The Nationwide Well being Insurance coverage Authority (NHIA) has directed Well being Administration Organisations (HMOs) to authorise the therapy of sufferers inside one hour from the time of requests by hospitals and different healthcare suppliers.
A spokesperson for the NHIA, Emmanuel Ononokpono, in a press release, stated decreasing delays in accessing providers and guaranteeing that enrollees obtain high quality healthcare providers have been a few of the mandates of the authority.
He stated the delays within the authorisation of therapy and issuance of codes continues to negatively influence beneficiaries’ expertise.
He stated although the adjustments concerning authorisation of care have been initially accepted at a stakeholders’ assembly in February 2025, it got here into operation on April 1, 2025.
READ ALSO: NAFDAC Tightens Pharmaceutical Imports from China, India
A number of the authorisations embody:
1. Authorisation of care and issuance of authorization codes by HMOs shall not exceed one hour from the time of requests by suppliers. Well being Care Services (HCFs) are to promptly submit requests for authorisation codes to HMOs to mitigate service entry delays to enrollees.
2. Communication of a response of ‘no authorization inside the one-hour interval the place the HMO has justifiable causes for not issuing the requested code.
3. Upkeep of data of all requests and responses for therapy authorisation by suppliers and HMOs.
4. The place delays happen, past the one-hour timeline, the healthcare suppliers are to proceed to render providers to the enrollee and inform NHIA instantly. The NHIA will confirm that such providers have been rendered.
5. Enrollees are to report any delays or limitations to well timed entry to well being service ensuing from receiving authorisation codes in extra of the one-hour restrict independently to the NHIA.
6. For all emergencies instances, authorisation codes shall not be required earlier than commencing therapy however shall be obtained with 48 hours of commencing care as stipulated within the operational pointers.
7. Sanctions shall be utilized appropriately to entities intentionally delaying authorisation of care.
The put up Approve Therapy Inside One Hour, NHIA Directs HMOs appeared first on Channels Tv.
