The National Health Insurance Authority (NHIA) has delisted six and suspended four healthcare facilities, while sanctioning 47 health maintenance organisations (HMOs) for delivering substandard services to patients enrolled in Nigeria’s state and national health insurance schemes.
According to the Authority, the sanctions followed investigations into complaints received from enrollees throughout 2024, as detailed in its Annual Complaints Report compiled by the agency’s Enforcement Department.
The report highlighted recurrent grievances against healthcare facilities, including the unavailability of medicines, denial of services, out-of-pocket payments for covered treatments, and non-provision of payment narrations. For the HMOs, the issues related to delays or denials of referral authorization codes, delays in settlement of agreed reconciled payments, refusal to monitor quality assurance in facilities etc.
