FCTA Clears N4 Billion Health Insurance Debt, Warns HMOs
THECONSCIENCE NG reports that the Federal Capital Territory Administration (FCTA) says it has cleared outstanding health insurance debts totaling N4 billion and will sanction any Health Maintenance Organisation (HMO) under the FCT Health Insurance Scheme (FHIS) that fails to remit payments to healthcare providers promptly.
Mr. Lere Olayinka, Senior Special Assistant to the FCT Minister on Public Communications and Social Media, issued the warning in a statement on Tuesday in Abuja, emphasizing the administration’s zero tolerance for delay in provider payments.
Olayinka disclosed that the FCT Minister, Nyesom Wike, approved and cleared outstanding capitation and fee-for-service payments amounting to about N4 billion, covering the period from 2022 to 2024.
The payments were made between 2024 and 2025 to improve the quality of healthcare services provided to the FHIS enrollees.
The FHIS, according to Olayinka, is a social health Insurance programme, offering financial protection through access to quality, affordable, and equitable healthcare services to all FCT residents.
He explained that staff of the FCTA and Area Councils, including vulnerable persons and pregnant women were being enrolled for free, while other members of the public could enroll upon payment of N22,500 as premium per annum.
Olayinka said one of the benefit packages of the FHIS was the Basic Minimum Package of Health Care services (BMPHS), ranging from promotive, preventive, curative, and some rehabilitative care services.
Other services, he said, included primary preventive care, screening, primary emergency services, and secondary level care such as dental, mental, eye, ear, nose, and throat care, physiotherapy, surgeries, laboratory investigations, and radiological investigations such as ultrasound scan, and X-rays.
The spokesman, however, said that complaints have been received from some healthcare providers concerning non-remittance of their payments by some of the HMOs.
According to him, the HMOs blamed the non-payment on the nonavailability of bank details of the affected hospitals, an excuse he described as “unacceptable to the FCT Administration.”
He said that henceforth, compliance of the HMOs with the prompt remittance of payments to healthcare providers and the commitment of the healthcare providers to the FHIS enrollees would be closely monitored.
“All defaulters would be sanctioned accordingly,” he warned.
Reflecting on one year of implementation, Olayinka highlighted key achievements, including the full settlement of outstanding payment for capitations and fee for service from 2022 to the end of 2024 had been paid.
He identified other successes as improved timeliness in the payment of capitation to HMOs, upward review of capitation to healthcare providers, free enrolment of vulnerable persons, especially pregnant women, children under five years, and indigent residents.
He added that the administration conducted accreditation visits to 100 Primary Health Care (PHC) facilities to expand the number of PHC facilities providing FHIS services and, in the long run, improve access to healthcare services in communities.
According to him, all pregnant women who enrolled through the Basic Health Care Provision Fund (BHCPF) PHCs across the six area councils in the FCT will continue to enjoy free health education, medical consultation, and treatment.
“Other services include routine antenatal drugs, laboratory investigations, and delivery,” he said.
He added that referral for secondary care, including caesarean section, blood transfusion, and treatment of other obstetric complications such as eclampsia in all the 14 General Hospitals in the FCT is also provided at no cost to the patient through the BHCPF.
