The army warns providers against the treatment of illegal registrants –
The managing director of Defense Health Maintenance Limited, retired Rear Admiral Bayo Afolayan, warned military healthcare providers on Wednesday against treating illegal registrants under the national health insurance scheme.
Afolayan issued the warning in Abuja during a stakeholder meeting with military secondary health care providers.
It was titled: “Strengthening Medicare in the Armed Forces”.
The Nigerian News Agency reports that DHML is the health maintenance organization that provides health care to military personnel under the federal government’s NHIS.
Afolayan issued an ultimatum to healthcare providers to open family medical records for all NHIS registrants and their dependents by April 2022.
The chief executive said the aim of the directive was to tackle abuse of the health insurance system, which could lead to the total collapse of the entire system if left unchecked.
He said any institution without a mechanism for introspection invites failure, because reviews can quickly identify flaws so as not to destroy the establishment.
Afolayan said the HMO military system, which was the best in the country, was large and complex, and health insurance had come to stay.
He said that in order to maintain health insurance in the military, it was necessary to remind stakeholders of the principles of the HMO insurance system, which had been adopted by the armed forces.
According to him, the system operates on accurate data of eligible registrants, loyalty in claims systems and rapid disbursement of funds by HMOs.
He said: “We are all here the main components of the military health care delivery establishment, our collaborative efforts are at the heart of the delivery of health care to serving and retired personnel, their families. and their dependents.
“One of the primary mechanisms that enable HMO-based insurance is the accurate capture of eligible registrants, as capitation is calculated based on the number of registrants.
“When the system is abused and ineligible people are registered, the result is a failure of the system because these illegal entries that are captured do nothing to contribute to the system they benefit from.
“Health care providers must scrupulously ensure that only eligible people have access to care under the scheme. “
Afolayan said they had to resist the temptation to register over-aged children, added wives, friends, relatives and additional children to access care under the capitation element of the program.
He said: “Such practices are not only illegal, but can lead to the collapse of the HMO program.
“As a result, it is now mandatory for military healthcare providers to open family medical report files for all registrants and their dependents with proof of registration.
“It should start immediately because people not registered in family files will not be able to access care under the program from April 1, 2022.”
The Acting Medical Director of the Nigerian Navy Medical Services, Commodore Ibrahim Nurudeen, called the personnel health services very good.
Nurudeen acknowledged that there were some challenges, especially in the area where the NHIS law made certain exclusions, which prevented staff from accessing some high-level medical services.
He asked DHML to make a presentation to NHIS for the law to be revised.
In addition, the Nigerian Air Force medical chief, Air Commodore Olabode Babalola, said the NAF has integrated the military approved HMO insurance system.
Babalola said the NAF is carrying out all of the program’s programs according to the rules and the force has participated in primary, secondary and tertiary health care, which has been of great benefit to the staff.
He said the system was working very well, but there was room for improvement, especially operational injuries and gunshot wounds and cardiovascular surgeries were not covered by NHIS.
Babalola called for changing the NHIS law to allow treatment of gunshot wounds to better serve force personnel.