AB1LLFOR A LA'Y'

TO PROVIDE FOR THE ESTABU -Hl'v]C?<T OF THE LAGOS STATE HFALTHlV[A1\'AGEMENT AGE1'\CY, TO fNST1TLJTE THE'LAGOS STATE!:-'IEALTH SCHEME H)R

ALL RESIDE" TS OF LAGOS STATE A"f\f) FOR CONNECTED PURPOSES

THE LAGOS STATE HOUSE OF ASSEMBLY enacts as follows:

Interpretation, 1. In this Law. unless the context other» ise requires-

"Agency" 111 \.:(111 S the Lagos Slate Coutriburory i-L',ilI.l1Agency established Linder Section 3 of this l1il!;

"benefit' means a benefit or advantage of any 1< inJwhatsoever derived from the Scheme;

"Board" means the Governing 13oc1l'(1 esiablisheci underSection 3 of this Law for the Agency;

"capitation" means a payment to (I health care provider inrespect of covered services to be provided to 8!1 insuredperson registered with the health care provider, whether theperson uses the services or not;

"CBH1" means 8 community based health iI15\11';II\C('

registered under section 20 of this Eill tu pr"vick hcnlrh careservices through health care providers iIPi)lO·/L·I.I ~ly the

,-\~ency;

"Commissioner' 1:1efH1S the C:f.)ll;m!~,~;i:'):'i,;r ck'I'SC,I, withresponsibility for matters relatir.g (U !ked!!\ iii i~lC ';r.;.;lc;

"contribution" means a premium payable to li~,ilUs,CHI-I ls,Ml-IAs and Lagos State Conrributorv j-k,ilth h!i1C{

(LASCOHf\ F')an) other funds: under this Bill;

"employee" means any person who is orrlinarily r(:~;ict..:'"nL inLagos State and is employed in the public service or ;)riVClicsector 0;' au apprenticeship with all C!IlP\'),CI' whether thecontract is express or implied, oral 01' in \v;i~il1g;

"employer" means an employer with ten 01 I1I\)J'I.' employeeswhich includes the Federal, State ~t)'ld Local Government or811Y Exna,Ministeri<d DepC1J'lmem 01' a persor: witi: \\'110111 anemployee has entered into a contract 0\ service orapprenticeship ami who is responsible G)I' the payment of tile

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wages or salaries of the employee including the lawfulrepresentative. successor or assignee of that person;

"fee-for-service" means payment made directly by HMOs,CBHls MHAs for completed health care services, notincluded in the capitation fees paid to health care providersfollowing approved referrals and/or professional services(specialist consultation, pharmaceuticals, laboratory andradiological investigations etc under this Scheme;

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"health care provider" means any government or privatehealth care facility, hospital, maternity centre, communitypharmacies and all other service providers registered by theAgency for the provision of prescribed health services forinsured persons and their dependants under this Scheme;

"HEFAMAA" means Health Facility Management andAccreditation Agency accredit health care providers andother relevant institutions;

"HMO" means a health maintenance organization registeredunder Section 27 of this Law to ensure health care servicesare adequately provided by health care providers approved bythe Agency;

"insured person" means any person and eligible dependantwho pays the required contribution under this Scheme;

"Local Government Chairman" means the political head of aLocal Government or Development Council Area.

"member of the Board" means any person, including theChairman who serves on the Board;

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"MEA" means a mutual health association registered underSection 27 of this Law to provide health care servicesthrough health care providers approved by the Agency;

"NHIS" ational Health Insurance Scheme accredited healthmaintenance organizations;

"vulnerable" refers to the following categories of people,pregnant women, children under 5, the aged, the disabled, thepoor and others falling with the group;

"wage" means remuneration in money paid to an employeeunder his contract of service or apprenticeship, as the case

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Establishment 2.of the Lagos StateContributory HealthScheme Agency.

Establishment of the 3.Lagos State HealthScheme AgencyGoverning Board.

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may be; and whether agreed to be paid at fixed or determ inedintervals of time.

(l) There is established a body to be known as the Lagos State.Contributory Health Agency (in this Law referred to as "theAgency).

(2) The Agency-

(a) shall be a body corporate with perpetual successionand a common seal;

(b) may sue and be sued in its corporate name;

(c) may acquire, hold or dispose of any moveable orimmoveable property for the purpose of its functionunder this Law.

(3) The principal object of the Agency shall be toregulate, upervise and ensure the effective administration ofLagos tate Contributory Health Scheme.

(1) There is established the Lagos State Health Scheme AgencyGoverning Board (in this Law referred to as "the Board") whichshall, subject to this Law, have general control of the Agency.

(2) The Board shall consist of the following-

(a) a Chairman who shall be appointed on a part timebasis by the Governor on the recommendation of theCorum issioner;

(b) one representative each of-

(i) the Ministry of Health not below the rank of aDirector;

(ii) Lagos State Primary Healthcare Board notbelow the rank of a Director;

(iii) the Ministry of Economic Planning andBudget not below the rank of a Director;

(iv) the Nigeria Employers ConsultativeAssociation Lagos State Branch;

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Components of the 4.Lagos StateHealth Scheme.

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(v) the Nigerian Labour Congress Lagos StateChapter

(vi) the Health Maintenance Organizatios HMO. (to be nominated by Health and Managed CareAssociation of Nigeria HMCA Lagos StateBranch)

the Health Care Provider Association of igeria (to benominated by HCPAN Lagos State Branch) (c) the CivilSociety (to be nominated by the LACSOP;

(d) the General Manager of the Agency, who shall alsobe the Secretary to the Board.

(3) The Chairman so appointed shall be a person of integritywith relevant qualifications and a minimum of 10 years experience.

(4) The other members of the Board shall be persons of provenintegrity to be appointed by the Governor on the recommendation ofthe Commissioner.

(1) The Lagos tate Health Scheme shall com prise in itiallyof three (3) components-

(a) The Lagos State Free Health Plan (FHP)Only point of access wi II be the Primary HealthCare Centers;

(b) The Community Based Health Plan (CBHP)This shall be the 'affordable' Plan providing aprescribed package of healthcare services at uniformcontributions accessible to all residents at thegrass roots and will be accessible from both Publicand Private Faci lities;

(c) The Lagos State Private Health Plan (PHP)This shall consist of a variety of Packages provid inghealthcare services in direct proportion to thecontribution; and

(d) any other component as may be developed by theAgency with the approval of the Board.

(2) Th Scheme shall be compulsory and apply to aJI residentsof the State that are not covered by an existing health scheme.

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Objectives of theHealth Scheme.

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(3) All residents in the formal or informal sector already coveredby an existing health scheme must provide evidence of same to theAgency.

5. The objectives of the Agency are to-

(l) ensure that every resident of Lagos State has goodaccess to health care services;

(2) ensure that all residents of Lagos State have financialprotection, physical access to quality and affordablehealth care services;

(3) protect families from the financial hardship of hugemedical bills;

(4) limit the rise in the cost of health care services;

(5) ensure equitable distribution of health care costsacross different income groups;

(6) maintain high standard of health care del iveryservices within the Health Scheme;

(7) ensure efficiency ill health care service delivery;

(8) improve and harness private sector participation in theprovision of health care services;

(9) ensure adequate distribution of health facilities withinthe State;

(10) ensure appropriate patronage at all levels of the healthcare delivery system;

(11) ensure the availability of alternate sources of fundingto the health sector for improved services;

(12) in cases where res idents do not have availablemedical services and other health services, to takesuch measures as are necessary to plan, organize anddevelop medical services and other health servicescommensurate with the needs of the residents.

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Tenure of Office.of Members of theBoard.

Cessation of 7.Membership of theAgency.

Resignation of aMember of theBoard.

Vacancy in the.Board.

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6. (1) A member of the Board shall hold office for a term offour(4) years in the first instance and may be re-appointed for a further.term of four (4) years only.

(2) The members of the Board shall be paid such remunerationsand allowances as the State Government may, from time to time,determine.

(1) A mem ber of the Board shall cease to ho ld office if-

(a) he becomes of unsound mind;

(b) he becomes bankrupt;

(c) he is convicted of a felony or of any offenceinvolving dishonesty; or

(f) he is gu ilty of serious 111 iscond uct in relation to hisduties.

(2) A member of the Board may be removed from office by theGovernor, if he is satisfied that it is not in the interest of the Agencyor the interest of the public that the member should continue inoffice.

8. A member of the Board may resign his appointment by notice, Inwriting under his hand, addressed to the Governor and theresignation shall take effect only on acknowledgement by theGovernor.

9.· Where a vacancy occurs in the membership of the Board, it shall befilled by the appointment of a successor to hold office for theremainder of the term of office of his predecessor, so however, thatthe successor shall represent the same interest.

Powers of the Board. 10. The Board shall have the power to-

(a) determ ine the organizational structure of the Agency;

(b) approve for the Agency all prepaid and private healthmaintenance organizations;

(c) determine the overall policies of the Health Scheme,including the financial and operative procedures oftile Scheme;

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Functions ofthe Agency.

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(d) ensure the effective implementation of the policiesand procedures of the Scheme;

(e) regulate and supervise the Health Scheme establishedunder this Law;

(f) establish standards, rules and guidelines for themanagement of the Health Scheme under this Law;

(g) approve, license, regulate and supervise HealthMaintenance Organizations and other institutionsrelating to the Health Plan as the Agency may fromtime to time determine;

(h) issue guidelines and approval for the administrationand release of funds under the Health Scheme;

(i) approve other Health Plans as presented and putforward to the Agency from time to time;

approve the recommendation of the Agency relatingto research, cousultancy and training in respect of theScheme;

(k) ensure the maintenance of a State Data Bank on allScheme matters;

(I) perform such other duties which, in the opinion of theAgency, are necessary or exped ient for the dischargeof its functions under this Law; and

(m) deterrn ine the remu neration and allowances of allstaff of the Board;

11. The Agency shall be responsible for-

(a) ensuring the effective implementation ofthe policiesand procedures of the health scheme;

(b) issuing appropriate regulations and guidel ines, asapproved by the board, to maintain the viability of thehealth scheme;

(c) the management of tile health scheme in accordancewith the provisions of this Law;

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(d) Registering NHIS accredited Health MaintenanceOrganizations, HEFAMAA accredited Health CareProviders and other relevant institutions

(e) approving format of contracts proposed by the healthmaintenance organizations for all health careproviders;

(f) carrying out public awareness and education on theestablishment and management of the health scheme;

(g) promoting the development of Mutual HealthAssociations for wider participation in scheme;

•(h) determining, after due consideration, capitation, fee-

for service and other payment mechanisms due tohealth care providers, by the Health MaintenanceOrganizations in line with similar schemes;

(i) advising the relevant bodie on inter-relationship ofthe agency with other social security services;

(j) coordinating research and statistics;

(k) establishing quality assurance for all stakeholders;(1) the collection, collation, analysis, and reporting on quarterly returns from the

HMOs, CEl-Is and MHAs; .

(m) exchanging information and data with the National HealthInsurance Scheme, State Health ManagementInformation System, relevant Tinancial institutionsdevelopment partners, NGOs; and other relevantbodies;

(n) ensuring manpower development in the agency;

(0) carrying out such other activities as are necessary orexpedient for the purpose of achieving the objectivesof the agency under this Law;

(p) receive and investigate complaints of impropriety leveledagainst any H lO, HCP and other relevant institutions andensure appropriate sanctions are given.

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Applicabilit of 12.NHIS Act to the Law.

Prohibiting 13.Healthcare OrganizationFrom refusing coverageBased on Patient'sMedical History.

Director-Generaland other Staff of the

The Provisions of the NHlS Act is applicable to the provisions ofthis Law and all the Regulations made here under.

An Healthcare organization shall not by reason of bad medicalhistory refuse coverage for any person.

14. (l)There shall be appointed by the Governor, on therecommendation of the Commissioner, a General Manager Agency.

for the Agency.

(2) The General Manager shall-

(a) be a person of integrity with relevant qualificationand a minimum of f fteen (10) years cognateexperience in health care financing.

(b) be the Chief Executive/Accounting Officer of theAgency and be responsible to the Board;

(c) hold office-

(i) for a period of 4 years in the first instance andmay be re-appointed for a further term of 4years only; and

(ii) on such terms and conditions as may bespecified in the letter of appointment.

(3) The General Manager shall, subject to the general directionof the Board, be responsible for the-

(a) day-to-day administration of tile Agency;

(b) general direction and control of all other employeesof the Agency.

(4) The Board shall-

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Secretary/ LegalAdviser.

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Pensions.

Appointment ofConsultants for theAgency.

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(a) appoint, for the Agency, such number of directors andother employees as may, in the opinion of the Board,be required to assist the Board in the discharge of anyof its functions under this Law; and

(b) pay to persons so appointed such remuneration andallowances as the Board may approve.

15. (1) There shall be for the Board of the Agency, a Secretary/Legal Adviser who shall-

(a) be appointed by the Board;

(b) be responsible to the Director-General and the Board;

(c) possess professional skills and cognate experience;

(d) be in-charge of the Legal affairs; and

(e) perform such other duties as may be assigned, fromtime to time, by the Board or the Director-General.

16. (1) Employment in the Agency shall be approved service forpurposes of the Pension Law.

_ (2) Employees of the Agency shall be entitled to pensions and otherretirement benefits.

(3) othing in subsections (1) and (2) of this Section or in thisLaw shall prevent the appointment of a person to any office on terms

. which preclude the grant of pension in respect of that office.

17. (1) The Board shall appoint for the Agency, a licensed actuaryon such terms and conditions as the Board may, from time to time,determ ine.

(2) The actuary shall review the services package and evaluate itactuarially, including the rates of contributions payable for theservice and make appropriate recommendation to the Board.(3) If having regard to the review and evaluation carried out bythe actuary under subsection (2) of this Section, the Board considersthat the rates of contributions have not retained their value in relationto the general level of earning in igeria, the Board shall inconsultation with the actuary modify the rates to the extentconsidered appropriate and bring the new rates to the notice of thepersons affected by the modification.

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Creation and 18.Management of LagosState Contributory HealthAgency Fund.

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Disbursement of the 19.Fund.

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(4) The Board shall appoint for the Agency, Auditors, PensionConsultants, etc. as it shall be determined from time to time.

(l) There is created the Lagos State HealthFund (LASHEF) (hereinafter referred to as 'the Fund ').

(2) The fund shall consist of-

(a) the initial takeoff grant from the Lagos StateGovernment;

(b) annual subvention from the Stale Government andcontributions on behalf of retirees. disabled, indigentor disadvantaged populations;

(c) such money as may be due from Health MaintenauceOrganizations, contributions from CBI-ll enrolleesand variegated Private Health Plan enrollees;

(d) Funds from THIS for pregnant women, childrenunder-five (5) years and any other relevant programs:

(e) Funds as may be approved from the Lagos StatePrimary Health Care Board (PF-ICB), from the

ational Primary Hcalthcare Development Agency(NPHCDA) for the CBHS and FHS.

(f) other appropriations earmarked by the national,state and local governments purposely for theimplementation of the Scheme;

(g) fees, fines and commissions charged by the Agency;

(h) Donations or Grants-in-Aid from privateorganizations, philanthropists, international donororganizations and iou-Goverumental organizationsfrom time to time;

U) dividends and interests on investments and stocksand;

(j) all other money which may, from time to time, accrueto the Agency.

(1) The Board shall approve disbursement of funds to thehealthcare providers from the established fund through the

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Power to acceptGift.

Annual estimate 21.Account and Audit.

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participating HMOs, CBHI and MHA with the recommendation ofthe Agency.

(2) The Agency shall on approval of the Governing Board, fromtime to time, apply the funds at its disposal-

(a) for and in connection with the objectives of theAgency under this Bill.

(b) to the cost of administration of the Agency;

(c) to the payment of fees, allowances and benef.ts ofmembers of the Board;

(d) to the payment of salaries, allowances and benefits ofofficers and employees of the Agency;

(e) for the maintenance of any property vested Il1 theAgency or under its adm inistration; and

(3) The Agency shall, invest any money not immediatelyrequired by it in the Lagos State Government securities or in suchother securities as the Board may determine from time to time.

20. (1) The Agency may accept gifts of land, money or otherproperty on such terms and conditions, if any, as may be specified bythe person or organization making the gift.

(2) The Agency shall not accept any gift if the conditions attachedby the person or organization offering the gi ft are inconsistent withthe objectives and functions of the Agency under this Law.

(1) The Board shall cause to be prepared, not later than 30th

September in each year, an estimate of the expenditure and incomeof the Agency during the next succeeding year and when prepared,they shall be submitted to the Accountant-General of the State.

(2) The Board shall cause to be kept proper accounts of theAgency and proper records in relation thereto and when certified bythe Board, the accounts shall be audited by auditors appointed by theBoard from the list and in accordance with the guidelines suppliedby the Auditor-General of the State.

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Annual Report.

Exemption from Tax. 23.

Payment ofContributionunder the Scheme.

(3) Any employee, member or agent of the Agency who fails,without reasonable cause, to comply with a requirement of an auditorunder subsection (2) of this Section, commits an offence and is liableon conviction to penalties contained in Schedule I of this Law.

22. The Board shall not later than six (6) months immediatelyfollowing the end of a year-

(a) submit to the Governor through the Commissioner forHealth, a report on the activities and theadministration of the Agency during the immediatelypreceding year and shall include in the report theaudited accounts of the Agency and the auditor'sreport on the accounts; and

(b) present and publish the audited annual accounts,auditor's report on the accounts and reports on theactivities of the Agency to Annual Meetingcomprising all Stakeholders and on the StateGovernment Website.

(1) The Agency shall be exempted from the payment of tax onany income accruing from investment made by the Board for theAgency or otherwise .

. (2) The provisions of any enactment relating to the taxation ofcompanies or trust funds shall however not apply to the Agency orthe Board.

24. (I) The Lagos State Contributory Heallh Scheme Fund'(LASCOHAF) shall be administered through carefully selected andapproved banks as advised by the Accountant-General of the State,for the pooling of all contributions derived from either the public orprivate sector (formal or informal) into dedicated accounts.

(2) The Agency shall cause the pooling of contributions derivedfrom the private sector to be made through the registered HMOs,CBHl and MHAs into a dedicated accounts.

(3) All other funds particularly by independent or private donorsshall be paid directly to LASCOl-lAF through approved banks intoded icaied accounts.

(4) The Agcncy shall cause I·:lMOs to establish accounts with theLagos State Contributory Health Scheme Fund (LASCOHAF)approved Banks for the agreed remittable percentage of the

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Registration: 25.Lagos State Residents,Employers andEmployees.

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premiums received for the private health plans and CommunityBased Health Plan all under this Law.

(5) The Agency shall cause HMOs to produce, in a recognizedformat and subject to guidelines to be issued by it from time to time,performance/security bond from accredited banks or insurancecompanies so as to protect contributions collected.(6)) The Agency on the advice of the actuary shall prescribe, fromtime to time, what percentages of contributions collected byHMOS, CBHI and MHAs shall be for provider reimbursement,administration, remittance to the Agency

(1) Subject to such guidelines and regulations as may be madeunder this Law, all residents shall be registered under the Schemeeither through their registered HMOs, CBf-Ils or MHAs or on anindividual basis. The LASRRA registration number shall be a pre-requisite for registration and shall itself grant eligibility to access anyand all benefits avai lab le under the scheme.

(2) All employers (public and private) shall register with theAgency and obtain a Corporate Identification Number CIN.Thereafter employers shall register their employees with I-IMOs oftheir choice.

Registration andservices of health careproviders 26. (1) The registration of I-lEfA lAA accredited health

care providers under.the Health Scheme shall be in accordance withguidelines as may be issued by the Agency, from lime to time, underthis Law.

Registration of 27.MaintenanceOrganizations, CBHIand Mutual HealthAssociation.

(2) A health care provider so registered in subsection (1) shall, illconsideration for an approved capitation payment or fee for service,to [he extent and manner prescribed herein, provide services inaccordance with-

(a) the approved Benefit Package as shall be actuariallydetermined from time to time by the Board; and

(b) Treatment Guideline.

(1) The Agency shall register HIS accredited HealthMaintenance Organization (HMOs) (in this Law referred to as"HMOs" ), Mutual Health Associations (MHAs) (in this Lawreferred to as "MI-IAs") and allied associations.

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Refusal of Licence. 28.

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(2) This Law recognizes the existence of prepaid healthinsurance organ izations before the commencement of the LagosState Health Scheme ..Such organizations operating in the State shallbe licensed and monitored by the Agency. However, all CommunityBased Health Plans must mandatorily be run in the manner asstipulated by the Agency for uniformity and to the economic benefitof community members.

(3) The registration of an organization under the Agency shall bein such form and manner as may be determined, from time to time,by the Board, using guidelines which shall include provisionsrequiring the organization to-

(a) be financially viable before and after registration;

(b) have a healthy track record of relationship withprivate providers;

(c) make a complete disclosure of the ownershipstructure and composition of the organization;

(d) have account(s) with one or more banks approved bythe Agency;

(e) comply with relevant insurance requirements throughinsurance companies accredited by the Agency;

(f) give an undertaking that the organization shallmanage and invest the funds aCCl"LIing to it fromcontributions received pursuant to this Law inaccordance with the guidelines to be issued, fromtime to time, by the Agency.

(4) The Agency shall reserve the right to allocate HMOs to coverdesignated divisions of the State under State sponsored coverage.

(5) Registration of an HMO shall be time bound as may bedetermined from time to time by the Agency, after which the HMOshall present itself for registration renewal.

(1) The Agency may refuse to issue a licence to any applicantpursuant to an application made uncler Section 24 of this Bill if it issatisfied that-

(a) the information contained in the application for alicence is false in any material particular; or

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Revocation ofLicence.

Functions of HMOs

CBHls and fHAs.

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(b) the application does not meet the requirementsprescribed by the Agency for grant of a licence;

(2) Where the Agency refuses to register any organization, itshall forthwith notify the applicant in the prescribed form, specifyingthe reasons for such refusal. However, such an organization mayreapply at a time it has fulfilled all the necessary conditions forregistration.

29. (1)if-

The Agency may revoke a license issued to an organization,

(a) it discovers after the grant of license that a statementwas made in connection with the application thereofwhich the applicant knew to be false in any materialparticular;

(b) the organizationproceedings or isdissolved;

IS subject to any insolvencyto be wound up or otherwise

(c) the conduct of affairs of the organization does notconform with the provisions of this Bill or anyregulations made pursuant to or any directive issuedunder this Bill;

(d) any event occurs which renders the organizationineligible to perform its duties; and

(e) the organization is in breach of any condition attachedto its licence.

(2) The Agency shall, before revoking the licence of anorganization give the organization at least 90 days notice of itsintention and shall consider any representations made to it in writingby the organization within that period before the revocation.

30. (1) An organization referred to in subsection (1) ofSection 21 ofthis Law shall have responsibility for-

(a) registration of eligible employers and employeesunder this Law;

(b) collection of contribution from voluntary contributors

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Participation of 31.Local GovernmentsAppointment of FocalPersons.

Establishment and 36.Functions of the LagosState Contributory HealthScheme AgencyArbitration Panel.

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(c)

under subsection (4) of Section 17 of this Law andshall rem it 1% of collection to LASCOHAF;subsequently register's shall be renewed fr0111time totime; .

(d) the payment of capitation fee for service or otherrecognized methods of payment for services renderedby health care providers registered under the Scheme;

(e) rendering to the Agency returns on its activities asmay be required by the Board;

(f) contracting only with the hea Ith care prov idersapproved under the Scheme for the purpose ofrendering health care services as provided by thisLaw;

(g) ensuring that contributions are kept in accordancewith guidelines issued by the Board;

(b) establishing a quality assurance system.

(2) An Association referred to in subsection (I) of Section 25 ofthis Law shall have responsibility for the functions stated insubsection (1) of this Section though with focus on the informalsector.

(3) otwithstanding anything contained in this Law, HealthMaintenance Organizations, CBHls and MHA shall not be involvedin the direct delivery of health care services or collection of fundsexcept in private or voluntary Health Plans and shall makeappropriate returns to the fund.

(1) A Local Government Chairman may in consultation withthe Primary Healthcare Board respectively appoint focal personswho shall be senior serving officers in the services of the LocalGovernment Departments of Health to coordinate and collaboratewith the Agency.

(1) Whenever there is a dispute amongst parties under this Law,it shall first be referred to Arbitration, Mediation or Conciliationbefore resorting to litigation.

(2) The parties shall by mutual consent appoint a 3-l11anpanel ofarbitrators (herein after referred to as "the Panel").

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Prosecution ofoffel{der.

37.

Jurisdiction. 38.

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Court to Order 39.Payment of Contribution.

Commencement of 40.Proceedings.

Limitations of Suits 41.Against the Agency etc.

(3) The membership of the panel and the applicable Arbitralprocedure shall be as provided for in the Arbitration and ConciliationLaw, Laws of Lagos . t.ate.

Any person who contravenes any of the provisions of this Law shallbe prosecuted by the Attorney-General of the State.

The State High Court shall have-

(a) jurisdiction to try offenders under this Law; and

(b) power, notwithstanding anything to the contrary inany other enactment, to impose the penalties providedfor the offence in this Law.

(1) The High Court before which a person is convicted of alloffence under this Law may, without prejudice to any civil remedy,order a person to pay to the fund of the Scheme the amount of anycontributions together with interest and penalty thereon, certified bythe Agency to be due and payable at the date of the conviction andsuch amount shall be paid into the Fund of the Plan for its credit,where applicable or of the employee concerned.

(2) Any contribution paid into the Fund of the Scheme undersubsection (1) of thi s Section shall be rem itted to the organ izationentitled to receive the contribution.

Proceedings for an offence under this Law may be commenced atany time after the commission of the offence.

(1) Subject to the provisions of this Law, the provisions of thePublic Officers Protection Act shall apply in relation to any suitinstituted against any officer or employee of the Agency.

(2) Notwithstanding anything contained in any other enactment,no suit shall lie against the Agency, any member of the Board, theDirector-General or any other officer or employee of the Agency foranything done in pursuance or execution of this Law or any otherenactment or law, or of any public duty or authority or in respect ofany alleged neglect or default in the execution of this Law or suchenactment or law, duty or authority, shall lie or be instituted in anycourt unless it is commenced-

(a) within three months after the act, neglect or defaultcomplained of; or

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Service ofDocument.

Restriction on 43.Execution againstProperty of the Agency.

Indemnity ofOfficers.

Confidentiality andNon-disclosure.

42.

(b) in the case of a continuation of damage or injury,within six months next after the ceasing thereof.

(3) No suit shall be' commenced against the Agency, a memberof the Board, the Director-General, officer or employee of theAgency before the expiration of a period of one month after writtennotice of intention to commence the suit shall have been served uponthe Agency by the intending plaintiff or his agent(s).

(4) The notice referred to in subsection (3) of this Section shallclearly and explicitly state the cause of action, the particulars of theclaims, the name and place of abode of the intended plaintiff and therelief which he claims.

A notice, summons or other document requ ired or authorized to beserved on the Agency under the provisions of this Law or any otherenactment of law may be served by delivering it to the Director-General or by sending it by registered post and addressed to theDirector-General at the principal office of the Agency.

(1) In any action or suit against the Agency, no execution orattachment of process in the nature thereof shall be issued against

the Agency not less than three (3) months unless notice of intentionto execute or attach has been given to the Agency.

(2) Any sum of moneys which may by the judgment of any courtbe awarded against the Agency shall, subject to any directions givenby the court where notice of appeal of the said judgment has beengiven, be paid from the general reserve fund 0 f the Agency.

44. . Any officer or employee of the Agency acting in the course of lawfulduty shall be indemnified out of the assets of tile Agency, againstany liability incurred by him in defending any civil proceeding.

4:5. (1) A member of the Board, the Director-General, officer orother employee of the Agency shall-

(a) not make use of any information which has come tohis knowledge in the exercise of his powers or isobtained by him in the ordinary course of his duty forhis personal gain or otherwise under this Law;

(b) treat as confidential any information which has comeobtained by him in the performance of his functions

under this Law;

(c) not disclose any information referred to under

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Contribution to beInalienable.

46.

Transfer of liability 47.of contribute in the caseof mergersacquisitions, etc.

Exclusion fromapplication of Cap449 LFN.

48.,

Collaboration with 49.the Federal Government

Professional SO.Indemnity forhealth care providers.

'.'

paragraph (b) of this subsection except when requiredto do so by an Arbitration or similar panel of the courtor in sLich other circumstances as may be prescribedby the "Board, from time to time,

(2) Any person who contravenes the provisions of subsection (J)of this Section commits an offence and is liable on conviction topenalties contained in Schedule 3 of this Law.

(1) Contributions payable under the Agency shall be inalienableand shall not be assets for the benefit of creditors in the event of thebankruptcy or insolvency of a contributor or an organization.

(2) otwithstanding anything in any law or enactment,contributions whether by an employer or an employee under thisLaw shall form part of tax deductible expenses in the computation oftax payable by an employer or, as the case may be, by an employee,under any other relevant law applicable to income tax.

Where, under Section 591 of the Companies and Allied Matters Act1990, an order is made by a court under subsection (3) of that sectionwhich include the trans fer to the com pany of the who Ie or any part ofthe undertaking and of the property and liabilities of a transferorcompany, the order shall include provisions for the taking over, asfrom such date as may be specified in the order, of any liability forany contribution which has become due and payable under this Law(together with any accrued interest thereon) in respect of theemployees concerned in the undertaking, property or liabilitytran s ferred.

The provisions of the Trustee Investment Act shall not apply to anyinvestment made by the Agency under this Law.

The Lagos State Government shall collaborate with relevantagencies of Federal Government in the realization of the setobjective of this Law.

A health care provider (institution and individual) shall be requiredto take professional indemnity cover from a list of insurancecompanies approved by the Board.

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Powers to makeRegulations andissue guidelines.

•

...

S1. (I) The Agency shall make regulations and issue guidelines for-

(a) the registration of employers and employees liable tocontribute under this Law.

(b) the registration of dependants of employees coveredby the Agency;

Cc) the compulsory payment of contributions byemployers and employees, the rates of thosecontributions and the deduction by the employers ofcontributions payable by employees under this Billfrom any salary, wage or other money payable;

(d) the voluntary payment of contributions by self-employed and other persons and rates of suchcontributions;

(e) the maintenance of the records to be kept for theAgenc and the records to be kept by employers inrespect of contributions payable under this Law andin respect of their employees;

(f) the methods of receiving contributions under thisLaw;

(g) the imposition of surcharges in respect of latepayment of contributions by employers or employees;

(i) the manner and circumstances in which contributionsmay be remitted and refunded;

(j) negotiated fees and charges payable for medical,dental, pharmaceutical and all other services providedunder the scheme;

(k) the nature and amount of benefits to be providedunder this Scheme, the circumstances and the mannerin which the benefits shall be provided;

(I) the nature and amount of capitation and fee forservice payment under this Scheme, thecircumstances and the manner in which health careproviders shalt receive the payment;

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Power to Enter,Inspect and Audit.

WithholdingPayments.

Offences andPenalties.

,..

(m) the reduction, suspension or withdrawal of anypayment under this Scheme;

(n) the submission of returns by employers regarding theemployers and their employees;

(0) the procedure for .assessment of contributions madeunder this Scheme;

(a) Any other matter whatsoever for which, ill theopinion of the Agency, is necessary or desirable tomake regulation and issue guidelines for giving effectto this Law.

(2) The guidelines issued under subsection (I) (c) of this Sectionmay provide for different levels of contributions to be payable bydifferent classe of persons.

(3) The guidelines issued under this section need not bepublished ill the Gazette but they are published as a Manual.

52. The Agency through her appointed Officers may enter, inspectand audit any premises, books, accounts and records of anyHospital, Ht,/\O or HMA that has received payments under this Lawat any time and may require the hospital 01 facility to verify in amanner prescribed, any information submitted to the Agency.

53. Where an hospital or health facility fail to keep the books,records and returns required under this Law 01' any Regulationsmade there under the Agency may withhold payments due to it untilthe hospital complies with the provisions of this Law and theRegulations made here under.

5-1-.(1) Any person who produces to an admitting official ofahospital or a ledical Practitioner or a member of his staff or to aperson authorized by Law to provide other health services or amember of his staff: a registration certificate-

(a) knowing that the person named therein is not atthe time of the production thereof, not covered underthe Law;

(b) knowing that the person on behalf of whom and tofacilitate whose treatment it is produced is not theperson named therein or a dependant of that person;

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\ \

? ,

Offences by Bodies 55.Corporate, etc.

..

commits an offence and shall on conviction pay a fineof fifty thousand naira (NSO,OOO.OO) in addition to tilebills incurred."

(2) Any member or agent of the Agency who fails, withoutreasonable cause .. to comply with a requirement ofan auditor undersubsection (2) of Section 13 of this Law, commits an offence and isliable on conviction to a fine not exceeding ~'IOO,OOO orimprisonment for a term not exceeding three months or to both suchfine and imprisonment.

(3) A person guilty of an offence under subsection (I) of Section24 ofthis Law is liable on conviction-

(a) in the case of a first offence, to a fine of not less thanOne I-Iunclrecl Thousand Naira (l'..--f100,000.00) 01'

imprisonment for a term not exceeding two years or to bothsuchfine and imprisonment; and

(b) in the case of a second or subsequent offence, to afine of not less than Two Hundred and Fifty Thousand Naira(W2S0,000.00) or imprisonment for a term not exceeding fiveyears or less than two years or to both such fine andim priscnm en l.

(4) Any person who contravenes the provisions of subsection (1)of Section 36 of this Law commits an offence and is liable onconviction to a fine of not less than Fifty Thousand Naira(WSO,OOO.OO) or imprisonment for a term not exceeding two years orto both such fine and imprisonment.

(1) \Vhere an offence under this Law has been committed by abody corporate or firm or other association of individuals, a personwho at the time of the offence-

(a) "vas an officer of the body corporate, firm or otherassociation; or

(b) was pmpOl'ting to act in the capacity of an officer orthe body corporate, firm or other association, isdeemed to have committed the offence and liable tobe prosecuted and punished for the offence in likemanner as if he had himself committed the offence,unless he proves that the commission or omission

23

. i..

constituting the offence took place without hisknowledge, consent or connivance.

(2) ln this section, "officer" includes-

(a) in the case of Ministries, Departments and Agencies(MDAs) the accounting officer;

(b) in the case of a body corporate, a Director, ChiefExecutive by whatever name called, Manager andSecretary 0 f the body corporate;

• (c) in the case of a firm, a partner, manager and secretaryof tile firm; and

(d) in the case of any other association of individuals, aperson involved in the management of the affairs ofthe association.

Citation andCommencement.

56. This law may be cited as the Lagos State Health Plan Law 2014 andshall come into force on the __ clay of~_ 2014.

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....1

UPPLEME TARY PROCEEDI G RELATING TO THE BOARD

Quorum

Meetings of theBoard.

Power to Co-opt.

Committees.

M iscellaneo LIS.

1. (1) ubject io this Law and ection 27 of tile Interpretation Act,the Agency may make-standing orders regulating its proceedings andthose of any ofits committees.

(2) The quorum of the Board shall be the Chairman or themember presiding at the meeting and live (5) other members and thequorum of any Committee of the Board shall be determined by theBoard.

2. (1) The Board shall meet not less than three (3) times in eachyear and subject thereto, the Board shall meet whenever it issummoned by the Chairman and if the Chairman is required to do soby notice given to him by not less than seven other members, heshall summon a meeting of the Board to be held within fourteen claysfrom the date on which the notice is given.

(2) At any meeting of the Board, (he Chairman shall preside butif he is absent, (he members present at the meeting shall appoint oneof their numbers to preside at the meeting.

3. Where the Board desires to obtain the advice of any person on aparticular matter, the Board may co-opt him to the Board for suchperiod as it thinks fit; but a person who is in attendan e by virtue ofthis sub-paragraph shall not be entitled to vote at any meeting of: theBoard and shall not count towards a quorum.

4. (1) The Board may constitute onc 01" more committees to carryout, on behalf of the Board such of its functions as it may determine.

(2) A committee appointed under this Paragraph shall consist ofsuch number of persons (not necessarily members of the Board asmay be determined by the Board) and a person other than a memberof (he Board shall hold office on the Committee in accordance withthe terms of his appointment.

5. (1) The fixing of the seal of the Ag IlCY shall be authenticated bythe signature of the Chairman, th ~ Director-General or of any otherperson authorized generally or specifically to act tor that purpose bythe Board.

(2) Any contract or instrument, which, if made or executed by aperson not being a body corporate, would not be required to be underseal may be made or executed all behalf of the Board by the

25

...

Chairman or any person generally or specially authorized to for thepurpose by the Board.

(3) Any documentpurporting to be a document duly executedunder the seal of the Agency shall be received ill evidence and shall,unless and until the contrary is proved, be presumed to be soexecuted.

(4) The validity of any proceeding of the Board 01' or acommittee thereof shall not be adversely affected by any vacancy inthe membership of the Board or C0l11m ittcc, or by reason that aperson not entitled to cia so took part in the proceedings of the Boardor committee .

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