The Association of Nigerian Private Medical Practitioners (ANPMP) says it will stop providing services to patients who have insurance under the Health Maintenance Organization (HMO).
In a statement on Saturday, Iyke Odo, the national head of the ANPMP, said this will come into effect from February 1, 2022, if HMOs fail to increase their tariffs and renegotiate service agreements with health providers.
The ANPMP said that although the cost of goods and services is rising in Nigeria, the public has not yet adapted to the fact that hospitals and clinics are also affected, and therefore they cannot charge the same fees.
The association also criticized the National Health Insurance Scheme (NHIS), noting that “health service providers have become the burden bearers of the National Insurance Project” as “legal procedures, standards, and accountability have been invalidated.”
“Health insurance is managed care but the only way its principles can stand is when the conditions for a successful health insurance plan payment are met and include appropriate premium rates. And appropriate service tariff pricing among other things,” Odo said.
“The change in price is happening almost daily. Nigeria has not experienced price hikes like in the past two years. The cost of medicines, medical consumables, medical devices, medical equipment, food and general cost of living have not changed the same.
“Nigerians are adjusting and adjusting to spending more on everything else in the environment, but hospitals and clinics are instead expected to charge less than they used to despite the apparent trajectory of inflation.
“We appreciate the number of HMOs that have responded to calls from providers to review tariffs as part of encouraging quality care at all times. For the vast majority who haven’t, I appeal to you to embrace the moment.”
Odo referred to a joint strategic meeting held in 2020 between the Healthcare and Managed Association of Nigeria (HMCAN), the Health Care Providers Association of Nigeria (HCPAN), and ANPMP where a call was made “to establish a national minimum tariff to help stabilize and sterilize the crisis in Our health insurance system arising from a “price war” between HMOs.
According to him, “the HMOs in negotiating premiums for different insurance plans undermine each other, accept very ridiculous premiums knowing that they will not pay for the services of the providers, just to secure the ‘work’.
HMOs like this end up delaying payment of claims, some failing to pay, others paying what they feel they are paying and daring providers. However, others have been liquidated with providers not being paid.
“This is why more than N15 billion claims of providers across the country are trapped with HMOs under various guises today. After this trip, HCPAN formed a Joint Tariff Review Committee to operationalize the proposed minimum service tariff, and here we are.
“NHIIS does not favor up to 10% of private providers due to poor enrollment. Health insurance schemes have shortened government support for you and me across the country.
“Private health insurance has made many providers mere workers, an inch away from forced labor. This is not health insurance. This is exploitation.
“This is an open war on the Nigerian healthcare system and a sure path to poverty for our caregivers. As much as we desire health insurance, our government must give us health insurance, not belief in beliefs or suspicions. If we cannot obtain health insurance in the way that is known to be productive and profitably Fair, it should be canceled until we are ready.
“This is a clear call to all members and all private providers across the country to use the recommended tariff and renegotiate their service agreements with their HMOs as of 1/2/22. The tariff is minimal. You can go over it, but you shouldn’t occupy it.”
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