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Group Exposes Fraud In National Health Insurance Scheme, Indicts David Mark, Anyim

A civil society organisation, Citizens Action to Take Back Nigeria (CATBAN), has exposed rot in the National Health Insurance Scheme (NHIS) and called for the arrest and prosecution of Dr. Femi Thomas and Mr. Olufemi Akingbade, former Executive Secretary and Acting Executive Secretary respectively of the of the scheme, who have been the identified masterminds. The group also indicted two former Senate Presidents, Messrs. David Mark, and Anyim Pius Anyim.

The group's made its position known in a statement signed on its behalf by Mr. Ibrahim Walan Garba. CATBAN said Dr. Thomas should immediately be arrested for unilaterally making illegal payment of N1.05billion to Health Maintenance Organizations (HMOs) and purchase of land at an inflated fee way beyond their budgetary allocation. It made the same demand of Mr. Akingbade, who conspired to use a corrupted database to make dubious payment of N1billion and N50million to some HMOs.                           

CATBAN equally called for the identification and prosecution of everyone involved in the theft of funds belonging to hospitals that render services to NHIS enrollees as well as those connected to the fixed deposit accounts in 11 commercial banks at ridiculous interest rates, contrary to the provisions of the Central Bank of Nigeria. The group similarly called for the prosecution of NHIS officials preventing the transfer of funds in commercial banks to the Federal Government’s Treasury Single Account (TSA).

The group’s position was based on a recent report published by SaharaReporters, which revealed details of how Dr. Femi Thomas and his successor, Mr. Akingbade, masterminded fraud totaling billions of naira, employment racketeering and other acts connoting abuse of office, and its own independent investigation.

Dr. Thomas was arraigned by the Economic and Financial Crimes Commission (EFCC) in March 2016 before the Federal High Court in Lagos over the illegal acquisition of $2.2million.The group noted that an Executive Secretary of the NHIS, Professor Yusuf Usman, had admitted that the level of fraud in the NHIS was worse than the fuel subsidy scam.

“According to him, the scheme was skewed against the enrollees. It was skewed for the HMOs. He stated that NHIS is paying the HMOs three months in advance on behalf of the enrollees, to pay hospitals. But unfortunately, they do not pay hospitals,” CATBAN stated.

Before the SaharaReporters' story, noted CATBAN, the Senate had resolved to probe an N860 million scandal at the NHIS. CATBAN recalled that in a motion sponsored by Mr. Kabiru Garba Marafa, a senator, it was noted that an Executive Secretary of the NHIS, Dr. Yusuf, had been involved in expenditures way beyond his limit.

On account of the revelations, CATBAN said it investigated the activities of the NHIS and, through relevant documentation and evidence, discovered the masterminds and collaborators.

Its investigation, it said, threw up three main issues: financial manipulation and violation of due process, fraudulent activities of HMOs as well as bank fraud and unaccounted earnings.

CATBAN noted that the budgetary allocation for the purchase of land for NHIS in 2014 was N500million. However, the undeveloped land at Plot 815 Utako, adjacent NHIS head office in Abuja, was purchased under Dr. Thomas at the cost of N990million. The NHIS paid N90million as agency fee vide voucher with reference No NHIS/ADM/002/2015 dated 12 January 2015.

 “This constitutes a major violation when the actual amount budgeted for that purpose in the 2014 NHIS budget was N500million. Investigation at the Federal Capital Development Authority (FCDA) revealed that contrary to the claim of
purchasing the said land at N990million, the FCDA placed a N639 million value on it, leaving a N351 million yawning difference,” said CATBAN.

On the fixed deposit accounts, the group noted that on 22 December 2014, via a memo (No. NHIS/CMD/12/Vol. Vii, page 985), the sum of N193.3 billion was placed in a fixed deposit in one day with 11 commercial banks at 2% interest rate. This, observed CATBAN, was at a time when the Central Bank of Nigeria (CBN) prevailing interest rate was 9.2%. The civil society organization said a probe was conducted in the financial misconduct,  but its outcome has been muzzled.

“It is important to note that the leadership of the NHIS at some point conducted some investigation into this matter in which many of the staff involved in the exercise were recommended for termination and subsequent prosecution. We do not know what has been done to these culprits years later. Additionally, we are also aware that the NHIS forwarded a petition to the Department of State Service (DSS) to investigate some of these atrocities and the final report of the investigation was submitted to the organization and till date, nothing was ever heard again,” lamented CATBAN.

The group’s investigation also unearthed illegal payment to HMOs, with Dr. Thomas paying N1.05billion on the pretext of arrears without approval or authorization from the Board of Governing Council or budgetary allocation. The illegal payment was confirmed by the 2015 Auditor-General of the Federation's report.

In a similar vein, the group discovered the NHIS management went beyond its approval limits. Approvals in excess of N2.5million, CATBAN noted, require the ratification of the board before approval for disbursement.

“The former Executive Secretary, Dr. Femi Thomas, unilaterally made payment of the above sum without any form of consultations with the Board,” observed CATBAN. The group also found that HMOs, which are medical insurance groups that provide health services for  fixed annual fees, have been corrupted and skewed against hospitals and beneficiaries.

"While the HMOs often get paid three months in advance, the hospitals do not receive their money and as a result, several hospitals are being owed," CATBAN discovered.
It stated that Mr. Anyim Pius Anyim, a former Secretary to the Government of the Federation (SGF) and Mr. David Mark, a former Senate President, are some of the owners of these HMOs involved in stealing billions under the NHIS.

The group found that as at 31 March 2015, more than 70% of HMOs had refused to pay hospitals that render services to enrollees their respective due sum of N2.4billion  for capitation and N298.3million for service fees
in 19 Northern states. It equally found that they refused to pay N318,428,275.75 for capitation and N49,936,529.29 for service fees in 17 Southern states.  "This is in spite of the fact that all the HMOs had been collecting billions of naira, advanced them upfront for every three months throughout 2015 and 2016.

Thus, the total amount due to hospitals being held illegally by some HMOs from the verification conducted in March 2017 stands at N3.1billion," said CATBAN. In addition, it uncovered duplication of data for the 2013 and 2014 Millennium  Development Goals (MDGs) and fraudulent payment to some ghost enrollees.

"The database of NHIS was compromised and the management was fully aware of this compromise. However, despite their knowledge of the situation, Dr. Thomas and the then General Manager of ICT, Mr. Femi Akingbade, both collaborated to use the corrupted database to make dubious payment of N1.050billion to some HMOs, knowing full well that the list was compromised and duplicated," CATBAN said.

It reasoned that fraud diminishes the objectives of the NHIS and if it remains unchecked, the scheme will die will die. CATBAN accused civil society organizations of doing little to arrest the drift.
"While the NHIS, HMOs, banks, and others are busy enriching themselves at the detriment of dying Nigerians, the members of the civil society are not doing enough. We are simply sitting back and watching while the people we claim to be speaking for are dying helplessly. In the fuel subsidy scam, people cashed the cheques and ran away, but here, human beings suffer and die from their inability or refusal to regulate and do the right thing," lamented CATBAN.

It advised Nigerians against buying into the stock spiel of witch-hunt used by those accused of corruption. 

"We should never buy into the baseless insinuation of witch-hunt, knowing full well that it is only a witch that can be witch hunted. We must also not succumb to the blackmail of the organized corrupt syndicates,
whose only hope of escaping justice lies in their ability to manipulate the system as well as the population," CATBAN counseled.

It called on civil society groups to join in its efforts to banish graft through the hashtag #TakeBackNHIS call on all civil society organizations to join it in the bid to sanitize the NHIS.

CATBAN said it was particularly depressing to discover that top NHIS management staff, in connivance with commercial banks, regularly denied the scheme proceeds of its investments.
Through it investigation, it found that13 banks refused to account for the interest on investment of the NHIS. 

It discovered that in Heritage Bank, the NHIS invested N140million and earned an interest of N1.9million, leaving N1.8million unaccounted for in interest.

 

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Corruption