Thursday, May 2, 2024

Osun Health Insurance Agency suspends hospital for allegedly defrauding enrolees

The Osun State Health Insurance Agency has placed an indefinite suspension and withdrawal of accreditation of one of its healthcare providers facility, Alaafia Oluwa Hospital and Maternity, Osogbo.

This was contained in a statement signed by the OSHIA information Officer, Segun Odewumi and made available to newsmen on Tuesday.

According to the statement, the suspension was necessary as a result of the facility’s continuous contravention of the stipulated laws and operational guidelines of Osun Health Insurance Scheme (OHIS)

“Among these infractions is the fraudulent claims and several attempts to defraud the scheme contrary to (Para 6.11 sub 3); refusal to treat enrollees despite receiving monthly panel list along with payment of enrollees capitation for the same month contrary to (Para 6.11 sub 4); incessant failure and deliberate neglect to follow laid down procedures of the scheme contrary to (Para 6.11 sub 5) all of the Osun Health Insurance Scheme operational guidelines.

“Other infractions include continuous verbal threats and use of derogatory words on staff of the Agency; inciting enrollees against the Agency as well as inciting other accredited healthcare providers against the Agency by continuously posting false allegations against the Agency on the Agency healthcare provider’s WhatsApp platform.

“In lieu of the above, Alaafia Oluwa Hospital and Maternity, Osogbo has been suspended with an order to pay the sum of five hundred thousand naira only (#500,000:00). This suspension is indefinite and commenced immediately.

“As a result of the above, all enrollees who are registered and are meant to receive treatment at the facility should proceed to the nearest OHIS accredited facility with their OHIS card,” it disclosed.

The statement also added that all OHIS accredited facilities are hereby directed to treat these individuals and write the agency for their claim as “out of station” claim.

“The agency is committed to delivering quality healthcare service for all enrollees and will therefore continue to ensure all healthcare facilities abide by the operational guidelines of the Osun Health Insurance Scheme,” it noted.

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