NHIA boosts fee-for-service payments to hospitals by 373%

The National Health Insurance Authority (NHIA) has significantly increased fee-for-service payments to hospitals by 373 per cent, as part of its efforts to enhance service quality and restore public confidence in Nigeria's health insurance system. NHIA Director-General, Dr Kelechi Ohiri, disclosed these measures during a media briefing.

The increase followed an actuarial review of healthcare tariffs, which had remained unchanged for a decade, despite rising costs of medicines and medical services. The review resulted in a doubling of capitation payments to healthcare providers, while the fee-for-service reimbursements were raised by 373 per cent. The adjustments, implemented from April 1, 2025, are aimed at ensuring healthcare facilities receive adequate reimbursement for services provided to insurance enrollees.

NHIA's measures also include a directive for hospitals to commence treatment if authorisation codes are not issued within an hour, and strengthened complaints-resolution mechanisms, with 87 per cent of complaints resolved within 48 hours. The NHIA has also sanctioned improper charges and delisted facilities that failed to comply.

The authority reported a 42 per cent increase in Nigerians covered by health insurance, from 16 million in January 2024 to 23.02 million. Additionally, 3.18 million poor and vulnerable Nigerians are benefiting from government-funded health insurance under the Basic Health Care Provision Fund.