The government has moved to quell concerns over the fate of outstanding claims owed to health facilities as it prepares to transition to the Social Health Insurance Fund (SHIF) while clarifying that Kenyans should continue to pay for the National Health Insurance Fund (NHIF) until the full transition to SHIF.
Health Cabinet Secretary Susan Nakhumincha, speaking to the Senate on Wednesday, April 17, amidst mounting pressure, outlined the government's plan, which includes the formation of a transition committee tasked with reviewing all claims. This committee will ensure that healthcare providers are compensated as the nation pivots to the new health coverage framework set to launch on July 1.
CS Nakhumincha stressed to the senators that there was no cause for alarm despite revealing a staggering debt of Ksh30 billion owed by the NHIF, with Ksh22 billion of this being attributed to government institutions. She assured that "service providers will be paid once claims are verified and reconciled and the resources are available."
However, in a significant announcement, CS Nakhumincha declared the imminent release of Ksh8.5 billion to begin settling these debts, with Ksh5.5 billion sourced from the Treasury and an additional Ksh3 billion drawn from NHIF reserves. These funds are expected to be disbursed by next week.
Despite some health institutions turning away NHIF cardholders due to unpaid claims, the Cabinet Secretary urged all Kenyans to continue their NHIF contributions during the transitional phase to SHIF.
While directing medical facilities to continue serving Kenyans, CS Nakhumincha stated, "Kenyans should not notice that there has been a change from NHIF to Social Health Insurance Fund (SHIF)."
Under the new system, Kenyans will not be required to select preferred medical facilities as previously mandated by NHIF.
According to the Health CS, the integration of all health facilities into SHIF will enable citizens to access medical services at any health facility nationwide, streamlining service delivery.
The urgency of resolving these financial discrepancies was spotlighted last week when the Kenya Conference of Catholic Bishops (KCCB) highlighted that outstanding NHIF claims amounting to Ksh2 billion had severely impacted operations across their network of facilities.
Bishop Anthony Muheria, Vice Chair of KCCB, conveyed the dire situation in a press address, stating, "Faith-based hospitals are owed huge amounts by NHIF, amounting to over Ksh2 billion. The effect is that most of our hospitals are crippled, and not able to operate optimally.”
The financial strain has reached a tipping point with an estimated 400 private hospitals, predominantly in rural areas, rejecting NHIF cards. These facilities are demanding immediate cash payments from patients due to an outstanding debt of Ksh6.1 billion owed by NHIF.
The transition committee is expected to play a pivotal role in this process, ensuring that all legitimate claims are honoured and that the transition to SHIF is seamless.
The shift to SHIF is anticipated to provide a more equitable and efficient healthcare system, crucial for improving health outcomes across the country.
