Source: Zainab Adewale

Health facility Used to illustrate the story

The Federal Capital Territory Administration (FCTA) has issued a strong warning to Health Maintenance Organizations (HMOs) participating in the FCT Health Insurance Scheme (FHIS) over delays in remitting payments to healthcare providers.

In a statement released on Tuesday by Lere Olayinka, Senior Special Assistant to the FCT Minister on Public Communications and Social Media, the administration stated that HMOs who fail to remit capitation and service fees risk sanctions, including possible removal from the scheme.

₦4 Billion Released to Clear Backlog

To address payment delays, FCT Minister Nyesom Wike approved the disbursement of ₦4 billion between 2023 and 2024 to offset outstanding debts dating back to 2022. The funds are meant to enhance healthcare delivery and strengthen provider confidence in the scheme.

Despite this intervention, some HMOs are reportedly still defaulting on payments, citing excuses such as lack of bank details from healthcare facilities — a justification the FCTA has dismissed as “unacceptable.”

“Compliance of the HMOs to the prompt remittance of payments to Healthcare providers, as well as commitment of the Healthcare providers to the discharge of their duties to the FHIS enrollees will be monitored with a view to sanctioning defaulters appropriately,” the statement noted.

FHIS: Improving Access for FCT Residents

The FCT Health Insurance Scheme (FHIS) provides social health coverage to FCT residents, with free enrollment for FCTA staff, area council employees, pregnant women, and other vulnerable groups. Other residents can join by paying an annual premium of ₦22,500.

The benefit package includes a broad range of services:

• Primary and secondary healthcare, including emergency services
• Preventive and promotive care, such as vaccinations and screenings
• Mental, dental, eye, and ENT care, surgeries, physiotherapy
• Laboratory and radiological investigations (e.g., x-rays and ultrasound scans)

Focus on Pregnant Women and Vulnerable Groups

The FCTA also emphasized its commitment to vulnerable populations, particularly pregnant women. Through the Basic Health Care Provision Fund (BHCPF), enrollees receive free antenatal care, medical consultations, laboratory tests, and safe delivery services, including caesarean sections and blood transfusions, at the 14 general hospitals in the territory.

Over the past year, the FCTA has:

• Cleared debts to providers from 2022
• Ensured quicker capitation disbursement
• Reviewed and increased capitation amounts
• Accredited 100 Primary Health Centres (PHCs) across the FCT

The administration reaffirmed that both HMOs and healthcare providers will now be closely monitored to ensure transparency, accountability, and improved care for all FHIS enrollees.