Yemi Obafemi
The National Health Insurance Authority (NHIA) has announced new regulations mandating Health Maintenance Organizations (HMOs) to authorize care and issue authorization codes within one hour of receiving requests from healthcare providers.
According to the NHIA, is a bold initiative to ensure faster access to healthcare services.
This was revealed in a statement issued by Emmanuel Ononokpono, the spokesperson for the NHIA.
Both healthcare providers and HMOs are now required to maintain comprehensive records of all treatment authorization requests and responses.
In cases where delays exceed the one-hour window, healthcare providers have been directed to proceed with treatment and notify the NHIA immediately, which will then verify that the services were rendered as claimed.
Enrollees are also encouraged to report any delays or barriers related to receiving authorization codes that surpass the one-hour limit directly to the NHIA.
The authority further clarified that for emergency cases, treatment should begin immediately without waiting for authorization codes, which must be obtained within 48 hours in line with NHIA’s operational guidelines.
The NHIA emphasized that sanctions will be imposed on any entity found deliberately delaying authorization of care, as part of efforts to ensure enrollees receive timely and uninterrupted healthcare services.
