ILERA EKO : LASHMA To Sanction Provider For Disenfranchisement Of Enrollees

The Lagos State Health Management Agency (LASHMA), has vowed to sanction any Provider under the Lagos State Health Scheme (LSHS) that disenfranchises ILERA EKO enrollees from their rights while accessing healthcare.

The Permanent Secretary, Lagos State Health Management Agency (LASHMA) Dr. Emmanuella Zamba gave the warning recently in Alausa, Ikeja, adding that henceforth, there will be zero tolerance for the disenfranchisement of ILERA EKO Enrollees from the providers.

She warned Providers that are depriving Enrollees of their rights, to desist from this act, noting that the Lagos State Government has good intentions for establishing the Social Health Insurance Scheme.

Dr. Zamba said that the Agency had received a lot of feedback from Enrollees that some Providers are depriving them of their rights while accessing care. She added that upon investigations, LASHMA confirmed that some of the complaints were true.

The Permanent Secretary explained that some of the disenfranchisements included denial of drugs, incomplete dispensing of drugs, demand of money for the purchase of drugs that are covered under the Health Scheme, denial of covered tests and demand of money for the payment of tests covered.

Noting that the untoward attitude of some of the Providers has prompted some Enrollees who are in serious need of these drugs or tests, to pay out-of-pocket, Dr. Zamba, who apologised to the Enrollees who had gone through these denials, said that the Agency is seriously working to curb the denial of drugs or inadequate supply of drugs to enrollees, adding that very soon the Agency will roll out an initiative that will permanently resolve these excesses from providers.

The Permanent Secretary said that henceforth, any Enrollee, who experiences any denial from his or her hospital, should feel free to contact ILERA EKO 24/7 Customer Service on 0800-ILERAEKO (0800-45372356) Toll-Free or 0700-ILERAEKO (0700-45372356).

Dr. Zamba said that they can also forward their complaints and evidence (test message only) to WhatsApp Numbers 07045358275 or 07046160051.

She said that upon investigation, once it is confirmed that such drugs or tests are covered under the Health Insurance Plan and the Enrollee is deprived, LASHMA, will refund the money spent by the Enrollee and debit the erring Provider.

Dr. Zamba warned that the Regulatory team of the Agency has been directed to step up monitoring in the Hospitals and any Provider found to constantly disenfranchise ILERA EKO Enrollees, will be appropriately sanctioned in line with the provisions of the Lagos State Health Scheme (LSHS) Law.

The Permanent Secretary urged ILERA EKO enrollees to request the benefit package of their Health Insurance plan to be conversant with what they are entitled to at their chosen Hospital.

This, she explained can be done by sending a WhatsApp message to 07045358275 or 07046160051. She added that Enrollees can also obtain their Bill of Rights from the Agency as this will also expose them to their rights and responsibilities.

Dr. Zamba said that the Agency has launched its service charter for ILERA EKO Providers and will commence a rollout before the end of the year. Posters indicating the benefit package that Enrollees will enjoy as well as complaint feedback channels will be pasted at strategic locations in all the Hospitals under the Scheme.

The Permanent Secretary said, “At LASHMA, quality and effective service delivery are our top priority and we are cognizant of the fact that the customers are king, therefore, we will not relent in our efforts to ensure that their rights are protected”.

While commending the providers who have taken ILERA EKO Enrollees as priorities and have been providing excellent healthcare service, she said that the Agency would continue to work hand-in-hand with them to ensure that quality and better service delivery are delivered to the enrollees.