*Nigeria’s National Health Insurance Authority directs all registered Health Management Organisations to authorise the treatment of patients within an hour, to promptly submit requests for authorisation codes to HMOs to mitigate service access delays to enrollees in the healthcare ecosystem

Isola Moses | 绿帽献妻

Against the backdrop of reported delays in accessing healthcare services, the National Health Insurance Authority (NHIA) has directed all registered Health Management Organisations (HMOs) to authorise the treatment of patients within an hour.

The NHIA noted the stipulated one-hour timeframe includes the time of requests by hospitals and other healthcare providers.

Emmanuel Ononokpono, Spokesperson at NHIA, in a statement, said reducing delays in accessing services and ensuring that enrollees receive quality healthcare services are some of the mandates of the Authority.

Ononokpono emphasised the delays in the authorisation of treatment and issuance of codes have continued to impact beneficiaries鈥� experience negatively in the country’s healthcare ecosystem.

The Authority also said though the changes regarding authorisation of care were initially approved at a stakeholders鈥� meeting February 2025, they came into operation April 1 this year.

The Spokesperson disclosed some of the adjusted authorisations include the following:

1. Authorisation of care and issuance of authorisation codes by HMOs shall no longer exceed one hour from the time of requests by providers. Health Care Facilities (HCFs) are to promptly submit requests for authorisation codes to HMOs to mitigate service access delays to enrollees.
2. Communication of a response of 鈥榥o authorisation within the one-hour period where the HMO has justifiable reasons for not issuing the requested code.
3. Maintenance of records of all requests and responses for treatment authorisation by providers and HMOs.
4. Where delays occur, beyond the one-hour timeline, the healthcare providers are to proceed to render services to the enrollee and inform NHIA immediately. The NHIA will verify that such services were rendered.
5. Enrollees are to report any delays or barriers to timely access to health service resulting from receiving authorisation codes in excess of the one-hour limit independently to the NHIA.
6. For all emergencies cases, authorisation codes shall not be required before commencing treatment but shall be obtained with 48 hours of commencing care as stipulated in the operational guidelines, and
7. Sanctions shall be applied appropriately to entities deliberately delaying authorisation of care.

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