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Government and Policy

We Will Not Offer NHIF Services, Private Hospitals Declare

BY Lynnet Okumu · January 28, 2022 01:01 pm

KEY POINTS

In a previous structure, NHIF would pay Ksh.9,500 for each dialysis session. Dialysis patients require at least two sessions a week. In the new review, NHIF says it would charge Ksh.6,500 per session,”

KEY TAKEAWAYS

Earlier this week, Health CS Mutahi Kagwe complained NHIF had been paying too much to private hospitals, attributing it to medical fraud, including impersonation of beneficiaries.

Private hospitals will not offer services to some members of the National Health Insurance Fund beginning Monday 31st, 2022.

This is according to the Kenya Association of Private Hospitals (KAPH) which said an agreement reached between them and NHIF has come to an end and no renewal talks have been initiated.

KAPH Secretary-General Timothy Olweny said they decided to boycott NHIF due to new terms of engagement that do not favor their course.

“Come Monday, January 31, which marks the end of our seven-month extension of the contract with NHIF, we, the private hospitals, won’t be in a position to offer services to patients depending on NHIF,” Mr. Olweny said.

According to KAPH chairman Dr. Abdi Mohamed, NHIF has failed to honor talks with the facilities and they cannot accept the heavily reduced rates that the fund has imposed on them.

“There has been no stakeholder engagement on the proposed rates. So, unfortunately, we cannot give services under those rates,” said Abdi.

KAPH boss said that the renewal of terms which happens every three years, saw costs of services such as dialysis and surgical services significantly slashed to about 50 percent.

“In a previous structure, NHIF would pay Ksh.9,500 for each dialysis session. Dialysis patients require at least two sessions a week. In the new review, NHIF says it would charge 6,500 shillings per session,” he said.

Stating his dissatisfaction, he further said that NHIF remits only a maximum of 32,000 shillings to private hospitals for the service. He insisted that this is way below the amount of money that the Kenya Medical Practitioners and Dentists Council recommends.

Moreover, Mr. Olweny said that private hospitals would lose at least.6,000 shillings per patient per week if the insurer was to stick to the new rates.

Earlier this week, Health CS Mutahi Kagwe complained NHIF had been paying too much to private hospitals, attributing it to medical fraud, including impersonation of beneficiaries.

He noted that claims by contracted facilities jumped from 19.7 billion shilling in the financial year 2015/2016 to 54.6 billion shillings in the financial year 2020/2021.

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