NHIA To Reaccredit Hospitals Over Poor Healthcare Services To Policyholders

The National Health Insurance Authority (NHIA) has said it is constantly re-accrediting hospitals and healthcare facilities over poor services to patients who are under health insurance policy across the country.

It stated that from time to time it  evaluates its partnering hospitals across states of the federation to ensure that they live up to expectations, warning that any hospital found wanting would not be allowed to provide services to patients.

Meanwhile, the Authority said, it is addressing drug shortages and care delays via a multi-pronged strategy.

The director general of NHIA, Dr. Kelechi Ohiri stated this at the annual general meeting (AGM) of Nigeria Association of Insurance and Pension Editors (NAIPE) in Lagos recently.

Ohiri, who was represented by deputy director, Lagos Zone, Aisha Abubakar Haruna, noted that NHIA was formerly known as the National Health Insurance Scheme (NHIS) stating that NHIA had expanded coverage to fistula patients.

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He added that the Fistula-Free Initiative and Financing CEmOC Services had collectively empowered over 7,500 women by May 2025, noting that, 2,690 women had received life changing obstetric fistula repairs at 17 dedicated centres while 5,289 women benefited from emergency obstetric care at over 200 CEmOC facilities.

He highlighted the NHIA’s strategic interventions from 2024 to 2025, to include: the revision of tariffs; resolving complaints; sanctioning non-compliant providers/HMOs; revising accreditation processes; as well as mandating a one-hour limit for care authorisation code.

The NHIA boss said: “These interventions are helping to mitigate previous issues of medicine shortages, care denials/delays in issuing code, and provider payment delays.

“On cancer treatment initiative, an MOU was signed with ROCHE for a cost sharing payment for NHIA enrollees for cancer treatment medication. Apart from the initial five teaching hospitals that were selected to flag off the initiative, there has been a scale up for more facilities to provide financial access to NHIA cancer patients with NHIA/ROCHE sharing the cost.

The DG noted that from 2024 to 2025, NHIA had strategically intervened in the revision of tariffs, revising the accreditation processes and mandating one hour limit on care authorisation while mitigating any previous issues for medicine shortages, denial, delay in issuing codes and provider payment delays.

He said: “A few years back, we upgraded to self-automation, but now we are fully automated on accreditation of NHI facilities, and I can assure you any facility that we ascertain to have met the standards will meet international standards. We use Safe Care tools, and everything is done online. You have over 100 questions on that platform, the tool that we use.

“We started an accreditation of over 192 facilities in Lagos. We are running accreditation, and we will soon be embarking on re-accreditation because we have upgraded the standard. We are going to carry out re-accreditation of these facilities to ensure that those that were initially accredited are still operating within the standard, or they can meet the current standard. For those who cannot meet the standard, they will be asked to exit the platform.”