In a continued push to improve the quality of healthcare delivery under its supervision, the National Health Insurance Authority (NHIA) has sanctioned 49 healthcare facilities (HCFs) and 47 Health Maintenance Organisations (HMOs) for various infractions in 2024.

The sanctions, issued in line with the Authority’s operational guidelines, followed investigations into complaints from enrollees under both state and national health insurance schemes.

A statement signed by NHIA’s Acting Director of Media and Public Relations, Emmanuel Ononokpono, revealed that key complaints against healthcare facilities included the unavailability of medicines, denial of services, out-of-pocket charges for covered services, and failure to provide payment narrations.

For HMOs, infractions included delays or denials in issuing referral authorisation codes, delayed settlement of reconciled payments, and failure to conduct quality assurance checks in contracted health facilities.

“These are some of the highlights of the 2024 Annual Complaints Report produced by the Enforcement Department of the NHIA under Acting Director, Enforcement, Abdulhamid Habib Abdullahi,” the statement noted.

The report, issued in line with the NHIA Act 17 of 2022, reflects the agency’s mandate to establish mechanisms for handling and resolving complaints from enrollees and service providers.

The health agency said 3,507 complaints were handled during the period, out of which 2,929 (84 per cent), majority of which were against HCFs, were resolved.

“Enrollees deserve the best care, and we will continue to do our best to ensure they get it. The sanctions are meant to send a clear message that the NHIA will not tolerate substandard service for enrollees,” he said.