FG Fixes New Medicine, Services Pricing Structure for Health Insurance
The National Health Insurance Authority (NHIA) and other stakeholders have agreed on a new medicine and services pricing structure.
The agreement was reached at the NHIA second Stakeholders’ Engagement in Abuja.
A statement released by the acting Director of Media and Public Relations at the NHIA, Emmanuel Ononokpono says the meeting settled for 60% increase in the capitation fee and 40% upward review in Fee-For-Service (FFS).
Capitation and Fee-For-Service are forms of payment made to healthcare providers for services rendered to Enrolees under NHIA.
While Capitation is a fixed amount of money per patient per unit of time paid in advance to the physician for the delivery of health care services, Fee-for-service is where a doctor or other health care provider is paid a fee for each particular service rendered under health insurance.
The statement states that the new tariffs, which apply to current services offered under the Authority, take immediate effect.
According to the statement, the new price regime is without prejudice to the outcome of the ongoing actuarial studies commissioned by the NHIA in February this year
Present at the Meeting were representatives of Association of private medical practitioners, health maintenance organizations (HMOs), Guild of Medical Directors (GMD) and other key players in the health insurance ecosystem who endorsed a six-point communique with a range of resolutions.
“One of the resolutions is that the forum will hold a quarterly meeting to align with developments in the sector to ensure synergy and transparency”
The Director General of the National Health Insurance Authority (NHIA) Dr Kelechi Ohiri said the review of the tariff was part of the ongoing efforts to improve health insurance access to Nigerians.
Health Care Providers in recent times have been complaining that both the capitation fee and the fee for service have not been reviewed for many years of health Insurance existence in the country.
Dr Ohiri therefore called for synergy and cooperation among the stakeholders, which is paramount in achieving the goal of universal health coverage, assuring that the Authority will maintain a close and cordial relationship with all relevant stakeholders.
