The suspended Executive Secretary of the National Health Insurance Scheme (NHIS), Prof. Usman Yusuf, has claimed that his war against corrupt practices in the scheme is why there's a campaign to get him kicked out.
Yusuf was first suspended as Executive Secretary by the Minister of Health, Prof. Isaac Adewole in July 2017, following allegations of monumental fraud, gross abuse of office and nepotic acts. After the initial three months suspension, it extended indefinitely after the panel that probed allegations against him found him "culpable in many areas" of his performance.
Yusuf was then suspended indefinitely again by the NHIS governing council on October 18, after a two-day closed-door meeting. The council's chairman, Ifenne Enyanatu, revealed that it had the approval of Prof. Adewole and also set up a panel to look into the allegations of gross misconduct and fraud levelled against Yusuf.
With Yusuf defying the latest suspension ordered by the board, President Buhari intervened through the Office of the Secretary-General to the Federation (SGF), Boss Mustapha, and directed him to proceed on administrative leave pending investigations by a 7-member independent fact-finding panel.
Allegations levelled against Yusuf include financial recklessness and refusal to follow due process as he's been accused of awarding contracts to his associates, including one to his own brother.
He's also accused of high-handedness, budget distortion, fraudulent cost manipulation, illegal investments and unprofessional manipulation of the human resources of the agency.
Yusuf fires back at allegations
In a recent video which he published to defend himself against allegations of fraud levelled against him, Yusuf said his war against the brazen impunity of health maintenance organisations (HMO) is why there's a sustained campaign to malign him and get him thrown out.
While explaining how the scheme works, he accused HMOs of collecting billions of naira from the NHIS but failing to pay hospitals as required, and, as a consequence, jeopardising the care that NHIS enrollees are entitled to.
He said when he was first appointed in 2016, he was warned to not rock the boat of how things were run in the scheme.
However, he said he was angered by the inappropriate conduct of HMOs who either owed hospitals billions of naira despite receiving money regularly from the NHIS.
He accused the HMOs of using the money to either accrue interest in commercial banks, buy foreign exchange, or use as collateral to get bank loans. He said the failure of the HMOs to make adequate payments meant hospitals could treat enrollees shabbily.
He also noted that the HMOs still received billions of naira while operating with expired licenses when he took over and wondered if such could be allowed in the banking sector or the judciary.
He explained, "Civilian HMOs when I came, it is like the Wild Wild West - land of brazen impunity. I gathered them in Abuja and I said there's a new Sheriff in town and I'm here to clean this mess.
"We were paying HMOs three months in advance for the past 12 years to pay hospitals but they were not (paying hospitals) and I asked why. Our people who go to hospitals are not treated well because HMOs have not paid hospitals and I asked why.
"Patients or hospitals call HMOs but they will not pick the phone. I have an HMO living in Port Harcourt with huge debt in the Federal Medical Centre in Abeokuta. Sick people are in Abeokuta, the money is in Port Harcourt. The hospital that sees the highest number of NHIS enrolees is Aminu Kano Teaching Hospital in Kano, HMOs live in Lagos. Sick people laying in Kano, money out there in Lagos.
"You call HMOs, they don't pick the phone. So I asked what do they do with this money that we gave them. They did one of three things. They either fix this money in the banks to accrue interest while our people go to hospitals and get treated shabbily, or they buy foreign exchange, or they use this money as collateral to get bank loans. This is what's been going on.
"I get inundated by complaints from hospitals about HMOs not paying. Not only that, all their licenses have expired, some as far back as 2013. And I asked my people, will a Central Bank deal with any bank that doesn't have a license? Will NNPC deal with any petrol station that doesn't have a license? Will I be able to go and practise at the National Hospital without a license? Will a lawyer be able to go to court without a license? Then why are we giving these unlicensed entities billions of naira of people's money and they're not licensed?
"HMOs are supposed to have contract with the NHIS and contract with the hospitals. The last time any contract was signed between the NHIS and HMOs was 2005 at the inception of NHIS. So much impunity. Everybody was here. Everybody was complaining. This is what I met.
"Unlicensed entities you give money three months in advance, they're not paying; they're living far away from where people are. And they're even on the board of the NHIS, so the regulated is on the board of the regulator.
"I said this is not going to continue, not this time. The boat of corruption, we're not going to rock it, we're going to sink it. We're going to clean up this system.
"HMOs will be licensed, HMOs will pay hospitals, NHIS will be responsible, hospitals will be responsible to our patients."
Why HMOs are after me - Yusuf
Yusuf explained that his effort to make HMOs accountable to hospitals and enrollees is why he's currently facing the controversies against him. He said he had put machinery in place to ensure that all HMOs are licensed and are also to be cleared by hospitals before they're paid by the NHIS.
He said the HMOs only started to wage a war against him after they realised that they could not get cleared by the hospitals that they've owed for years which would mean they could not get payouts from the NHIS.
He said, "I said all HMOs in this country will be licensed. The first condition I set is every HMO must present to the NHIS a signed letter of non-indebtedness form signed by the CMD of all the hospitals they serve, and they would pay NHIS all money owed NHIS.
"Before I came, 2013 to 2015, the security agency, DSS, investigated corruption in the NHIS and discovered that N1.025 billion was paid to HMOs illegally and recommended that this money is recouped. When I came back, I started writing letters to them to recoup this money.
"I'm very happy to report to Nigerians over 75% of this money has been returned. By the end of December, all will be refunded, if not, I'll delist the HMO and hand them over to the EFCC."
Yusuf further complained that two big HMOs were outrightly taken over by a foreign company without the approval of the NHIS, the implication of which he noted would be profit being repatriated outside the shores of the country instead of investing it in Nigeria.
"This is impunity - HMOs doing whatever they wanted, NHIS sleeping on duty, hospitals not treating our patients well, our patients get lost in the shuffle. They had no recourse.
"I said I'm going to be the Chief Executive Secretary of the enrollee, I'm going to empower the enrollee," he said.
Yusuf further noted that the allegations that have been levelled against him are false allegations sponsored by the HMOs to stop him from fixing the NHIS.
He said, "They're funding unions, they're funding the press, they've taken me to court to hold status quo. Fellow Nigerians, status quo is not acceptable.
"Status quo is we give these unlicensed entities people's money to pay to hospitals and they're not paying. I'm happy to report to Nigerians they're paying. CMDs of hospitals are now calling me and thanking me for empowering them."
He later added, "HMOs are the ones that have been inciting all the rancour in the boardroom. They've been paying unions as their foot soldiers. They've been paying the press and taking me to court to maintain the status quo."
How I fixed NHIS finances - Yusuf
Yusuf further revealed how he commissioned a forensic audit of the NHIS finances when he took over and how it was discovered that the scheme has billions of naira hiding in 13 commercial banks.
He said, "Another thing that I found was that NHIS finances were in shambles. I had no clear idea as to how much NHIS money was transferred from commercial banks into our TSA account.
"I started work in August 2016 and commissioned a forensic auditing firm in December 2016 to look at the books of the NHIS.
"Three years after TSA, NHIS still has billions of its money in 13 commercial banks in this country. This money that no one would have known about until I set up this forensic auditing firm.
"This is people's money still in commercial banks. Is somebody still getting that interest? We're finding out."
Yusuf raises questions over latest suspension
Yusuf urged Nigerians to be suspicious of the timing of his latest suspension as it coincided with a major reform he had been planning. He revealed that he was set to present a new list of licensed HMOs to be paid by the NHIS to the governing council the day his suspension was announced.
"I've told Nigerians, Thursday the 18th had significance. On the day of the purported suspension was the day I was going to announce to the council HMOs that qualified to be licensed or not. It was a pre-emptive strike. It was a coup.
"I call on all Nigerians to look deeper than themselves and do the right thing and filter the truth from evil," he said.
He also questioned the legality of the suspension itself, arguing that a part-time council of any ministries, departments and agencies (MDA) in the country doesn't have the power to suspend a chief executive.
"It is very important because we're asking fundamental questions about the law. If you do not have the legal authority to do what you did, on what basis did you do it? As a council, you're usurping the power of the president. This is very serious," he said.
He also called on the governing council's chairman, Enyanatu, to show evidence that his latest suspension was indeed approved by the Minister of Health as she claimed.
Yusuf remained resolute that his controversial suspension and the campaign against him will not stop him from doing what is right to ensure Nigerians get the best benefits out of the NHIS.
"I ask myself, what is the real purpose for all of this? Is it to malign me, embarrass me, kick me out of office or to embarrass this government? My answer is all of the above.
"If it is me you're after, good luck, because I remain focused, I will not be shaken or intimated into doing anything that's wrong. You can do more than suspend me but I'll continue to do that which is right," he vowed.