…as Reps plan fresh probe in two weeks
- Missing NHIS fund diverted for 2019 elections – PDP
The next few weeks may be challenging for the Ministers of Finance and Health, Mrs. Kemi Adeosun, and Prof. Isaac Adewole, respectively, as the lawmakers in the House of Representatives have perfected plans to further beam their searchlight on what they describe as financial misappropriation surrounding the activities of the National Health Insurance Scheme.
Investigations by our correspondents revealed that the House Committee on Health matters would query the ministers in two weeks’ time over their roles in the controversial withdrawal of a whopping N10 billion from the Treasury Single Account of the NHIS, activities of the Health Maintenance Organisations, and lack of access to the contributory health insurance scheme by civil servants and the private sector.
HMOs are designed to deliver quality health care to a designated population in a cost effective manner, through health care providers, who are paid either a fixed budget or discounted fee. They use a value-driven system of managed care to provide affordable health services.
Findings also revealed that, while Adeosun is expected to answer questions on the “whereabouts” of the missing fund, which she allegedly authorised after her health ministry counterpart had suspended the Executive Secretary of the NHIS, Prof. Usman Yusuf, the health minister will be expected to tell the committee all he knows about the fund, alleged fraudulent activities of HMOs, and reasons 95 per cent of the contributors cannot access the NHIS fund.
A member of the committee, who preferred anonymity, due to the ongoing investigation by the lawmakers, told The Point that a team of auditors had monitored the activities of the HMOs, especially in Lagos, and found that the NHIS had paid several millions of naira to the organisations, but that the money didn’t get to the healthcare providers.
He said, “Most of the HMOs did not pay to healthcare providers. We have documents and facts from NHIS showing that the scheme had paid huge sums of money to HMOs. The HMOs would also be invited in two weeks to defend themselves on how they remitted the money to the hospitals, the care providers, for Nigerians to know whether the officials of NHIS are corrupt or it is the HMOs or service providers or Nigerians that are getting Medicare and they are lying that they are not.”
Investigations also revealed that about N20 million was paid as capitation to 23,000 contributors, who were later found as ‘ghost enrollees’ by the HMOs.
Capitation is the payment, which the client makes on a regular basis (monthly) to a clinic or a hospital (the provider), and started with N550 monthly, before it was increased to N850.
HEALTH EXPERTS REACT
Stakeholders, under the aegis of the Pharmaceutical Association of Nigeria, are not happy with the scheme, especially with the capitation method of payment.
A pharmacist, Mr. Tope Oretade, blamed the managers of the NHIS for allowing medical doctors to hijack the scheme and determine what other professionals would get from the bounty.
He said, “Some of the HMOs do not pay the retainer hospitals as and when due. On the other hand, the retainer hospitals do not give the patients the best services, because they are either being owed by the HMOs or do not have the capacity to provide the services they promised.
“The implication of all these with the alleged fraud is that the nation might witness increased mortality rate because a lot of Nigerians are suffering from diseases that could be taken care of, if they can access adequate healthcare.”
The President, Association of Clinical and Academic Physiotherapists of Nigeria, Prof. Rufus Adedoyin, explained that if such allegations were swept under the carpet, it would erode foreign investors’ confidence in the sector.
He said, “If the money meant for public health services is mismanaged, it will affect the health of Nigerians negatively, especially the workers.
“The scheme is meant to be a succour to the contributors, when they have health challenges. It will add more strain to the pockets of Nigerians, if they cannot get adequate health access from the government, which will make them turn to the private health sector that is expensive. This means that the whole objective of the scheme has been defeated.”
FUND DIVERTED FOR 2019 ELECTIONS – PDP
However, other stakeholders in the political scene alleged that the intention of the ruling All Progressives Congress-led Federal Government was to use the missing N10 billion to partly fund the 2019 general elections.
The National Publicity Secretary of the Peoples Democratic Party, Mr. Kola Ologbondiyan, said, “The money might have been withdrawn for political reasons, to further entrench and deepen the political interest of APC. The National Assembly should thoroughly investigate the allegations and probe anyone found guilty of financial misappropriation. The committee should make the sittings public for transparency.”
He added that his party had earlier issued a statement urging the Presidency to investigate the circumstances surrounding the alleged missing fund from the TSA.
“But till this moment, the Presidency has not responded to the party’s query, and as concerned citizens, we are not pleased with his silence on the issue,” he added.
Recall that the fund was reportedly taken in two tranches of N5billion in December 2016 and N5billion in January, 2018.
The deductions had initially been tagged as “missing,” prompting the House Committee on Healthcare Services to invite Yusuf to explain what happened to the N10billion.
The committee is chaired by a member of the APC from Imo State, Mr. Chike Okafor.
Before the committee, Yusuf had argued that it was inappropriate to have described the N10billion as ‘missing.’
Rather, he said the money was deducted from the NHIS account by the Ministry of Finance and the AGF as operating surplus recorded against the NHIS.
The NHIS boss said that there was the erroneous classification of the NHIS as a revenue-generating agency that was required to remit operating surpluses to the Consolidated Revenue Fund of the Federal Government in compliance with the Fiscal Responsibility Act, 2007.
He recalled that as of December 2016, the Ministry of Finance was already asking the agency to remit N8.8billion as operating surplus, from 2012 to 2015.
Yusuf told the committee, “I went to the minister (Finance) to explain that we are not a revenue-generating agency and that we didn’t breach any Act, neither were we expected to remit operating surpluses.
“The money we keep is contributed by Nigerians and the government for their health services, as different from revenue.”
