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FCTA Targets HMOs for Delaying Provider Payments

Federal Capital Territory Administration Takes Action Against Defaulting HMOs

The Federal Capital Territory Administration (FCTA) has made it clear that it will not tolerate delays in payments by Health Maintenance Organisations (HMOs) under the FCT Health Insurance Scheme (FHIS). The administration has issued a strong warning to these organisations, stating that they will face appropriate sanctions if they fail to remit payments to healthcare providers in a timely manner.

This message was conveyed through a statement released on Tuesday by the Senior Special Assistant to the FCT Minister on Public Communications and Social Media, Lere Olayinka. According to the statement, the FCTA is committed to ensuring that all healthcare providers are paid promptly for services rendered under the FHIS programme.

Overview of the FCT Health Insurance Scheme

The FHIS is a social health insurance programme designed to provide financial protection to all residents of the Federal Capital Territory. It aims to ensure access to quality, affordable, and equitable healthcare for everyone. While enrolment is free for FCTA and Area Council staff, as well as vulnerable groups such as pregnant women, other residents are required to pay an annual fee of N22,500 to join the scheme.

The FCT Minister, Nyesom Wike, recently approved a sum of N4 billion to address outstanding or backlog payments for capitation and fee-for-service from 2022 to 2024. This payment was made between last year and this year, as part of efforts to improve the healthcare system. However, the FCTA has received complaints from healthcare providers regarding some HMOs failing to remit their due payments. These HMOs have reportedly used the excuse that hospital bank details were missing, which the government has deemed unacceptable.

Ensuring Compliance and Accountability

In response to these issues, the FCTA has pledged to monitor the compliance of HMOs with their obligation to remit payments promptly to healthcare providers. Additionally, the government will also track the performance of healthcare providers to ensure they fulfill their duties to FHIS enrollees. Any defaulters will be sanctioned accordingly.

The SSA highlighted several achievements in the implementation of the FHIS over the past year. These include the clearance of all capitation and service payment backlogs, improved payment timelines for HMOs, increased capitation rates for providers, and expanded access to healthcare through the accreditation of 100 Primary Health Care (PHC) centres across the FCT.

Support for Pregnant Women

Pregnant women enrolled through the Basic Health Care Provision Fund (BHCPF) at PHCs in the six Area Councils will continue to receive free health education, medical consultation, and treatment. They will also have access to routine antenatal drugs, laboratory investigations, and delivery services.

Furthermore, referrals for secondary care, including caesarean sections, blood transfusions, and treatment for obstetric complications such as eclampsia, will be provided at no cost to patients at all 14 General Hospitals in the FCT through the BHCPF.

Commitment to Healthcare Improvement

The FCTA remains committed to enhancing the quality of healthcare services provided to FHIS enrollees. By addressing payment delays and improving accountability, the administration aims to build a more reliable and efficient healthcare system that benefits all residents of the Federal Capital Territory.

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