Health Cabinet Secretary Dr Cleophas Mailu has suspended with immediate effect the decision by the National Health Insurance Fund (NHIF) to limit outpatient visits to only four per year.
In a press statement sent on Saturday morning, Mailu stated that patients should continue enjoying NHIF services without limits.
“The Cabinet Secretary for Health Dr Cleophas Mailu has suspended with immediate effect the decision by NHIF to limit the outpatient visits to only four per year until further notice. This is until further consultations are held between NHIF board and other stakeholders. Meanwhile, patients should continue to enjoy the services as it has been the case before,” the statement read in part.
The National Hospital fund (NHIF) had released new guidelines that significantly reduced contributors’ benefits for outpatient treatment at authorised clinics.
The contributors were only entitled to four outpatient visits per year, the NHIF stated, leaving them to the pain of out-of-pocket spending whenever they fall sick.
[caption caption="NHIF Chief Executive Geoffrey Mwangi"]
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Civil servants and those in managed schemes whose employers make additional monthly contributions to the scheme were, however, spared the cut and continued to enjoy unlimited outpatient services of at least Sh100,000.
Under the new rules, once a family (under the national scheme) exceeds the maximum visits per card a year (four), they would be forced to pay for all outpatient services in cash.
This meant that the larger the family, the fewer services would be available for each member of the family.
“This is one way of dealing with fraud since a member would have control over the number of visits, which are fixed-for-service, meaning NHIF would only pay a facility the actual cost incurred and not the initial Sh1,500 cap for all facilities per year,” NHIF Chief Executive Geoffrey Mwangi argued.
[caption caption="Kenyan nurses during their recently concluded strike"]
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NHIF had on Wednesday stated that it will no longer require patients to pre-select health facilities for outpatient services, in a move that could ensure all those covered by the agency get timely medical help.
