Whistle Blowing: NHIS, HMOs, Others Revolve Around Monumental Fraud

·     HMOs refuse to remit N2.44bn to hospitals
·     2 banks hold on to Scheme’s N21.38bn
·     Corrupt elements fuel feud between Minister, NHIS boss

All is not well with the National Health Insurance Scheme (NHIS) as huge funds meant for its smooth op­erations are at present in wrong hands.
The worst culprits are banks and Health Management Organisations (HMOs).

While the banks have re­fused to transfer the NHIS funds in their vaults to the ap­propriate accounts, the HMOs have failed to remit monies they collected from NHIS patrons or subscribers to the affected hos­pitals.
At the last count, two banks are alleged to have refused to transfer NHIS’ N21.382 bil­lion to the Treasury Single Ac­count (TSA) while the HMOs are holding on to N2.442billion due to the hospitals as fees.
Apart from the sleaze per­petrated by these institutions, the NHIS is also facing board­room politics with the Minister of Health, Prof. Isaac Adewole and the NHIS boss, Prof. Us­man Yusuf, pitted against each other.
The tension between Ade­wole and Yusuf is reported­ly fuelled by corrupt officials who do not want sanity to be restored in the NHIS.
The sordid state of affairs at the NHIS was brought to the public domain on Tuesday by the Convener of Governance with Responsibility Project, Mr. Funsho Tajudeen.

In a statement issued yes­terday, Tajudeen said that his group was forced to draw atten­tion to happenings in the health sector of the Nigerian econo­my, particularly as it pertains to the NHIS.
He said the sour relation­ship between Adewole and Yu­suf could threaten the agenda of the Muhammadu Buhari ad­ministration on healthcare.
While acknowledging that both professors are men of in­tegrity, Tajudeen claimed that some corrupt elements in the health insurance industry were desperately trying to create a wedge between Adewole and Yusuf by leveraging on primor­dial sentiments.
He also deplored the activ­ities of HMOs, which, he said, received N32 billion quarter­ly payment from the NHIS, but leave “nothing to chance in their desperate desire to en­sure a continuation of the ugly past where billions of naira are pocketed every month with­out commensurate service de­livery.”
“The HMO in charge of the Nigeria Police Force, for example, receives N4.7 billion alloca­tion every quarter, even when they have not still fulfilled re­quirements of becoming a HMO. It was former President Goodluck Jonathan who di­rected that they should be giv­en temporary licences, which they still use.”
“Most HMOs in the coun­try have not even fulfilled the criteria set up by law. But they are still in practice because they are owned by powerful individ­uals. Any attempt to stop them always meets with serious re­sistance. For example, a former Senate President (name with­held) is believed to be the own­er of Precious HMO. Another former Senate President also has his own HMO. It will be interesting to establish wheth­er these HMOs are delivering quality services or are being used as drainpipes,” he said.
According to Tajudeen, when Yusuf was appointed as the Executive Secretary of the NHIS last August, he met an institution that was deeply en­meshed in nauseating corrup­tion.
Tajudeen said that a piece of land adjacent to the institution was purchased at close to one billion naira, at a time its ac­tual value, as confirmed by the Federal Capital Territory (FCT) Land Department, was a third of that amount (N300 million).
He alleged that contract-splitting was the order of the day, and the procurement pro­cess had broken down.
Tajudeen therefore ap­pealed to the Health Minster and the NHIS boss to close ranks and ensure they do not betray Nigeria by “treating these monumental cases of massive corruption with kid gloves. Even if a corrupt HMO belongs to the family of any of them, they should remember the fact that tens, if not hun­dreds of people, might have died through their activity or inactivity, and this shows they should not continue to exist.”
Tajudeen urged the unions of the NHIS being used against the agency’s management to remember that Nigerians are watching, and posterity is go­ing to judge them.
He said that their grudge against the secondment of some key personnel from some fed­eral parastatals was untenable because “it is well located in the civil service rules. Not eve­ry chief executive of a govern­ment parastatal will be com­fortable working with people who were part and parcel of the corrupt past. We are not in the least suggesting all of them are corrupt.”
The group said that a sit­uation where subscribers are treated like lepers in hospitals because HMOs have pocketed the monies meant for payment to hospitals must be stopped.
Among the sharp prac­tices that are raging in NHIS, according to him, are unap­proved/unauthorised/unbudg­eted and illegal payment of N1.05 billion to HMOs under the guise of arrears as reported by the 2015 Auditor-General of the Federation’s Report.
He recalled that on 22nd December, 2014 vide memo No NHIS/CMD/ 12/ Vol Vii page 985, the sum of N193.3 billion was placed on fixed de­posit in one day with 11 com­mercial banks at 2% inter­est rate at the time when the CBN’s prevailing interest rate was 9.2%.
The group observed that as at 31st March, 2015, more than 70% of HMOs have blatantly refused to pay hospitals that render services to enrollees the sum of N2.442 billion for cap­itation and N298.334 million fee for service in 19 northern states and N318.428 million for capitation and N49.936 million for fee for service in 17 South­ern states.
This is in spite of the fact that all HMOs have been collecting billions of naira throughout 2015 and 2016, three months in advance.
Thus, the total amount due to hospitals being held illegally by some HMOs from the ver­ification conducted in March 2017 stands at N3.109 billion.