NHIS HCPs

National Health Insurance Scheme
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Utako District, Abuja.

NHIS Nigeria > Healthcare Providers

Healthcare Providers

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Healthcare Providers (HCPs) are Health Institutions accredited by the NHIS for the specific function of providing healthcare services to the beneficiaries of the Scheme.

Beneficiaries are at the liberty to select any Healthcare Provider of their choice whether it is government or private.

The following information is essential to prospective and functioning Healthcare Providers

Categories of Healthcare Professionals under the NHIS
Requirements for Healthcare Professionals
Classification of Healthcare Providers
General Requirements for Healthcare Providers
Facility and Personnel Requirements for Primary Healthcare Providers
Facility and Personnel Requirements for Secondary Healthcare Providers
Facility and Personnel Requirements for Tertiary Healthcare Providers
Referrals
Actions and Procedures at each Level
Procedure for the Accreditation of Healthcare Providers

Categories of Health Care Professionals under the NHIS
General Medical Practitioners Specialist Medical Practitioners Pharmacists Nurses/Midwives Laboratory Scientists Radiographers Physiotherapists Dental Surgeons Community Health workers
Requirements for Healthcare Professionals
General Medical Practitioners Possession of the Bachelor of Medicine, Bachelor of Surgery (MBBS) degree, or its equivalent recognised by the Medical and Dental Council of Nigeria; Registration with the Medical and Dental Council of Nigeria; and Possession of the current licence to practise, issued by the Medical and Dental Council of Nigeria (MDCN) Specialist Medical Practitioners They include: physicians, dental surgeons, radiologists, paediatricians, psychiatrists, surgeons, gynaecologists, ENT surgeons, ophthamologists, etc. Possession of recognised specialist qualifications in the proposed area of practice in addition to (1) above. Pharmacists Possession of the Bachelor of Pharmacy (B Pharm) degree or equivalent qualification, recognised by the Pharmacists Council of Nigeria (PCN); and Possession of the professional licence to practise, issued by the Pharmacists Council of Nigeria (PCN). Medical Laboratory Scientists Possession of the Bachelor of Medical Laboratory Science (BMLS) degree or equivalent qualification, recognised by the Medical Laboratory Science Council of Nigeria (MLSCN); Registration with the MLSCN; and Possession of the current licence to practise, issued by the Pharmacists Council of Nigeria (PCN). Nurse Practitioners Double qualifications (i.e, Nursing and Midwifery or other specilised areas of Nursing); Registration by the Nursing and Midwifery Council of Nigeria (NMCN); Possession of the current licence to practice, issued by the Nursing and Midwifery Council of Nigeria (NMCN). Radiograpers and Ultrasonographers Possession of the Bachelor of Radiography degree, or equivalent qualification, recognised by the Nigerian Council of Radiographers (NCR); Registration with the Nigerian Council of Radiographers NCR; and Possession of the current licence to practice, issued by the Nigerian Council of Radiographers (NCR). Physiotherapists Possession of the Bachelor of Science in Physiotherapy degree, or equivalent qualification, recognised by the Medical Rehabilitation Board of Nigeria (MRBN); Registration with the Medical Rehabilitation Board of Nigeria (MRBN); and Possession of the current licence to practice, issued by the Medical Rehabilitation Board of Nigeria (MRBN). Dental Surgeons Possession of the Bachelor of Dental Surgery degree, or equivalent qualification, recognised by the Medical and Dental Council of Nigeria (MDCN); Registration with the Medical and Dental Council of Nigeria (MDCN); and Possesion of the current licence to practice, issued by the Medical and Dental Council of Nigeria (MDCN). Community Health Workers Community Health Officers Must have completed a 12 - month course for Community Health Officer course in an approved University Teaching Hospital or College of Health Technology as additional to qualification in (2) and (3) below. Must be registered by the Community Health Practitioners Registration Board of Nigeria (CHPRBN). Must have the Standing Orders from the Federal Ministry of Health for Community Health Officers and Community Health Extension Workers. Senior Community Health Extension Workers Must have completed a 36 month course for Community Health Extension Worker in an approved Health Institution. Must have complied with (1) 2 - 3. Junior Community Health Extension Workers. Must have completed a 24 month course for Junior Community Health Extension Worker in an approved Health Institution. Must have complied with (1) 2 - 3.
Classification of Health Care Providers
Primary Health Care Providers This is the first point of call by beneficiary for medical attention/service. These include: Primary Healthcare Centers Comprehensive Healthcare Centers Nursing and maternity homes (Prove of access to Medical Practitioner) Out-patient departments of general Hospitals, specialist Hospitals, Federal Medical Centers, teaching Hospitals, Armed Forces, the Police and other uniformed services Hospitals/Clinics, University Medical Centers, and Federal Staff Clinics/Hospitals. Secondary Health Care Providers Secondary Healthcare Providers provide health services on referral from Primary Healthcare Providers. These include: General/Divisional Hospitals (out-patient specialist care and in-patient care for medical, surgical, paediatrics, obstetrics and gynaecology etc) Specialist Hospitals/Refernce Hospitals Federal Medical Centers Pharmacies Laboratories Dental Clinics Physiotherapy Clinics Radiography centers, etc Tertiary Health Care Providers Tertiary Healthcare Providers provide health services on referral from primary and secondary levels. These include: Teaching Hospitals Specialist Hospitals Specialized Hospitals (orthopedic, psychiatric,etc) Federal Medical Centers and, Military Reference Hospitals
General Requirements for Healthcare Providers
Possession of the relevant academic qualifications in the field of an endeavour; Registration with the relevant professional body; Possession of the current licence to practice; Appropriate facility for service delivery; Registration by state authorities (where necessary); and Possession of malpractice insurance cover.
Facility and Personnel Requirements for the Primary Healthcare Provider
Facility Requirements The following minimum features shall be provided at a Primary Healthcare Facility. Waiting and Reception Area At least 4 x 3 meters Sitting facilities Reception table Registration table Medical record keeping facility Wheel chair/patients' trolley Adequate ventilation Weighing scale Stadiometre for heights Consulting Room At least 4 x 3 meters Examination couch Wash hand basin Thermometer Good light source Stethometer Diagnostic set Sphygmomanometer Table and chairs Adequate ventilation Treatment Room At least 2 x 3 meters Instruments cabinet Dressing trolley/tray Cotton swab Needles and syringes Gailpot Dressing forceps Needle holder Suture materials Antiseptics and disinfectants Gauze/bandages Diaspora gloves Injection trolley and equipment Wash hand basin Dressing stool Patients' tiolet facilities with adequate water supply Sterilizer/Autoclave Containers for disposal of sharp objects Emergency tray containing: Needles and syringes Scalp vein needles IV giving set Injection hydrocortisone Injection adrenaline 5% dextrose Normal saline Injection Aminophyline Gloves Resuscitative equipment Ambubag Oxygen trolley Suction machine (auto or pedal) Drip stand Appropriate fire fighting equipment Adequate waste disposal facilities Refrigerator Theatre/Labour Room Labour room at least 4 x 3 meters Equipment in Labour room: Delivery bed Baby's cot Weighing scale for babies Delivery tray containing: Episiotomy scissors Kocher forceps Artery forceps Mucous extractor Surgical scissors Straight scissors Needle and Syringes Surgical gloves Disposable gloves Draw Mackintosh Tape rule Sterilizer (for delivery pack) Kidney dish with cover (2) Kidney dish without cover (2) Resuscitative Equipment: Oxygen Suction machine (auto or pedal) Resuscitative table Oropharyngeal tube Disposable gloves Needles and Syringes 50% dextrose Scalp vein needle 21G, 23G IV giving test normal saline Dextrose saline At least one bed Adequate tiolet facilities Adequate lighting Adequate water supply Adequate waste disposal Washable floor Personnel Requirements Primary Healthcare Centers Primary Healthcare centers should meet the standards as set by the National Primary Healthcare Development Agency (NPHCDA), while the other Primary Healthcare Providers should have the following: At least one medical practitioner At least two registered nurses/midwives At least two hospitals assistants At least one adminstrative staff for medical records and secretarial duties Nursing and Maternity Homes At least one medical practitioner At least two registered nurses/midwives At least two hospitals assistants At least one adminstrative staff for medical records and secretarial duties.
Facility and Personnel Requirements for the Secondary Healthcare Provider
This level of healthcare is to have facilities for out-patient and in-patient services, for general, medical, surgical, paediatric, maternal care, etc. The wards are divided strictly into gender compartments. The different types of Secondary Healthcare Providers include: Pharmacy Laboratory Services Radiodiagnostic/Ultrasonography Services Physiotherapy Services Dental Clinics Ear, Nose and Throat/Otorhinolaryngology Clinics Paediatric Clinics Eye Clinics
Requirements for the Pharmacy
Possession of approved premises as specified by the Pharmacist Council of Nigeria (PCN) Possession of required malpractice/professional indemnity insurance as stipulated in the Guidelines Presence of a resident pharmacist Pharmacy must be equipped to meet the minimum requirements as prescribed below: Pharmacist with the basic qualification that is registrable with the Pharmacists Council of Nigeria Pharmacist's possession of current licence to practise from the Pharmacists Council of Nigeria (PCN) Possession of current premises licence issued by the PCN Compliance with the contractual agreement with the NHIS & the HMOs Phamacy must be supervised by a resident pharmacist, approved and registered by the Pharmacists Council of Nigeria General outlay of the premises: Entire space area of at least 20sqm Arrangement of shelves and drugs for easy access Pharmacist's office/counselling area Display of original certificates Seperate dispensing area with tray and spatula/spoon Washable floor Adequate storage for drugs Adequate shelves Seperate air-conditioned store with shelves Refrigerator Air-conditioner Fans Possession of refrence books: Medi-Pharm of MMs Africa Martindale-Extra-pharmacopoeia Pharmacy Laws British Pharmacopoeia National Drug Policy National Essential Drugs List Schedule drugs Seperation of schedule drugs from over-the-counter drugs Availability of lockable DDA cupboard Adequate record keeping/computerization Drug receipts Sales invoices Sales books/ledgers Bin cards Availability of a Dangerous Drug Register Regular entries into the Dangerous Drug Register Note:Pharmacy services may be provided by hospital facilities as stated above, or by the community pharmacies accredited by the NHIS.
Requirements for the provision of Laboratory Services
Possession of a laboratory approved by the Medical Laboratory Science Council of Nigeria (MLSCN) The laboratory should be equipped to perform full investigations in the following areas: Haematology Clinical Chemistry Medical Microbiology Blood Serology Medical Parasitology Possession of personnel requirements for comprehensive laboratory services, i.e, qualified medical laboratory scientists in the following specialised areas: Microbiology Heamatology/Blood Transfusion Clinical Chemistry Parasitology Possession of the following minimum equipment and consumables. Microscope Incubator Weighing balance Water bath Centrifuge Haemoglobin electrophoresis machine Micro-Haematocrit centrifuge and reader Westergreen tubes and stand Bunsen burner and gas cylinder Microbiological culture media Biochemistry reagents Disposable gloves Laboratory glassware Serology kits Spectrophotometer Improved Nuclear counting chamber Refrigerator Autoclave Couch Adequate Waste Disposal Pipettes Adequate water supply Washable floors Note: Laboratory services may be provided by in-house facilities as stated above, or by stand-alone laboratories accredited by the NHIS.
Radiodiagnostic/Ultrasonography Services
Premises duly registered with the Government of the State in which the facility operates as an X-ray center, and possession of minimum radiological equipment for routine and special investigation, as specified by the relevant registration board. Radiodiagnosis Minimum requirements as follows: Waiting room Standard X-Ray room as specified by the RRBN At least one static X-Ray machine with a minimum of 100 MAS and 125 KVP output rating. One sizeable proccessing room equipped with a set of manual processor, including a drier. One X-Ray couch with Bucky One chest stand 2 lead aprons 1 protective cubicle Hangers - all sizes Cassettes - all sizes X_Ray viewing box Possession of relevant personnel i.e. a registered radiographer. Ultrasonography Patient waiting room One ultrasound machine - with at least standard probes of different resistance rating. Stand alone premises must be registered with the RRBN as well as with the government of the State in which it operates. Possession of required malpractice insurance as may be determined from time to time by the NHIS. Note: The above services may be provided by in-house facilities or by stand-alone centers registered with the NHIS.
Physiotherapy Service
The premises must be equipped to meet the minimum requirements as prescribed below: Registration with the Medical Rehabilitation and Therapist Board (MRTB) Current licence to practice Well-equipped gym Bicycle ergometer Wall & parallel bars Hand and wrist exercise Traction machines Reduction mattress Shoulder wheels Tread mill Treatment room (rehabilitation equipment electrical) Short-wave diathermy Infra-red Hydropak (Hot, cold) Electrical Stimulators Ultarsound stimulators Wax bath stimulators Ultarviolet stimulators Micro wave stimulators Assistive devices (store) Walking stick Churhes Walking frame Wheel chairs Medical record Good ventilation Washable floor Generator Fire fighting equipment Others include: Sphygomanometer Splints Clean linen Gloves and masks Crape bandages Stadiometer Ointment/cream for message Possession of required malpractice/professional indemnity insurance in addition to performance bond insurance cover as stipulated in the NHIS Guidelines Physiotherapy services may be provided by in-house facilities or by stand-alone physiotherapy centers accredited by the NHIS.
Dental Clinics
Premises must be duly registered with the Government of the State in which it operates The minimum requirements are as follows: Registration with the MDCN Current licence in practise Certificate of Registration of Premises Possession of MAlpractice Insurance Dental Clinic Complete dental unit Autoclave Extraction forceps Elevators Amalgamator Tooth extraction Dental Syringes Xylocaine catridges/spray Medical Records Adequate record keeping Computerization if available General Location General Outlay (20 sq meter) Waiting area Screened/partitioned cubicle Dental X-Ray Unit X-Ray Machine Washable floors Waste disposal facilities Clean toilet facilities Adequate water supply Constant Electricity supply Sterilizer Fire fighting equipment Personnel At least one dental surgeon At least one dental nurse/therapist/dental surgeon assistant Note" Dental services may be provided by in-house facilities or stand-alone dental centers accredited by the NHIS.
Eye, Nose and Throat/Otorhinolaryngology Clinics
Premises must be duly registered with the Government of the State in which they operate. The minimum requirements at each premises are as follows: Registration with MDCN Current licence to practice Certificate of registration of the premises Possession of malpractice insurance Well-Equiped Clinic ENT examination table with instrument set(console) Head lamp/Head mirror Auroscope Fibre optic Naso-laryngo-pharyngoscope Suction machine Sterilizer systems Chemical sterilization Steam sterilzation (Autoclave) Audiometry Unit Audiometer Tympanometer Bera equipment Calorimeter Special Therapy Unit
Paediatric Clinics
Premises duly registered with the Government of the State in which they operate. General Requirements The minimum requirements at each premises are as follows: Registration with the MDCN Current licence to practice displayed Certificate of registration of the premises displayed Possession of malpractice insurance Adequate medical records keeping Adequate ventilation Washable floor Adequate waste disposal facility Adequate toilet facility Adequate water supply Adequate electricity supply Equipment Paediatric Clinic Examination Couch Auroscope Laryngoscope/Endotracheal tube Oxygen cylinder with face mask Torchlight/spot light Tongue depressor Weighing scale Tape rule Suction machine Treatment tray/Cupboard Sphygmomanometer Paediatric stethoscope Sterilizer Waiting area Clinical thermometer Emergency Paediatric Unit (EPU) Paediatric couch/beds Solusets and Haemosets Weighing scale Tape rule Suction machine Oxygen cylinder/face mask/endotracheal tube Diagnostic set Emergency drug tray/cupboard Treatment tray Sphygmomanometer/stethoscope Paediatric ambu bag Gloves Special Care Baby Unit (SCBU) Scrubbing room Incubator Heat radient Exchange blood transfusion Solusets (various) Phototherapy machine Oxygen cylinder/face mask/endotracheal tube Weighing scale and tape rule Spot light/torch light Diagnostic set Emergency drug tray/cupboard Treatment/Instrument tray Nutritional Rehabilitation Unit (NRU) Demonstration laboratory (i.e. room with demonition aids) Nutritional clinic Weighing scale Tape rule Health Education Aids (i.e. posters, flow charts, e.t.c) Personnel Paediatrician Medical Officer Paediatric nurses Nutrionist/dietician
Eye Clinic
Premises must be duly registered with the Government of the State in which they operate. The minimum requirements are as follows: Registration with the MDCN Current licence to practice Certificate of registration of premises Possession of malpractice insurance Eye Clinic Waiting area Instrument tray/trolley Slit lamp Application lensometer Ophthaltmoscope Retinoscope Flash light VA chart box Trial lens set (for refraction) Visual field machine AB scoring machine CVF machine Ophthalmic drops Treatment Room Examination couch Minor treatment set Sterilization systems Autoclave Angle poised lamp Treatment tray/trolley Flash light Adequate Inpatient Ward Theatre Operating microscope General ophthalmic surgery set Oxygen delivery system Medical records General Outlay Washable floors Waste disposal facilities Adequate water supply Central sterile supply department Toilet facilities Adequate ventilation Electricity supply Standby generator Personnel Ophthamologist Ophthalmic nurses Requisite medical records staff
Facility and Personnel Requirements for the Tertiary Healthcare Provider
The minimum staff/equipment requirements for a tertiary hospital is as in a secondary healthcare center, but with the additional requirements that each specialty be fully devoted to the specialty services and the appropriate sub-specialties.
Referrals
Sending a patient for a range of specialized investigations or care through the recognised three levels of service: Primary, Secondary and Tertiary is termed 'Referral'. These levels are not, however, exclusive but complementary. This is essential for cost-efficiency and the effective management of patients under the NHIS. Levels of Referral Entry into the programme is via the Primary Healthcare Provider. At that level, treatment is administered as recommended by the guidelines. Cases that require specialized attention are referred following the laid down guidelines from the Primary to Secondary and Tertiary Levels Types of Referral Referrals made by the Primary Healthcare Provider to the Secondary Provider. Referrals made by the Secondary Provider to the Tertiary Provider Lateral referral from one specialist to another. Need for Referral A patient may be referred from a Primary to a Secondary Healthcare Provider due to the need for specialised investigations, for medical/surgical reasons or other services - diagnostic, physiotherapy, etc, or from secondary to tertiary level. Approval by the HMOs is necessary, except in emergencies where he cannot be reached and notification of such should be served within 48hrs. Referrals should be to the nearest specialist as contained in the list of NHIS Registered Providers in the area Basic Principles for Referral A referral line must be established. There must be a clinical basis for referral. A referral letter must accompany every case. Primary care physicians are obliged to refer early enough to the next level of care. Personal and medical details must be contained in the referral letter. All investigations carried out at a lower level must be sent to a higher level. The outcome of a referral should be satisfactory and properly documented. Referred cases must be sent back by the specialist after completion of treatment to the referring provider, with a medical report and instructions for follow-up management. Information Required for Referral Patient's name, gender, age and address Referral location (dept/clinic) Patient's hospital number Patient NHIS number Referring Provider's NHIS registration number Referral date Clinical findings/investigations and results Provisional diagnosis Reasons for referral The patient's HMO and registration number Referring personnel's name and signature Radius of Referrals Referrals are restricted to the nearest specialist facility accredited by the NHIS. Any referral outside the radius must be justified.
Actions and Procedures at Each Level
The Primary Level Immunization Out-Patient Care Emergency Care Family Planning Services Child Welfare Services Immunization Immunization against childhood killer diseases is one of the responsibilities at the primary healthcare level. The vacancies are BOG, Oral Polio, DPT Measles, Hepatitis B and Vitamin A supplementation, they are sourced from the NPI cold chain stores, either from the Local Government headquaters, the States, or the Zonal NPI Stores and distributed via the HMO Network of Providers. Out-Patient care Services to be offered include proper history taking, examination and routine laboratory investigations to help reach a diagnosis. Laboratory investigations include malaria parasite, WBC, Haemoglobin estimate or packed cell volume, urinalysis, stool microscopy, MCS of urine, wound, troat, HVS and widal test. Other procedures at this level include: Surgical Procedures Drainage of simple abscess (I&D) Minor wound debridement Surgical repairs of simple lacerations Circumcision of male infants Evacuation of impacted faeces Correction of cases of simple polydactyly Drainage of paronychia Other procedures as may be listed from time to time by the NHIS. Internal Medicine Malaria and other acute uncomplicated febrile illness. Diarheal diseases. Uncomplicated pneumonia. Acute respiratory tract infections. Simple anaemia (not requiring blood transfusion). Simple skin diseases, e.g. Taenia vesicolor, M. furfur, T.Capitis, etc. Worm infestation Other uncomplicated bacteria, fungal, parastic and viral infections and illness. Follow-up treatment of chronic illness, e.g. hypertension, diabetes, mellitus, sickle cell, asthma, glaucoma Dog bites, snake bites, scorpion stings Arthritis and other minor musculoskeletal diseases Other illness as may be listed from time to time by the NHIS HIV/AIDS and STIs Voluntary Counselling and Testing (VCT) Health Education Mental Health Anxiety neurosis Psychosomatic illness Insomnia Other illness as may be listed from time to time by the NHIS Paediatrics Feeding problems and nutritional services Treatment of common childhood illness e.g., (malaria, other febrile illnesses, diarrhoea diseases, uncomplicated malnutrition, failure to thrive, measles, upper respiratory tract infections, uncomplicated pneumonia and other childhood exanthemas, simple skin diseases and viral illness Other illnesses as may be listed from time time by the NHIS. Obstetrics and Gyneacology Acute pelvic inflamatory disease Vaginal discharges Routine ANC for uncomplicated pregnancy (ante-natal and post-natal) i.e., 2nd, 3rd and 4th pregnancies. Other illnesses as may be listed from time to time by the NHIS. Ophthamology Treatment for minor eye ailments including: Conjunctivitis Parasitic and allergic ailments Simple contusion, abrasions, etc. Emergency Care The beneficiary requiring emergency care treatment shall visit his primary provider or his nearest health facility. Such provider has to offer First Aid treatment before referral. The procedures include: Establishing an intravenous (infusion) line Simple tracheostomy Management of convulsion, coma, etc. Control of bleeding Cardio-pulmonary resuscitation Immobilization of fractures (using splints, neck collars, etc) to ease transportation of patients Aspiration of mucus plug to clear airways Family Planning Services This include family planning education on the following: Safe period Pills Condoms Other methods (implant and surgical contraception) Child Welfare Services Growth monitoring Routine immunization Nutritional advice and health education, etc and other services to be included from time to time by the NHIS Note: Beneficiaries are entitled to hospitalization for cummulative 15 days. Secondary and Tertiary Levels Surgical Procedures All other procedures that cannot be handled at the Primary level of care can be undertaken at the Secondary and Tertiary levels, depending on the complexity and the components of the facility and its personnel, except those conditions on the exclusion list. internal medicine All other cases that cannot be traeted at the Primary level due to lack of facilities, personnel or skills must be promptly referred to either a Secondary or tertiary center except those conditions on the exclusion list. HIV/AIDS Management of cases requiring admission Treatment of opportunistic infections Paediatrics All cases that cannot be handled at the Primary level, except such surgical procedures that are on the exclusion list. Simple congenital abnormalies, e.g. cleff palate, and life threatening congenital abnormalies, e.g. Tracheosophageal Fistulae (T.O.F), etc, would be handled at the Secondary level Obstetrics and Gynaecology Specialist consultation Multiple gestation/High risk pregnancies Caesarian sessions Ectopic pregnancies Other obstetrical and gynaecological surgical procedures that are not on the exclusion list. Ophthalmology Specialist consultation Eye problems e.g. major trauma, pterygium, glaucoma, cataract extraction and other simple ophthamological surgical procedures. Removal of foreign bodies Refraction, excluding provision of spectacles and contact lenses Ear, Nose and Throat (ENT) Specialist consultation Antral wash-out Minor treatment e.g. removal of foreign body Surgical operations, e.g. Tonsillectomy, Polypectomy, Tracheostomy, Adenoidectomy, Myringotomy, etc Other ENT procedures except those on the exclusion list. Pathology All investigations, excluding post-mortem, should be referred to appropriately registered facilities at Secondary or Tertiary level of care Dental Health Dental services under the auspicies of the NHIS are paid for on a Fee-for-Service basis and shall be referred appropriately to the dental surgeon. Simple tooth extraction and amalgam feeling will be provided. Physiotherapy Post-surgical procedure within the prescribed 15 days Post-traumatic rehabilitation Simple chest drainage Palsies within 15 days after initial treatment Post-CVA therapy within 15 days
Procedures for the Accreditation of Healthcare Providers.
All healthcare providers are to be accredited by the NHIS as a prequisite for participation in the scheme. Providers are to obtain the necessary documents stipulating the minimum requirements for accreditation. The NHIS may accredit Providers only after inspection. Note: Providers who do not meet the criteria for accreditation may be advised on their inadequacies. Periodic visits will be paid by the NHIS for monitoring purposes. Accreditation Fee Each accreditation facility shall pay Ten Thousand Naira (N10,000.00) as accreditation fee and Five Thousand Naira (N5,000.00) as renewal fee. The fees are subject to review Obligations of the Provider These shall include: Providing the NHIS with the following information: Names of serving health professionals and their qualifications (doctors, nurses, pharmacists, etc). Work hours Details of equipment available for mediacal care Ensuring that every beneficiary who visits the facility for care is attended to with utmost care, skill and prompt attention. Suspension and Withdrawal of Accreditation of Providers The Scheme may upon a complaint by the HMO or registered contributor, and after investigation including affording the Provider or his legal represntative an opportunity of being heard, cancel or suspend the accreditation of a Provider if: it ceases to operate, or is declared bankrupt or it is accredited by virtue of misleading information, or it is incompetent, unable to, or incapable of rendering the prescribed services under the NHIS, or it lacks the facilities to provide prompt and efficient services to registered beneficiaries it breaches any term or agreement with the HMO it is found to engage in fraudulent activities
Guidelines for the Accreditation of Pharmacies
These guidelines have been designed to provide information, acceptable standards of practice, and recommendations for harnessing the professional skills of pharmacists in the Sheme. Essential drugs according to the World Health Organization (WHO), are those drugs that satisfy the healthcare needs of the majority of the population. They should be available at all times in adequate quantity, and in appropriate dosage forms at all levels of the healthcare delivery system of the country. The drugs on the National Essential List are generic and registered by the National Agency for Food and Drugs Administration and Control (NAFDAC). The list of essential pharmacauticals, in terms of products, packs, prices, strengths and presentations will be reviewed periodically. While a pharmacy may need to stock a wider variety of drugs, medical consumables, etc, in response to demand by patients who are not covered under the NHIS, only drugs from the NHIS approved manufacturers, and at the approved prices should be dispensed to NHIS subscribers. Payments to pharmacies in the Scheme shall be by fee-for-service, and the rate shall be determined from time to time by the Sheme. Requirements for the Accreditation of Pharmacies as Providers The requirements for the accreditation of pharmacies as Providers under the National Health Insurance Scheme are based on the regulations of Pharmacists Council of Nigeria (PCN), which include: Scheduled drugs clearly seperated from over-the counter (OCT) drugs; Good general out lay of the pharmacy; Possession of current licence to practice issued by the PCN and to be on display; Possession of the current certificate of Registration of premises and to be on display; Possession of reference books; Adequate pharmacist's room/counseling area not less than 2.5m x 2.5m Properly kept accounting records, delivery notes, receipts and invoices Air conditioner; Possession of a refrigerator; Possession of a Poisons Disposal Book; Washable floor Obligations of Accredited Pharmacies To obtain drugs in a cost-effective manner from NAFDAC approved manufacturers; To dispense generic drugs prescribed by healthcare providers accredited by the NHIS; To provide pharmaceutical care to the participants; To ensure that only genuine, safe, efficacious and unexpired drugs are dispensed to the participants; To ensure that only drugs on the National Essential Drugs List are dispensed; To package drugs in safe and suitable containers, and label same with the prescriber�s instruction and other appropriate directions; To charge only the approved price per prescribed item(s); To maintain a Resident Pharmacist, required staffing, drug storage, and environmental conditions for continued registration, in accordance with the provisions of the Pharmacists Council of Nigeria (PCN); To allow properly identified inspectors from the Scheme reasonable access to their premises and records on NHIS participants; To keep all records, accounts, invoices, bills, etc., relating to the transactions under the Scheme in clear terms; To discharge their duties under the Scheme in a most professional manner; To comply with all Guidelines of the Scheme. Agreement to Serve as Pharmacy Provider under the NHIS All accredited Pharmacy Providers shall enter into an agreement with the Health Maintenance Organizations (HMOs), which shall be in accordance with the NHIS format. Co-payment A co-payment of 10% per prescription, shall be paid under the Formal Sector Social Health Insurance Programme by enrollees at the point of service delivery. The money so collected shall be retained by the pharmacy.