FCTA Declares War On Corrupt HMOs Over Health Insurance Failures

The Federal Capital Territory Administration (FCTA) has announced that Health Maintenance Organisations (HMOs) under the FCT Health Insurance Scheme (FHIS) will face strict sanctions if they fail to promptly remit payments to healthcare providers.....KINDLY READ THE FULL STORY HERE▶

The FHIS, a social health insurance programme, is designed to provide financial protection and access to quality, affordable, and equitable healthcare for all residents of the FCT.

Enrollment is free for FCTA staff, Area Council workers, and vulnerable groups such as pregnant women. Other residents can join the scheme by paying an annual premium of ₦22,500.

To enhance healthcare services for enrollees, the FCT Minister, Nyesom Wike, approved and disbursed approximately ₦4 billion in backlog payments for capitation and fee-for-service charges covering 2022 to 2024.

In a statement released on Tuesday by the Senior Special Assistant to the Minister on Public Communications and Social Media, Lere Olayinka, the FHIS benefit package was highlighted to include the Basic Minimum Package of Health Services (BMPHS). These cover promotive, preventive, curative, and some rehabilitative services.

Services under the scheme include primary preventive care, screenings, emergency treatments, surgeries, dental and mental health care, ENT services, physiotherapy, laboratory tests, and radiological investigations like ultrasound and X-rays.

Despite these provisions, some healthcare providers have raised concerns over non-payment by certain HMOs, who reportedly claim they lack the hospitals’ bank details—an explanation the FCTA has deemed unacceptable.

The administration emphasized that both HMOs and healthcare providers will be closely monitored for compliance. HMOs must remit payments on time, while providers are expected to deliver services diligently. Defaulters will be sanctioned accordingly.

Over the past year, FHIS implementation has seen marked improvements including:

• Full payment of outstanding capitations and service fees dating back to 2022

• Timelier capitation disbursements to HMOs

• Increased capitation rates to enhance service quality

• Free enrolment of vulnerable groups such as pregnant women, children under five, and the indigent

• Accreditation of 100 Primary Healthcare Centres to expand access across FCT communities

In addition, pregnant women enrolled via the Basic Healthcare Provision Fund (BHCPF) continue to receive free antenatal care, consultations, medications, lab tests, and delivery services at PHC centres in all six Area Councils.

They also benefit from free referrals for advanced care—such as caesarean sections, blood transfusions, and treatment of complications like eclampsia—at all 14 General Hospitals in the FCT, fully covered under the BHCPF.