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Lagos Govt. threatens sanction against health insurance providers violating standards

By Monsurudeen Olowoopejo

As a measure to ensure universal healthcare coverage in Lagos, the State Government through its Health Management Agency (LASHMA), has threatened to sanction any of its health insurance providers, Ilera Eko, that run foul of the existing healthcare practices and standards.
It stated that the need for sanctions was to ensure that every healthcare facility that had signed up to be a provider under the scheme, perform as promised to enrollees across the state.
According to the government, LASHMA had been inundated with complaints received from enrollees on healthcare providers’ mode of conducts, particularly acting against promises made by the government to them.
The General Manager of LASHMA, Dr. Emmanuella Zamba, gave the warning on Monday at the agency’s headquarters in Secretariat in Alausa, Ikeja.

She said that the State Government is doing its best to ensure that affordable and quality healthcare is provided to the residents and would not be folding its arms and allow some providers to destroy the good intentions which the programme was initiated in the state.

Stressing on Universal Health Coverage (UHC), she noted that the complaints received from enrollees included hospitals not giving drugs, not admitting patients, not carrying out tests, and collecting money from patients on some of the drugs or tests covered among others.

The General Manager added that government would not hesitate to deal decisively with any hospital which is giving the State Government a bad name or any hospital whose staff treats ILERA EKO enrollees with levity.

Zamba while commending the hospitals which are performing credibly well and taking care of ILERA EKO enrollees even above expectations, for a job well done, said that the Agency would ensure that quality healthcare is provided for all Lagos residents as healthy residents would be more productive and make a wealthy State.

Commending ILERA EKO enrollees for their patronage and perseverance since the Agency commenced access to care in the Year 2020, the General Manager said that not all medical conditions are covered by ILERA EKO.

She warned that no enrollee should pay for any medical condition covered such as consultation, laboratory tests, admissions for 15 days in a year, treatment of diabetes and hypertension as well as monthly refill of drugs, antenatal and delivery including caesarean section, surgeries such as herniotomy, appendectomy, and herniorrhaphy.

Zamba appealed to enrollees to call the dedicated 24/7 customer service toll-free line 0800ASKLASHMA (0800275527462) or call rate applies line 0700ILERAEKO (070045372356) while at the Hospital for any complaint so that LASHMA could resolve the issue before leaving the hospital.

The General Manager said that enrollees can also send text messages only via WhatsApp to 07046160051 in case they want to obtain a benefits package, Hospital list, information, inquiry or even complaint about the health insurance plan. This information, she added is also available, as posters in the hospitals.

The LASHMA boss urged customers to know their rights, and pursue and claim them at all times as LASHMA is out to serve them better.

Dr Zamba reiterated that the new National Health Insurance Act (NHIA) signed by President Muhammadu Buhari in May 2022 has made health insurance mandatory for all Nigerians. She, therefore, appealed to Lagos residents who are yet to enroll in the health plan to do so without further delay in order to adhere to the law and reduce their out-of-pocket payment for medical bills.

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