Nigeria's National Health Insurance Authority has suspended nine healthcare facilities and secured refunds of more than ₦14.2 million for health insurance enrollees as it intensifies enforcement of patient protection and healthcare service standards.

The NHIA said it has resolved 3,878 complaints and issued 368 warning letters to healthcare providers as part of measures aimed at improving accountability within Nigeria's health insurance system.

The figures were disclosed by NHIA Director General and Chief Executive Officer Dr Kelechi Ohiri during the inaugural Civil Society Organisation Led Mid Year Review of Nigeria's National Health Sector Reforms in Abuja.

The authority said inspection teams have also been deployed to healthcare facilities to monitor compliance with treatment authorisation rules and other patient protection requirements.

NINE HEALTHCARE FACILITIES SUSPENDED

The NHIA said nine healthcare facilities have been suspended following its enforcement activities.

The authority did not identify the nine facilities in the statement reported on Sunday or provide individual details of the infractions that resulted in each suspension.

It said 368 warning letters had also been issued to healthcare providers.

More than ₦14.2 million has been refunded to affected enrollees following the resolution of complaints.

The enforcement action comes as the authority seeks to ensure that Nigerians enrolled in health insurance schemes receive the services and financial protection to which they are entitled.

3,878 COMPLAINTS RESOLVED

According to the NHIA, 3,878 complaints have been resolved through its patient protection mechanisms.

The authority has increasingly focused on complaints involving healthcare providers and the experience of patients attempting to access treatment under health insurance programmes.

Previous complaints handled by the authority have included allegations involving unavailable medicines, denial of covered services and additional payments demanded from insured patients.

The latest statement did not provide a detailed breakdown of the 3,878 resolved complaints.

INSPECTION TEAMS DEPLOYED

The NHIA has also deployed inspection teams to healthcare facilities.

The teams are monitoring compliance with the authority's one hour treatment authorisation policy and other requirements covering patient protection and quality of care.

Under the policy, delays in obtaining authorisation should not unnecessarily prevent insured patients from receiving treatment.

The authority has been increasing oversight as it attempts to ensure that expanding health insurance coverage translates into actual access to healthcare.

MORE THAN 23 MILLION NIGERIANS NOW COVERED

Nigeria's health insurance enrolment has increased substantially in recent years.

The NHIA said the number of people covered has risen from approximately 16 million at the beginning of the current administration to more than 23 million.

More than 2.7 million poor and vulnerable Nigerians have also received support through the Basic Health Care Provision Fund.

Despite the increase, Ohiri acknowledged that a large proportion of Nigeria's population remains outside the health insurance system.

He said the next challenge is ensuring that increased insurance membership translates into reliable healthcare access, better health outcomes and genuine financial protection for patients.

PAYMENTS TO HEALTHCARE PROVIDERS INCREASE

The authority said recent reforms have also increased payments to healthcare providers.

Capitation payments have risen by 93 percent while fee for service reimbursements have increased by 378 percent.

More than 7,500 healthcare facilities have undergone digital assessment through the SafeCare quality framework.

The measures are intended to improve service standards while ensuring providers receive appropriate payments for treating insured patients.

CANCER PATIENT SUPPORT EXPANDED

The NHIA has also expanded financial assistance for cancer treatment.

Under a cost sharing partnership involving pharmaceutical company Roche, the company covers 50 percent of the cost of selected oncology medicines, while the NHIA pays 30 percent and eligible patients contribute the remaining 20 percent.

Eligible radiotherapy patients can receive financial assistance ranging from ₦400,000 to full coverage.

Other covered services include mammography, CT scans, MRI scans, bone scans, diagnostic testing and radiotherapy.

HIV AND TB COVERAGE ALSO EXPANDS

The authority said more than 51,000 people had been covered under its HIV and tuberculosis programme across Anambra, Ebonyi, Gombe and Kwara states as of September 3.

That includes more than 38,000 people living with HIV, more than 7,400 patients with drug sensitive tuberculosis and 594 patients with drug resistant tuberculosis.

More than 2,000 additional healthcare facilities are being considered for accreditation ahead of a planned nationwide expansion of HIV and tuberculosis coverage in 2027.

PATIENT PROTECTION REMAINS FOCUS

The latest enforcement measures highlight the NHIA's attempt to combine expanding health insurance coverage with stronger oversight of healthcare providers.

Suspending facilities, issuing warnings and securing refunds for patients are intended to strengthen accountability within the insurance system.

However, the authority has acknowledged that increasing enrolment alone will not be sufficient.

For millions of insured Nigerians, the effectiveness of the system will ultimately depend on whether membership results in timely treatment, adequate services and protection against unexpected healthcare costs.