NHIA imposes one hour timeline for treatment authorisation

By Ifeoma Nwovu

In fulfillment of its regulatory role to promote patient health outcomes, the National Health Insurance Authority (NHIA) has mandated a one-hour timeline for the authorisation of care and issuance of treatment codes by Health Maintenance Organisations (HMOs).

This is aimed at reducing delays in accessing services and ensuring that enrollees receive quality healthcare services.

A statement by the Ag. Director of Media and PR of NHIA, Emmanuel Ononokpono, indicates that the directive took effect on April 1, 2025, and aligns with the provisions of the NHIA Act 2022, while the changes regarding authorization of care were approved at a Stakeholders’ Meeting in February, 2025.

According to the statement, Enrollees are to report any delays or barriers to timely access to health service resulting from receiving authorization codes in excess of the one-hour limit independently to the NHIA.

It further states that where delays occur beyond the one-hour timeline, the healthcare providers are to proceed to render services to the enrollee and inform NHIA immediately.

For emergency cases, the NHIA stated that treatment may commence without prior authorization. However, authorization codes must be obtained within 48 hours of beginning care, as stipulated in the operational guidelines.

The Authority warned that sanctions would be imposed appropriately to entities that deliberately delay in the authorization of care and added that it will continue to review compliance as well as provide feedback to ensure accountability across the system.