Why Beneficiaries In Rural Hospitals Won’t Access NHIF Cards

National Health Insurance Fund, NHIF, beneficiaries in rural parts of the Country will be required to pay cash to access hospital services effective Wednesday, May 30, the Rural Private Hospital Association of Kenya (RUPHA) has said.

The Rural Private Hospitals Association of Kenya (Rupha) says the NHIF Board has not remitted a single coin to the healthcare facilities in the April-June 2023 quarter making them unable to pay salaries as well as some layoffs.

RUPHA, in a statement, noted that the national insurer had breached the terms of the agreement by failing to make the required payments for the April-June 2023 quarter

“As a result of the board’s failure to honor its financial commitments, the health facilities under the Rupha are left with no other recourse but to issue an immediate notice that beneficiaries of the NHIF Capitated Schemes will be required to make cash payments to access services, effective from May 31, 2023,” said Rupha chairman Brian Lishenga in a letter to NHIF chairman Michael Kamau.

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Additionally, Lishenga noted that no money had been remitted to RUPHA despite numerous letters of assurance from the NHIF board.

In a recent post on Twitter, the association gave notice to NHIF outpatient beneficiaries to start making cash payments for health services.

The association with over 350 hospitals decried late payment from the scheme for the April-July 2023 quarter. Rupha chairman Brian Lishenga argued that the delays in remittances have stalled operations in the hospitals, leading to delayed salaries and layoffs.

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“Please be advised that all your capitation beneficiaries, those in the villages and small towns who pay Sh.500 faithfully every month have depleted their credit limits with hospitals. Hospitals have offered them “credit services” for 60 days now since 31st March,” said RUPHA.

Under the outlined agreements, the board is supposed to pay to the health facility a capitation amount of Sh1000 for a beneficiary per year within the first thirty days of the capitation period.

In April 2023, NHIF revealed that the claims payment process is continuous for the Fund, with claims being received and continuously being paid out by the scheme.

The Fund also said that it is mandated to receive all contributions and other payments to buy essential healthcare benefits for its members. NHIF paid 49 billion shillings to over 4.5 million claims, saying that it continuously makes payments to declared hospitals to facilitate access to quality healthcare.

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