What we do?
(1) Ensure the effective implementation of the policies and procedures of the Health Insurance Scheme.
(2) Approve formats of contracts for the Third-Party Administrators and all Health Care Providers.
(3) Carry out public awareness and education on the establishment and management of the Health Insurance Scheme.
(4) Promote the development of other programs for wider participation in the Scheme including developing new Health Plans;
(5) Implementation of the basic minimum benefit package as defined under the National Health Act.
(6) Classifying healthcare facilities and providers in a manner that shall help improve health outcomes in the FCT as required under the National Health Act;
(7) Reimburse Health Care Providers in line with services delivered under the Scheme.
(8) Determining the percentage of the premiums or other contributions from private health plans that shall be payable as cross subsidy to the Fund for the purpose of financing the Health Equity Plan under Section 16 for the poor and vulnerable;
(9) Determine, after due consideration capitation, fee-for service and other payment mechanisms due to Health Care Providers, by the Third-Party Administrators.
(10) Coordinate research and statistics.
(11) Establish and Monitor quality assurance mechanism for all stakeholders;
(12) Ensure the collection, collation, analysis, and reporting on quarterly returns from the Third-Party Administrators and other stakeholders;
(13) Exchange information and data with the National Health Insurance Scheme, FCT Health Management Information System, relevant financial institutions, development partners, Non-Governmental Organizations; and other relevant bodies;
(14) Receive and investigate complaints of impropriety levied against any Third-Party Administrators, Health Care Provider, Enrollee and other relevant institutions and ensure appropriate sanctions are meted out.
Welcome to FHIS
FCT Health Insurance Scheme is a corporate body established under FHIS Act, of 2020, to regulate and provide health insurance to all residents of FCT where health care services are paid for from the common pool of funds contributed by the participants of the Scheme.