400 Hospitals To Reject Patients With NHIF Cards As Doctors Strike Looms
The move by RUPHA comes amid uncertainty over the phase-out of the long-standing NHIF and replacing it with the Social Health Insurance Fund (SHIF).
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At least 400 private hospitals in the rural parts of Kenya will from Sunday, March 17 reject National Health Insurance Fund (NHIF) cards and instead compel patients to pay in cash in response to an outstanding Ksh6.1 billion debt owed by the private insurer.
According to the Rural Private Hospitals Association of Kenya (RUPHA), NHIF owes them Ksh2.3 billion for general claims, Ksh2 billion for the Linda Mama programme and Ksh1.8 billion for outpatient claims.
The association accused NHIF of not remitting money to the concerned healthcare facilities, a delay that lasted until March when a sum of Ksh56 million was released to hospitals that had pending capitation for the January to March quarter.
Rural Private Hospitals Association of Kenya national chairperson Dr Brian Lishenga speaks to the media on April 22, 2023. /THE STAR
“Given the foregoing, we have resolved that, instead of continuing to accumulate debts, which we are uncertain will be settled, we transition to a cash-based system and allow the transition to complete then we can resume under new terms,” RUPHA chairman Brian Lishenga announced.
He added that RUPHA's members had decided to opt out of NHIF until the transition to the Social Health Authority (SHA) is completed, a move which will force patients to pay for healthcare services in cash, putting the Universal Health Coverage (UHC) initiative in jeopardy.
Dr Lishega added that there has been no commitment from either the NHIF or the Ministry of Health to pay the debts.
“These bills have been forwarded to the Pending Bills Verification Committee that is headed by the former auditor-general [Edward Ouko].
"Statutory remittances and self-employed contributions to NHIF have been falling since 2022. NHIF collects less every month than it used to do one year ago,” he noted.
RUPHA also raised concern over what it termed as biases whenever any money is available, claiming that NHIF prioritises payments to levels five and six hospitals first, an approach it opposes.
The move by RUPHA comes amid uncertainty over the phase-out of the long-standing NHIF and replacing it with the Social Health Insurance Fund (SHIF).
Health Cabinet Secretary Susan Nakhumicha had earlier announced that SHIF deductions would start in March, but then changed this to July before reverting to March, confusing the public even more.
The CS further stated that, despite the deductions beginning soon, Kenyans will access services in July.
Meanwhile, the association's notice comes just hours before the countrywide doctors' strike beginning tomorrow, Wednesday, March 13 which could further paralyze health services in the country.
The Kenya Medical Practitioners Pharmacists and Dentists Union (KMPDU) affirmed its decision to initiate the strike, citing unresolved grievances and the absence of constructive dialogue with the government.
The core demands of the medics revolve around the hiring of intern medics and the allocation of resources towards the health sector.
KMPDU has set forth a demand for the government to allocate at least 15 per cent of the annual budget to health, a target yet to be met.
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