Capital Territory, is expected to serve as a pilot before being expanded to more facilities across the FCT and other states.

n

The development comes as the Federal Government continues to pursue Universal Health Coverage by expanding access to affordable, quality healthcare through the NHIA.

n

While health insurance coverage has steadily increased in recent years, concerns have persisted over delayed treatment, out-of-pocket payments for covered services, medicine shortages and complaints from enrollees about the quality of care at some accredited facilities.

n

To address these challenges, the NHIA has intensified efforts to strengthen compliance with operational standards and improve accountability among healthcare providers participating in the national health insurance scheme.

n

The agency explained that the deployment of Compliance Officers forms part of its statutory responsibility to guarantee quality healthcare for all Nigerians enrolled in the scheme.

n

In a statement it issued on Thursday, the authority noted, “The National Health Insurance Authority (NHIA) has taken a major step to ensure quality and accountability in healthcare facilities.

n

“As part of its mandate to provide financial access to quality care for all, the NHIA has commenced the deployment of Compliance Officers to selected accredited facilities — starting with 18 facilities in the Federal Capital Territory (FCT).”

n

According to the NHIA, the programme will be scaled up nationwide after the pilot phase, adding that the compliance officers would be responsible for ensuring that healthcare providers comply with NHIA operational guidelines and that enrollees receive the benefits to which they are entitled.

n

It stated, “This pilot initiative will be expanded to more facilities across the FCT and other states upon successful implementation.”

n

Clarifying the role of the officers, the NHIA stressed that they would not interfere with medical decisions taken by healthcare professionals.

n

It listed their responsibilities as follows: “Prevent delay or denial of approved services to enrollees, and stop illegal out-of-pocket payments. “Ensure availability of medicines and consumables, receive and resolve enrollee complaints promptly, monitor adherence to benefit packages, and report compliance issues for necessary action.

n

“Compliance Officers are NHIA representatives who serve as on-site liaisons for regulatory oversight, enrollee support, and quality assurance. They do not interfere with clinical decision-making.”

n

The authority described the initiative as another milestone in its ongoing reforms aimed at improving healthcare delivery under the Federal Government’s Renewed Hope Agenda.

n

“This move is another strong step toward protecting enrollees and improving service delivery under the Renewed Hope Agenda. Share this if you support quality healthcare!”

n

PUNCH Online reports that the NHIA has, in recent years, introduced a series of reforms to expand health insurance coverage, improve provider accountability and reduce the financial burden of healthcare on Nigerians.

n

The deployment of Compliance Officers is expected to strengthen oversight at accredited facilities, improve patient experience and enhance confidence in the national health insurance programme.

n n