NHIS fraud: How Ayim,Mark,Thomas, sent sick Nigerians to early grave -Group

NHIS fraud: How Ayim,Mark,Thomas, sent sick Nigerians to early grave -Group

NHIS fraud: How Ayim,Mark,Thomas, sent sick Nigerians to early grave -Group

By Abdullahi Mohammed

Uncovering the alleged alarming proportion of fraudulent activities and financial irregularities taking place at the National Health Insurance Scheme, NHIS, a civil society group, Citizens Actions to Take Back Nigeria, CATBAN is calling on relevant agencies to arrest and prosecute the former Executive Secretary of NHIS, Dr Femi Thomas, former Secretary to the Federal Government, SGF, Ayim Pius Ayim, former Senate President, David Mark and other allegedly involved in the fraud.

The group warned that if not checked, fraud will diminish the objectives of the NHIS thereby ultimately shutting down the program.

According to CATBAN, its findings unearthed issues ranging from financial irregularities and violation of due processes,
health maintenance organization (HMO) fraudulent activities, and
Bank fraud and, unaccounted earnings.

Addressing newsmen in Abuja, the Coordinator of CATBAN Coalition, Ibrahim Garba Wala pointed out that part of the findings show that NHIS under the leadership of Dr Thomas purchased a land at inflated price against the Budgetary provision.

“The budgetary allocation for the purchase of land for NHIS in 2014 was N500million. However, the undeveloped land at Plot no 815 Utako, adjacent NHIS head office in Abuja was purchased under former Executive Secretary of the Scheme, Dr. Femi Thomas at the cost of N990million (N90million as Agency fee) vide voucher with reference No NHIS/ADM/002/2015 dated 12/01/2015. This constitutes a major violation, when the actual amount budgeted for that purpose in the 2014 NHIS budget was N500million.

“Investigation at the Federal Capital Development Authority (FCDA) revealed that contrary to the claim of purchasing the said land at N990million, the FCDA placed a N639 million value on it, leaving a N351 million yawning difference.

He further disclosed that “On 22nd December 2014 vide memo number NHIS/CMD/12/Vol. Vii, page 985, the sum of N193.3 billion was placed in a fixed deposit on one day with eleven (11) commercial banks at 2% interest rate at a time when CBN prevailing interest rate was 9.2%”.

He also cited Illegal payment to Health Maintenance Organisations, HMO’s, disclosing that “the erstwhile Executive Secretary of NHIS, Dr. Femi Thomas made illegal payments of N1.05billion to Health Maintenance Organizations (HMO’s) under the guise of arrears without any approval or authorization from the Board of Governing Council or budgetary allocation as stated by the 2015 Auditor General of the Federation’s report.

He said that based on the provision of the act setting up the Scheme, monetary approvals in excess of N2,500,000 must be ratified by the Board before approval for disbursement, but this was never followed, as the former Executive Secretary, Dr. Femi Thomas allegedly unilaterally made payment of the above sum without any form of consultations with the Board.

Health Maintenance Organizations (HMOs) are medical insurance groups that provide health services for a fixed annual fee. They provide or arrange managed care for health insurance, self funded healthcare benefit plans, individuals, and other entities, acting as a liaison with healthcare provider (hospitals, doctors, etc.) on a prepaid basis.

Wala however said these organizations have been corrupted and screwed against the citizens, as the HMO’s often get paid 3 months in advance, without the hospitals ever getting to receive their money and as a result, many Nigerians are deprived of proper medication thereby leading health complications or untimely deaths.

The group fingered former Senate Presidents, Ayim Pius Ayim and David Mark as owners of some of the HMO’s stealing billions of naira from the scheme.

“It may interest everyone here today to know that Senator Anyim Pius Anyim, a former Secretary to the Government of the Federation (SGF) and Senator David Mark, a former Senate President are some of the owners of these HMO’s involved in stealing billions under the National Health Insurance Scheme”.

“As at 31st March 2015, more than 70% of HMOs had blatantly refused to pay hospitals that render services to enrollees their due sum of N2,442,891,628.95 for capitation and N298,334,233.01 for service fees in 19 northern states; and N318,428,275.75 for capitation and N49,936,529.29 for service fees in 17 Southern states.

“This is in spite of the fact that all the HMO’s had been collecting Billions of Naira, advanced them upfront for every 3-months throughout 2015 and 2016. Thus, the total amount due to hospitals being held illegally by some HMOs from the verification conducted in March 2017 stands at N3,109, 590,667.00”, he said.

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