The National Health Insurance Authority Act, 2021 (“the Act”) was recently enacted by the National Assembly. The Act repeals the National Health Insurance Scheme (NHIS) Act, Cap. N42, LFN, 2004 and aims to facilitate health coverage for all Nigerian residents by overseeing the promotion, regulation, integration of health insurance schemes and other related matters in Nigeria.
Below is a summary of some of the significant provisions of the Act:
1. Administration of the National Health Insurance Authority
The Act establishes the National Health Insurance Authority (NHIA or “the Authority”) which will be overseen by a Governing Council (“the Governing Council”) consisting of a chairman, the directorgeneral of the NHIA, who will serve as the secretary, one representative each of the six geo-political zones, two (2) representatives of organised labour, one representative of a civil society organisation focused on health activities and one representative from Federal Ministry of Health, Federal Ministry of Finance, Nigeria Employers Consultative Association and the Armed Forces, respectively.
The objectives of the NHIA include:
i. promotion, regulation, and integration of health insurance schemes;
ii. improving and harnessing private sector participation in the provision of health care services; and
iii. assisting the authority in achieving universal health coverage for all Nigerians.
The Authority shall among its other functions:
• secure mandatory health insurance for every Nigerian and legal resident.
• establish a basic minimum package of health service across all health insurance providers in the country.
• provide general guidelines for the implementation and utilisation of the Basic Health Care Provision Fund (BHCPF).
• regulate the activities of Healthcare Facilities, Health Maintenance Organisations (HMOs), Mutual Health Associations (MHAs), and Third-Party Administrators.
• establish mechanisms for receiving and resolving complaints by members of the schemes and Healthcare Facilities, HMOs, MHAs, and Third-Party Administrators.
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