AB1LL

FOR A LA'Y'
TO PROVIDE FOR THE ESTABU -Hl'v]C?<T OF THE LAGOS STATE HFALTH
lV[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
Interpretation,

1.

enacts as follows:

In this Law. unless the context

other ise requires-

"Agency"
111 \.:(111 S the
Lagos Slate Coutriburory
Agency established Linder Section 3 of this l1il!;
"benefit'
means a benefit or advantage
whatsoever derived from the Scheme;

of any

1<

i-L',ilI.l1

inJ

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

under

"capitation"
means a payment to (I health care provider in
respect of covered services to be provided to 8!1 insured
person registered with the health care provider, whether the
person 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 care
services through
health care providers
iIPi)lO/LI.I
~ly the
,-\~ency;

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

with

"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 in
Lagos State and is employed in the public service or ;)riVClic
sector 0;' au apprenticeship
with all C!IlP\'),CI' whether the
contract is express or implied, oral 01' in \v;i~il1g;
means an employer with ten 01 I1I\)J'I.' employees
which includes the Federal, State ~t)'ld Local Government
or
811Y Exna,Ministeri<d DepC1J'lmem
01' a persor: witi: \\'110111 an
employee
has entered
into a contract
0\
service
or
apprenticeship
ami who is responsible G)I' the payment of tile

"employer"

wages or salaries of the employee including the lawful

representative. successor or assignee of that person;
"fee-for-service"
means payment made directly by HMOs,
CBHls MHAs for completed health care services, not
included in the capitation fees paid to health care providers
following approved referrals and/or professional services
(specialist
consultation,
pharmaceuticals,
laboratory and
radiological investigations etc under this Scheme;

"health care provider" means any government or private

health care facility, hospital, maternity centre, community
pharmacies and all other service providers registered by the
Agency for the provision of prescribed health services for
insured persons and their dependants under this Scheme;
"HEFAMAA" means Health Facility Management and
Accreditation Agency accredit health care providers and
other relevant institutions;
"HMO" means a health maintenance organization registered
under Section 27 of this Law to ensure health care services
are adequately provided by health care providers approved by
the Agency;
"insured person" means any person and eligible dependant
who pays the required contribution under this Scheme;
"Local Government Chairman" means the political head of a
Local Government or Development Council Area.
"member of the Board" means any person,
Chairman who serves on the Board;

including

the

"MEA" means a mutual health association registered under

Section 27 of this Law to provide health care services
through health care providers approved by the Agency;
"NHIS"
ational Health Insurance Scheme accredited health
maintenance organizations;
"vulnerable" refers to the following categories of people,
pregnant women, children under 5, the aged, the disabled, the
poor and others falling with the group;
"wage" means remuneration in money paid to an employee
under his contract of service or apprenticeship, as the case
2

.i

..

may be; and whether agreed to be paid at fixed or determ ined

intervals of time.
Establishment
of the Lagos State
Contributory Health
Scheme Agency.

2.

(l)
There is established a body to be known as the Lagos State
.Contributory Health Agency (in this Law referred to as "the
Agency).
(2)

The Agency(a)

shall be a body corporate with perpetual succession

and a common seal;

(b)

may sue and be sued in its corporate name;

(c)

may acquire, hold or dispose of any moveable or

immoveable property for the purpose of its function
under this Law.

(3)
The principal object of the Agency shall be to
regulate, upervise and ensure the effective administration
Lagos tate Contributory Health Scheme.
Establishment of the
Lagos State Health
Scheme Agency
Governing Board.

3.

of

(1)
There is established the Lagos State Health Scheme Agency
Governing Board (in this Law referred to as "the Board") which
shall, 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 time

basis by the Governor on the recommendation of the
Corum issioner;

(b)

one representative

each of-

(i)

the Ministry of Health not below the rank of a

Director;

(ii)

Lagos State Primary Healthcare

below the rank of a Director;

(iii)

the Ministry of Economic

Planning
Budget not below the rank of a Director;

(iv)

the
Nigeria
Employers
Association Lagos State Branch;

Board

not

and

Consultative

..

(v)

the Nigerian Labour Congress Lagos State

Chapter
(vi)
the Health Maintenance Organizatios HMO
. (to be nominated by Health and Managed Care
Association of Nigeria HMCA
Lagos State
Branch)
the Health Care Provider Association of
igeria (to be
nominated by HCPAN Lagos State Branch) (c)
the Civil
Society (to be nominated by the LACSOP;
(d)

the General Manager of the Agency, who shall also

be the Secretary to the Board.

(3)
The Chairman so appointed shall be a person of integrity
with relevant qualifications and a minimum of 10 years experience.
(4)
The other members of the Board shall be persons of proven
integrity to be appointed by the Governor on the recommendation of
the Commissioner.
Components of the
Lagos State
Health Scheme.

4.

(1)
The Lagos tate Health Scheme shall com prise in itially
of three (3) components(a)

The Lagos State Free Health Plan (FHP)

Only point of access wi II be the Primary Health
Care Centers;

(b)

The Community Based Health Plan (CBHP)

This shall be the 'affordable'
Plan providing a
prescribed package of healthcare services at uniform
contributions
accessible
to all residents at the
grass roots and will be accessible from both Public
and Private Faci lities;

(c)

The Lagos State Private Health Plan (PHP)

This shall consist of a variety of Packages provid ing
healthcare
services in direct proportion to the
contribution; and

(d)

any other component as may be developed by the

Agency with the approval of the Board.

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

...

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

Objectives of the
Health Scheme.

5.

The objectives of the Agency are to(l)

ensure that every resident of Lagos State has good

access to health care services;

(2)

ensure that all residents of Lagos State have financial

protection, physical access to quality and affordable
health care services;

(3)

protect families from the financial hardship of huge

medical bills;

(4)

limit the rise in the cost of health care services;

(5)

ensure equitable distribution of health

across different income groups;

(6)

maintain high standard of health

services within the Health Scheme;

(7)

ensure efficiency ill health care service delivery;

(8)

improve and harness private sector participation in the

provision of health care services;

(9)

ensure adequate distribution of health facilities within

care costs

care

del ivery

the State;
(10)

ensure appropriate patronage at all levels of the health

care delivery system;

(11)

ensure the availability of alternate sources of funding

to the health sector for improved services;

(12)

in cases where res idents do not have available

medical services and other health services, to take
such measures as are necessary to plan, organize and
develop medical services and other health services
commensurate with the needs of the residents.

..

Tenure of Office.
of Members of the
Board.

(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.

6.

(2)
The members of the Board shall be paid such remunerations
and allowances as the State Government may, from time to time,
determine.
Cessation of
Membership of the
Agency.

7.

(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 offence

involving dishonesty; or

(f)

he is gu ilty of serious
duties.

111

iscond uct in relation to his

(2)
A member of the Board may be removed from office by the
Governor, if he is satisfied that it is not in the interest of the Agency
or the interest of the public that the member should continue in
office.
Resignation of a
Member of the
Board.

8.

A member of the Board may resign his appointment by notice, In

writing under his hand, addressed to the Governor and the
resignation shall take effect only on acknowledgement by the
Governor.

Vacancy in the.
Board.

9.

Where a vacancy occurs in the membership of the Board, it shall be

filled by the appointment of a successor to hold office for the
remainder of the term of office of his predecessor, so however, that
the successor shall represent the same interest.

Powers of the Board.

10.

The Board shall have the power to(a)

determ ine the organizational

(b)

approve for the Agency all prepaid and private health

maintenance organizations;

(c)

determine the overall policies of the Health Scheme,

including the financial and operative procedures of
tile Scheme;

structure of the Agency;

..

(d)

ensure the effective implementation

and procedures of the Scheme;

of the policies

(e)

regulate and supervise the Health Scheme established

under this Law;

(f)

establish standards, rules and guidelines for the

management of the Health Scheme under this Law;

(g)

approve, license, regulate and supervise

Health
Maintenance
Organizations
and other institutions
relating to the Health Plan as the Agency may from
time to time determine;

(h)

issue guidelines and approval for the administration

and release of funds under the Health Scheme;

(i)

approve other Health Plans as presented

forward to the Agency from time to time;

and put

approve the recommendation of the Agency relating

to research, cousultancy and training in respect of the
Scheme;
(k)

ensure the maintenance

Scheme matters;

of a State Data Bank on all

(I)

perform such other duties which, in the opinion of the

Agency, are necessary or exped ient for the discharge
of its functions under this Law; and

(m)

deterrn ine the remu neration

and allowances

of all

staff of the Board;

Functions of
the Agency.

11.

The Agency shall be responsible for(a)

ensuring the effective implementation

and procedures of the health scheme;

(b)

issuing appropriate regulations and guidel ines, as

approved by the board, to maintain the viability of the
health scheme;

(c)

the management of tile health scheme in accordance

with the provisions of this Law;

ofthe policies

...,

(d)

Registering
NHIS accredited
Health
Organizations,
HEFAMAA accredited
Providers and other relevant

Maintenance
Health Care

institutions

(e)

approving format of contracts proposed by the health

maintenance
organizations
for all health care
providers;

(f)

carrying out public awareness and education on the

establishment and management of the health scheme;

(g)

promoting
the development
of Mutual Health
Associations for wider participation in scheme;

(h)

determining, after due consideration, capitation, feefor service and other payment mechanisms due to
health care providers, by the Health Maintenance
Organizations in line with similar schemes;

(i)

advising the relevant bodie on inter-relationship

the 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
HMOs, CEl-Is and MHAs; .
(m)

of

from the

exchanging information and data with the National Health

Insurance
Scheme,
State
Health
Management
Information System, relevant Tinancial institutions
development
partners, NGOs; and other relevant
bodies;
(n)

ensuring manpower development

in the agency;

(0)

carrying out such other activities as are necessary or

expedient for the purpose of achieving the objectives
of the agency under this Law;

(p) receive and investigate complaints of impropriety leveled

against any H lO, HCP and other relevant institutions and
ensure appropriate sanctions are given.

Applicabilit
of
12.
NHIS Act to the Law.

The Provisions of the NHlS Act is applicable to the provisions of

this Law and all the Regulations made here under.

Prohibiting
13.
Healthcare Organization
From refusing coverage
Based on Patient's
Medical History.

An Healthcare organization shall not by reason of bad medical

history refuse coverage for any person.

14.
(l)There shall be appointed by the Governor, on the
Director-General
recommendation of the Commissioner, a General Manager Agency.
and other Staff of the
for the Agency.
(2)

The General Manager shall(a)

be a person of integrity with relevant qualification

and a minimum of f fteen (10) years cognate
experience in health care financing.

(b)

be the Chief Executive/Accounting

Officer
Agency and be responsible to the Board;

(c)

hold office-

of the

(i)

for a period of 4 years in the first instance and

may be re-appointed for a further term of 4
years only; and

(ii)

on such terms and conditions as may be

specified in the letter of appointment.

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

(4)

(a)

day-to-day administration

(b)

general direction and control of all other employees

of the Agency.

The Board shall-

of tile Agency;

---------------------

Secretary/ Legal
Adviser.

15.

Pensions.

16.

(a)

appoint, for the Agency, such number of directors and

other employees as may, in the opinion of the Board,
be required to assist the Board in the discharge of any
of its functions under this Law; and

(b)

pay to persons so appointed such remuneration

allowances as the Board may approve.

(1)
There shall be for the Board of the Agency,
Legal Adviser who shall-

and

a Secretary/

(a)

be appointed by the Board;

(b)

be responsible to the Director-General

(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, from

time to time, by the Board or the Director-General.

and the Board;

(1)
Employment in the Agency shall be approved service for
purposes of the Pension Law.
_ (2) Employees of the Agency shall be entitled to pensions and other
retirement benefits.
(3)
othing in subsections (1) and (2) of this Section or in this
Law shall prevent the appointment of a person to any office on terms
. which preclude the grant of pension in respect of that office.

Appointment of
Consultants for the
Agency.

17.

(1)
The Board shall appoint for the Agency, a licensed actuary
on such terms and conditions as the Board may, from time to time,
determ ine.
(2) The actuary shall review the services package and evaluate it
actuarially, including the rates of contributions payable for the
service and make appropriate recommendation to the Board.
(3)
If having regard to the review and evaluation carried out by
the actuary under subsection (2) of this Section, the Board considers
that the rates of contributions have not retained their value in relation
to the general level of earning in
igeria, the Board shall in
consultation
with the actuary modify the rates to the extent
considered appropriate and bring the new rates to the notice of the
persons affected by the modification.
10

""""':i

.1

(4)
The Board shall appoint for the Agency, Auditors, Pension
Consultants, etc. as it shall be determined from time to time.
Creation and
18.
Management of Lagos
State Contributory Health
Agency Fund.

(l)
There is created the Lagos State Health
Fund (LASHEF) (hereinafter referred to as 'the Fund ').
(2)

The fund shall consist of(a)

the initial takeoff grant from the Lagos State

Government;

(b)

annual subvention from the Stale Government and

contributions on behalf of retirees. disabled, indigent
or disadvantaged populations;

(c)

such money as may be due from Health Maintenauce

Organizations,
contributions
from CBI-ll enrollees
and variegated Private Health Plan enrollees;

(d)

Funds from THIS for pregnant women, children

under-five (5) years and any other relevant programs:

(e)

Funds as may be approved from the Lagos State

Primary Health Care Board (PF-ICB), from the
ational Primary Hcalthcare Development Agency
(NPHCDA) for the CBHS and FHS.

(f)

other

appropriations

state

and

local

implementation

Disbursement
Fund.

of the

19.

earmarked

governments

by the
purposely

national,
for

the

of the Scheme;

(g)

fees, fines and commissions

(h)

Donations
or
Grants-in-Aid
from
private
organizations,
philanthropists,
international
donor
organizations and iou-Goverumental
organizations
from time to time;

U)

dividends
and;

(j)

all other money which may, from time to time, accrue

to the Agency.

and interests

charged by the Agency;

on investments

and stocks

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

..
11

participating
the Agency.

HMOs, CBHI and MHA with the recommendation

of

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

for and in connection

Agency under this Bill.

(b)

to the cost of administration

(c)

to the payment of fees, allowances

members of the Board;

(d)

to the payment of salaries, allowances and benefits of

officers and employees of the Agency;

(e)

for the maintenance of any property vested

Agency or under its adm inistration; and

with the objectives

of the

of the Agency;
and benef.ts of

Il1

the

(3)
The Agency shall, invest any money not immediately
required by it in the Lagos State Government securities or in such
other securities as the Board may determine from time to time.
Power to accept
Gift.

20.

(1)
The Agency may accept gifts of land, money or other
property on such terms and conditions, if any, as may be specified by
the person or organization making the gift.
(2) The Agency shall not accept any gift if the conditions attached
by the person or organization offering the gi ft are inconsistent with
the objectives and functions of the Agency under this Law.

Annual estimate
Account and Audit.

21.

(1)
The Board shall cause to be prepared, not later than 30th
September in each year, an estimate of the expenditure and income
of 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 the
Agency and proper records in relation thereto and when certified by
the Board, the accounts shall be audited by auditors appointed by the
Board from the list and in accordance with the guidelines supplied
by the Auditor-General of the State.

12

..

(3)
Any employee, member or
without reasonable cause, to comply
under subsection (2) of this Section,
on conviction to penalties contained
Annual Report.

22.

Exemption from Tax. 23.

agent of the Agency who fails,

with a requirement of an auditor
commits an offence and is liable
in Schedule I of this Law.

The Board shall not later than six (6) months immediately
following the end of a year(a)

submit to the Governor through the Commissioner for

Health,
a report
on the activities
and the
administration of the Agency during the immediately
preceding year and shall include in the report the
audited accounts of the Agency and the auditor's
report on the accounts; and

(b)

present and publish the audited annual accounts,

auditor's report on the accounts and reports on the
activities
of the Agency
to Annual
Meeting
comprising
all Stakeholders
and on the State
Government Website.

(1)
The Agency shall be exempted from the payment of tax on
any income accruing from investment made by the Board for the
Agency or otherwise .
. (2)
The provisions of any enactment relating to the taxation of
companies or trust funds shall however not apply to the Agency or
the Board.

Payment of
Contribution
under the Scheme.

24.

(I)
The Lagos State Contributory
Heallh Scheme Fund
'(LASCOHAF) shall be administered through carefully selected and
approved banks as advised by the Accountant-General of the State,
for the pooling of all contributions derived from either the public or
private sector (formal or informal) into dedicated accounts.
(2)
The Agency shall cause the pooling of contributions derived
from 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 donors
shall be paid directly to LASCOl-lAF through approved banks into
ded icaied accounts.
(4)
The Agcncy shall cause I:lMOs to establish accounts with the
Lagos State Contributory
Health Scheme Fund (LASCOHAF)
approved Banks for the agreed remittable percentage of the
13

...

premiums received for the private health

Based Health Plan all under this Law.

plans and Community

(5) The Agency shall cause HMOs to produce, in a recognized

format and subject to guidelines to be issued by it from time to time,
performance/security
bond from accredited banks or insurance
companies so as to protect contributions collected.
(6)) The Agency on the advice of the actuary shall prescribe, from
time to time, what percentages
of contributions
collected by
HMOS, CBHI and MHAs shall be for provider reimbursement,
administration, remittance to the Agency
Registration:
25.
Lagos State Residents,
Employers and
Employees.

(1)
Subject to such guidelines and regulations as may be made
under this Law, all residents shall be registered under the Scheme
either through their registered HMOs, CBf-Ils or MHAs or on an
individual basis. The LASRRA registration number shall be a prerequisite for registration and shall itself grant eligibility to access any
and all benefits avai lab le under the scheme.
(2)
All employers (public and private) shall register with the
Agency and obtain a Corporate Identification
Number CIN.
Thereafter employers shall register their employees with I-IMOs of
their choice.

Registration and
services of health care
providers
26.
(1)
The registration of I-lEfA lAA accredited
health
care providers under.the Health Scheme shall be in accordance with
guidelines as may be issued by the Agency, from lime to time, under
this Law.
(2)
A health care provider so registered in subsection (1) shall, ill
consideration for an approved capitation payment or fee for service,
to [he extent and manner prescribed herein, provide services in
accordance with-

Registration of
27.
Maintenance
Organizations, CBHI
and Mutual Health
Association.

(a)

the approved Benefit Package as shall be actuarially

determined from time to time by the Board; and

(b)

Treatment Guideline.

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

14

..

(2)
This Law recognizes the existence of prepaid health
insurance organ izations before the commencement
of the Lagos
State Health Scheme ..Such organizations operating in the State shall
be licensed and monitored by the Agency. However, all Community
Based Health Plans must mandatorily be run in the manner as
stipulated by the Agency for uniformity and to the economic benefit
of community members.
(3)
The registration of an organization under the Agency shall be
in such form and manner as may be determined, from time to time,
by the Board, using guidelines which shall include provisions
requiring the organization to(a)

be financially viable before and after registration;

(b)

have a healthy track

private providers;

(c)

make a complete disclosure

of the ownership
structure and composition of the organization;

(d)

have account(s) with one or more banks approved by

the Agency;

(e)

comply with relevant insurance requirements through

insurance companies accredited by the Agency;

(f)

give an undertaking
that the organization
shall
manage and invest the funds aCCl"LI
ing to it from
contributions
received pursuant to this Law in
accordance with the guidelines to be issued, from
time to time, by the Agency.

record

of relationship

with

(4)
The Agency shall reserve the right to allocate HMOs to cover
designated divisions of the State under State sponsored coverage.
(5)
Registration of an HMO shall be time bound as may be
determined from time to time by the Agency, after which the HMO
shall present itself for registration renewal.
Refusal of Licence.

28.

(1)
The Agency may refuse to issue a licence to any applicant
pursuant to an application made uncler Section 24 of this Bill if it is
satisfied that(a)

the information contained in the application

licence is false in any material particular; or
15

for a

...

(b)

the application does not meet the requirements

prescribed by the Agency for grant of a licence;

(2)
Where the Agency refuses to register any organization, it
shall forthwith notify the applicant in the prescribed form, specifying
the reasons for such refusal. However, such an organization may
reapply at a time it has fulfilled all the necessary conditions for
registration.
29.

Revocation of
Licence.

(1)
if-

The Agency may revoke a license issued to an organization,

(a)

it discovers after the grant of license that a statement

was made in connection with the application thereof
which the applicant knew to be false in any material
particular;

(b)

IS
subject to any insolvency
the organization
proceedings or is to be wound up or otherwise
dissolved;

(c)

the conduct of affairs of the organization does not

conform with the provisions of this Bill or any
regulations made pursuant to or any directive issued
under this Bill;

(d)

any event occurs which renders

ineligible to perform its duties; and

(e)

the organization
to its licence.

the organization

is in breach of any condition attached

(2)
The Agency shall, before revoking the licence of an
organization give the organization at least 90 days notice of its
intention and shall consider any representations made to it in writing
by the organization within that period before the revocation.
Functions of HMOs
CBHls and

fHAs.

30.
(1)
An organization
referred
Section 21 of
this Law shall have responsibility for-

to in subsection

(a)

registration of eligible employers and employees

under this Law;

(b)

collection of contribution

16

(1) of

from voluntary contributors

..

(c)

under subsection (4) of Section 17 of this Law and

shall rem it 1% of collection to LASCOHAF;
subsequently register's shall be renewed fr0111time to
time; .

(d)

the payment of capitation fee for service or other

recognized methods of payment for services rendered
by health care providers registered under the Scheme;

(e)

rendering to the Agency returns on its activities as

may be required by the Board;

(f)

contracting
only with the hea Ith care prov iders
approved under the Scheme for the purpose of
rendering health care services as provided by this
Law;

(g)

ensuring that contributions are kept in accordance

with guidelines issued by the Board;

(b)

establishing a quality assurance system.

(2)
An Association referred to in subsection (I) of Section 25 of
this Law shall have responsibility
for the functions stated in
subsection (1) of this Section though with focus on the informal
sector.
(3)
otwithstanding
anything contained in this Law, Health
Maintenance Organizations, CBHls and MHA shall not be involved
in the direct delivery of health care services or collection of funds
except in private or voluntary Health Plans and shall make
appropriate returns to the fund.
Participation of
31.
Local Governments
Appointment of Focal
Persons.

(1)
A Local Government Chairman may in consultation with
the Primary Healthcare Board respectively appoint focal persons
who shall be senior serving officers in the services of the Local
Government Departments of Health to coordinate and collaborate
with the Agency.

Establishment and
36.
Functions of the Lagos
State Contributory Health
Scheme Agency
Arbitration Panel.

(1)
Whenever there is a dispute amongst parties under this Law,
it shall first be referred to Arbitration, Mediation or Conciliation
before resorting to litigation.
(2)
The parties shall by mutual consent appoint a 3-l11an panel of
arbitrators (herein after referred to as "the Panel").

17

(3)
The membership
of the panel and the applicable Arbitral
procedure shall be as provided for in the Arbitration and Conciliation
Law, Laws of Lagos . t.ate.
Prosecution
o ffel{der.

of

Jurisdiction.

37.

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

38.

The State High Court shall have(a)

jurisdiction

(b)

power, notwithstanding
anything to the contrary in
any other enactment, to impose the penalties provided
for the offence in this Law.

Court to Order
39.
Payment of Contribution.

to try offenders

under this Law; and

(1)
The High Court before which a person is convicted of all
offence under this Law may, without prejudice to any civil remedy,
order a person to pay to the fund of the Scheme the amount of any
contributions
together with interest and penalty thereon, certified by
the Agency to be due and payable at the date of the conviction and
such 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 under
subsection (1) of thi s Section shall be rem itted to the organ ization
entitled to receive the contribution.

Commencement
Proceedings.

of

40.

Limitations of Suits
41.
Against the Agency etc.

Proceedings for an offence under this Law may be commenced

any time after the commission of the offence.

at

(1)
Subject to the provisions of this Law, the provisions of the
Public Officers Protection Act shall apply in relation to any suit
instituted 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, the
Director-General
or any other officer or employee of the Agency for
anything done in pursuance or execution of this Law or any other
enactment or law, or of any public duty or authority or in respect of
any alleged neglect or default in the execution of this Law or such
enactment or law, duty or authority, shall lie or be instituted in any
court unless it is commenced(a)

within three months

complained of; or

18

after the act, neglect

or default

..

(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 member
of the Board, the Director-General,
officer or employee of the
Agency before the expiration of a period of one month after written
notice of intention to commence the suit shall have been served upon
the Agency by the intending plaintiff or his agent(s).
(4)
The notice referred to in subsection (3) of this Section shall
clearly and explicitly state the cause of action, the particulars of the
claims, the name and place of abode of the intended plaintiff and the
relief which he claims.

Service of
Document.

42.

Restriction on
43.
Execution against
Property of the Agency.

A notice, summons or other document requ ired or authorized to be

served on the Agency under the provisions of this Law or any other
enactment of law may be served by delivering it to the DirectorGeneral or by sending it by registered post and addressed to the
Director-General at the principal office of the Agency.
(1)
In any action or suit against the Agency, no execution or
attachment of process in the nature thereof shall be issued against
the Agency not less than three (3) months unless notice of intention
to execute or attach has been given to the Agency.
(2)
Any sum of
be awarded against
by the court where
given, be paid from

Indemnity of
Officers.

44. .

Confidentiality and
Non-disclosure.

4:5.

moneys which may by the judgment of any court

the Agency shall, subject to any directions given
notice of appeal of the said judgment has been
the general reserve fund 0 f the Agency.

Any officer or employee of the Agency acting in the course of lawful

duty shall be indemnified out of the assets of tile Agency, against
any liability incurred by him in defending any civil proceeding.
(1)
A member of the Board, the Director-General, officer or
other employee of the Agency shall(a)

not make use of any information which has come to

his knowledge in the exercise of his powers or is
obtained by him in the ordinary course of his duty for
his personal gain or otherwise under this Law;

(b)

treat as confidential any information which has come

obtained by him in the performance of his functions
under this Law;

(c)

not disclose any information referred to under

19

paragraph (b) of this subsection except when required

to do so by an Arbitration or similar panel of the court
or in sLich other circumstances
as may be prescribed
by 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 to
penalties contained in Schedule 3 of this Law.
Contribution
Inalienable.

to be

46.

(1)
Contributions
payable under the Agency shall be inalienable
and shall not be assets for the benefit of creditors in the event of the
bankruptcy 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 this
Law shall form part of tax deductible expenses in the computation of
tax payable by an employer or, as the case may be, by an employee,
under any other relevant law applicable to income tax.

Transfer of liability
47.
of contribute in the case
of mergers
acquisitions, etc.

Where, under Section 591 of the Companies and Allied Matters Act
1990, an order is made by a court under subsection (3) of that section
which include the trans fer to the com pany of the who Ie or any part of
the undertaking and of the property and liabilities of a transferor
company, the order shall include provisions for the taking over, as
from such date as may be specified in the order, of any liability for
any contribution which has become due and payable under this Law
(together
with any accrued interest thereon)
in respect of the
employees
concerned
in the undertaking,
property
or liability
tran s ferred.

Exclusion from
application of Cap
449 LFN.

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

48.,

Collaboration with
49.
the Federal Government

Professional
Indemnity for
health care providers.

SO.

The Lagos State Government shall collaborate with relevant

agencies of Federal Government in the realization of the set
objective of this Law.
A health care provider (institution and individual) shall be required
to take professional indemnity cover from a list of insurance
companies approved by the Board.

'.'

20

S1.

Powers to make
Regulations
and
issue guidelines.

(I)

The Agency

shall make regulations

and issue guidelines

for-

(a)

the registration
of employers
contribute under this Law.

and employees

(b)

the registration
by the Agency;

of employees

Cc)

the compulsory
payment of contributions
by
employers
and
employees,
the rates
of those
contributions
and the deduction
by the employers
of
contributions
payable by employees
under this Bill
from any salary, wage or other money payable;

(d)

the voluntary payment of contributions

employed
and other
persons
and
contributions;

of dependants

liable to

covered

by selfrates of

such

(e)

the maintenance
of the records to be kept for the
Agenc
and the records to be kept by employers
in
respect of contributions
payable under this Law and
in respect of their employees;

(f)

the methods
Law;

(g)

the imposition
of surcharges
in respect
of late
payment of contributions
by employers or employees;

(i)

the manner and circumstances

may be remitted and refunded;

(j)

negotiated
fees and
dental, pharmaceutical
under the scheme;

(k)

the nature and amount

of benefits
to be provided
under this Scheme, the circumstances
and the manner
in which the benefits shall be provided;

(I)

the nature and amount

of capitation
and fee for
service
payment
under
this
Scheme,
the
circumstances
and the manner in which health care
providers

...
21

of receiving

shalt receive

contributions

in which

under

this

contributions

charges
payable
for medical,
and all other services provided

the payment;

(m)

the reduction, suspension

payment under this Scheme;

or withdrawal

(n)

the submission of returns by employers regarding the

employers and their employees;

(0)

the procedure for .assessment

under this Scheme;

(a)

Any other matter whatsoever for which, ill the

opinion of the Agency, is necessary or desirable to
make regulation and issue guidelines for giving effect
to this Law.

of contributions

of any

made

(2)
The guidelines issued under subsection (I) (c) of this Section
may provide for different levels of contributions to be payable by
different classe of persons.
(3)
The guidelines
issued under this section need
published ill the Gazette but they are published as a Manual.

not

be

Power to Enter,
Inspect and Audit.

52.

The Agency through her appointed Officers may enter, inspect

and audit any premises, books, accounts and records of any
Hospital, Ht,/\O or HMA that has received payments under this Law
at any time and may require the hospital 01 facility to verify in a
manner prescribed, any information submitted to the Agency.

Withholding
Payments.

53.

Where an hospital or health facility fail to keep the books,

records and returns required under this Law 01' any Regulations
made there under the Agency may withhold payments due to it until
the hospital complies with the provisions of this Law and the
Regulations made here under.

Offences and
Penalties.

5-1-.

,..

(1)
Any person who produces to an admitting official ofa
hospital or a ledical Practitioner or a member of his staff or to a
person authorized by Law to provide other health services or a
member of his staff: a registration certificate(a)

knowing that the person named therein is not at

the time of the production thereof, not covered under
the Law;

(b)

knowing that the person on behalf of whom and to

facilitate whose treatment it is produced is not the
person named therein or a dependant of that person;
22

..

commits an offence and shall on conviction pay a fine

of fifty thousand naira (NSO,OOO.OO)
in addition to tile
bills incurred."

? ,

(2)
Any member or agent of the Agency who fails, without
reasonable cause ..to comply with a requirement ofan auditor under
subsection (2) of Section 13 of this Law, commits an offence and is
liable on conviction to a fine not exceeding ~'IOO,OOO or
imprisonment
for a term not exceeding three months or to both such
fine and imprisonment.
(3)
A person guilty of an offence under subsection
24 ofthis Law is liable on conviction-

(I) of Section

(a)
in the case of a first offence, to a fine of not less than
One
I-Iunclrecl
Thousand
Naira
(l'..--f100,000.00)
01'
imprisonment
for a term not exceeding two years or to both
suchfine and imprisonment;
and
(b)
in the case of a second or subsequent
offence, to a
fine of not less than Two Hundred and Fifty Thousand Naira
(W2S0,000.00) or imprisonment
for a term not exceeding five
years or less than two years or to both such fine and
im 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 on
conviction to a fine of not less than Fifty Thousand Naira
(WSO,OOO.OO) or imprisonment
for a term not exceeding two years or
to both such fine and imprisonment.
Offences by Bodies
Corporate, etc.

55.

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

"vas an officer of the body corporate,

association; or

(b)

was pmpOl'ting to act in the

the body corporate,
firm
deemed to have committed
be prosecuted
and punished
manner as if he had himself
unless he proves that the

23

firm or other

capacity of an officer or
or other association,
is
the offence and liable to
for the offence in like
committed the offence,
commission
or omission

..

constituting
knowledge,

(2)

Citation and
Commencement.

56.

the offence
took
consent or connivance.

place

without

his

ln this section, "officer" includes(a)

in the case of Ministries, Departments

(MDAs) the accounting
officer;

(b)

in the case of a body corporate, a Director, Chief

Executive
by whatever
name called, Manager
Secretary 0 f the body corporate;

(c)

in the case of a firm, a partner,

of tile firm; and

(d)

in the case of any other association

person involved in the management
the association.

and Agencies

manager

and

and secretary

of individuals,
of the affairs

a
of

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

24

.1

...

UPPLEME
1.

Quorum

TARY PROCEEDI

RELATING

TO THE BOARD

(1)
ubject io this Law and ection 27 of tile Interpretation
Act,
the Agency may make-standing
orders regulating its proceedings and
those of any ofits committees.
(2)
The quorum of the Board shall be the Chairman
member presiding at the meeting and live (5) other members
quorum of any Committee of the Board shall be determined
Board.

Meetings
Board.

of the

2.

or the
and the
by the

(1)
The Board shall meet not less than three (3) times in each
year and subject thereto, the Board shall meet whenever it is
summoned by the Chairman and if the Chairman is required to do so
by notice given to him by not less than seven other members, he
shall summon a meeting of the Board to be held within fourteen clays
from the date on which the notice is given.
(2)
At any meeting of the Board, (he Chairman
if he is absent, (he members present at the meeting
of their numbers to preside at the meeting.

shall preside but

shall appoint one

Power to Co-opt.

3.

Where the Board desires to obtain the advice of any person on a

particular matter, the Board may co-opt him to the Board for such
period as it thinks fit; but a person who is in attendan e by virtue of
this sub-paragraph
shall not be entitled to vote at any meeting of: the
Board and shall not count towards a quorum.

Committees.

4.

(1)
The Board may constitute onc 01" more committees to carry
out, on behalf of the Board such of its functions as it may determine.
(2)
A committee appointed under this Paragraph shall consist of
such number of persons (not necessarily
members of the Board as
may be determined by the Board) and a person other than a member
of (he Board shall hold office on the Committee in accordance with
the terms of his appointment.

M iscellaneo

LIS.

5.

(1)
The fixing of the seal of the Ag IlCY shall be authenticated by
the signature of the Chairman, th ~ Director-General
or of any other
person authorized generally or specifically to act tor that purpose by
the Board.
(2)
Any contract or instrument, which, if made or executed by a
person not being a body corporate, would not be required to be under
seal may be made or executed all behalf of the Board by the

25

...

Chairman
or any person
purpose by the Board.

generally

or specially

authorized

to for the

(3)
Any documentpurporting
to be a document
duly executed
under the seal of the Agency shall be received ill evidence and shall,
unless
and until the contrary
is proved,
be presumed
to be so
executed.
(4)
The validity
of any proceeding
of the Board 01' or a
committee
thereof shall not be adversely affected by any vacancy in
the membership
of the Board or C0l11m ittcc, or by reason that a
person not entitled to cia so took part in the proceedings
of the Board
or committee .

..

'

26