Private Hospitals Resolve to Reject All NHIF Patients

A photo showing National the Hospital Insurance Fund (NHIF) headquarters in Nairobi.
National Hospital Insurance Fund (NHIF) headquarters in Nairobi.
Photo
NHIF

Private hospitals will deny services to National Hospital Insurance Fund (NHIF) patients starting Monday, January 31. 

Speaking to Kenyans.co.ke, Joseph Otieno, Head of Communications from the Kenya Association of Private Hospitals (KAPH), noted that the insurer pays little in claims as compared to public facilities. 

 "Yes, they (NHIF) at times don't even end up paying (in claims). We are compiling a number of complaints from our facilities before releasing an official report," he stated. 

Patients queue in order to access medical services.
Patients queue in order to access medical services.
courtesy

In a statement seen by Kenyans.co.ke, the association pointed out that they had received notable complaints from a number of facilities over the non-payment claims. 

"Due to the long-standing relation with NHIF we have had our members plea of claims of non-payments to our facilities. The health professional bodies had faulted the engagement done in the process of developing the contracts saying the benefit packages are aimed at lowering the quality of health services in the country."

"There was no stakeholders involvement process in the development of the benefit packages as envisaged in the constitution. We thus propose that the proposed NHIF service provider contract be put on hold until proper stakeholder is held on mutually agreed contract,” read part of the statement. 

The private hospitals sector has been at loggerheads with the insurer over a number of issues.

Recently, more than 800 private hospitals had sued NHIF over the newly introduced biometric registration- with the hospitals claiming that they were given a limited time to comply with the new changes- which further affected patients access to the service.

Among the complaints from the private hospitals is that the biometric system is not recognised by the NHIF Act. 

"The memorandum/ directions despite having a significant economic burden on the petitioners were not formulated through public participation of the petitioners nor did the NHIF come up with regulatory impact assessment in line with section 6 of statutory Instruments Act, there making the memorandum/ directions illegal, null and void," read part of the petition. 

NHIF had recently announced a one-month contract extension for all health care providers to give them more time to review the new contracts. 

"In light of this and based on numerous requests from health care providers to be accorded more time to review the new contracts, the Fund has resolved to extend your contract for a period of one month effective January 1, 2022 to January 31, 2022," Kamunyo previously stated. 

The associations, inclusive of Kenya Medical Association (KMA), Kenya Medical Pharmaceutical and Dentist Union (KMPDU) and Rural Private Hospital Association of Kenya (RUPHA) had declined to sign the contracts- terming the benefits package as a way of lowering the quality of health services. 

National Hospital Insurance Fund CEO Peter Kamunyo Gathege attends a past meeting.
National Hospital Insurance Fund CEO Peter Kamunyo Gathege attends a past meeting.
Daily Nation
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