HMOs deny endorsing Lagos private health plan

Health Management Organisations under the Health and Managed Care Association of Nigeria and the Association of Health Insurance Providers of Nigeria have denied endorsing the Lagos Private Health Plan Partnership unveiled by the Lagos State Government on Tuesday.

The associations disputed the government’s claim that 21 HMOs had endorsed the partnership, insisting that the scheme must obtain approval from the National Health Insurance Authority before implementation.

They also called for clarification on a proposed 13 per cent levy on private-sector health insurance arrangements, warning that additional charges could increase costs for employers and reduce funds available for patient care.

PUNCH Healthwise reported on Tuesday that Lagos State Governor, Babajide Sanwo-Olu, had unveiled the partnership, giving residents until December 31, 2026, to obtain health insurance ahead of the enforcement of the state’s mandatory health insurance policy on January 1, 2027.

At the launch, Sanwo-Olu disclosed that 21 HMOs had endorsed participation in the new plans, describing the arrangement as a partnership between the government and private operators to expand health insurance coverage and strengthen healthcare delivery.

However, in a statement sent to PUNCH Healthwise on Thursday by HMCAN Chairman, Dr Abdulkadri Osumah, the associations said attendance at the launch, consultations and expressions of interest by individual HMOs did not amount to collective endorsement by the two bodies.

They also stressed that accreditation of an HMO was different from approval of a specific health plan.

“The Health and Managed Care Association of Nigeria, the umbrella association of Health Maintenance Organisations, unequivocally states that it has not endorsed the Lagos Private Health Plan (LPHP) partnership as presented. HMCAN and AHIPN will not endorse its implementation until the requisite National Health Insurance Authority approval is obtained, in line with the NHIA Act 2022 and the agreed regulatory framework.

“Attendance at the launch, consultations or expressions of interest by individual HMOs do not constitute HMCAN’s endorsement. HMO accreditation is also distinct from approval of a specific health plan. We request correction of reports suggesting collective industry endorsement,” the statement said.

HMCAN and AHIPN expressed support for the Federal Government’s universal health coverage directive and the objectives of the Lagos State Executive Order, while commending Sanwo-Olu’s commitment to expanding health insurance coverage.

However, they insisted that implementation must be lawful, affordable and properly coordinated.

The associations said the communiqué issued by the NHIA and Lagos State on October 28 and 29, 2025, provided the agreed framework for the plan. According to them, it recognised the NHIA as the sole statutory regulator, made participation by HMOs voluntary and allowed employers to choose NHIA-approved plans.

They added that all health plans required prior NHIA approval. The communiqué also provided for compliance certificates issued by the authority and recognised nationally, with collaboration from the state government, they said.

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According to the associations, Lagos State could issue certificates on behalf of the NHIA bearing the logos of both organisations. They urged the authority and the state government, through the Lagos State Health Management Agency and relevant bodies, to coordinate compliance and enforcement within their respective mandates.

The associations also called for the publication of the applicable NHIA approval documents.

On the proposed levy, HMCAN and AHIPN said their understanding was that the framework included an aggregate 13 per cent tax on private-sector health insurance arrangements.

They, however, called for clarification on the legal basis, calculation base and components of the levy.

“If imposed in addition to existing premiums and statutory obligations, HMCAN considers it an unnecessary burden and a form of double taxation on employers already funding healthcare,” the statement said.

They warned that additional charges should not undermine affordability or reduce the funds available for patient care.

The associations further said compliance requirements had not been communicated satisfactorily and urged the government to publish clear guidance for employers on acceptable coverage, minimum benefits, certification and sanctions.

They maintained that existing NHIA-approved coverage should be recognised without duplicate enrolment or payment.

HMCAN and AHIPN also called for a review of the December 31, 2026, compliance deadline, arguing that employers needed adequate notice and a realistic transition period before sanctions began.

The associations expressed readiness to work with the Lagos State Government, LASHMA, the NHIA, the Nigeria Employers’ Consultative Association, healthcare providers, labour and other stakeholders to agree on a compliance roadmap.

They called for an urgent stakeholder meeting to resolve outstanding issues and agree on phased implementation.

They also cautioned that implementation during the election season should remain consultative to avoid unnecessary industrial tension and disruption.

The associations said the process should protect existing enrollees, support timely payments to healthcare providers and extend reliable health insurance coverage to uninsured residents.