Kenyans can breathe a sigh of relief — for five months —after private hospitals agreed to continue offering services to NHIF members while contract talks continue.
The decision followed consultations between the Health ministry, NHIF and stakeholders in the sector. They agreed that services and reimbursements will continue as before while talks go on.
The old contracts will remain in effect for the next five months, with the new contracts, which had sparked controversy, expected to be signed in March but take effect in July.
But this is only a reprieve. Premiums could go up, services covered could be reduced, the amount of payment to hospitals for services could be reduced.
NHIF had given healthcare providers until end of Monday to sign the contracts, a move that made private hospitals threaten to turn away patients covered only by the national insurer.
“We have been able to engage and ensure Kenyans access services. There shall be no haltof services by the private sector and we shall continue to work together hand in hand, collaborating towards ensuring you are able to access services,” Health CAS Dr Mercy Mwangangi said.
“Today we have had deliberations that are nested on ensuring service continuity continues and, more importantly, that as we work together as partners we ensure that services are affordable for the Kenyan,” she added.
Last week, the private hospitals had said they cannot accept the greatly reduced rates the fund has imposed on them.
Kenya Association of Private Hospitals chairman Dr Abdi Mohamed told the Star NHIF has failed to honour talks with the facilities.
“We wouldn't want NHIF to collapse so what we need is a balance that is acceptable on both ends,” Mohammed said on Monday.
“We will negotiate to push the UHC agenda and at the same time ensure that services remain sustainable,” Geoffrey Mwale from the faith-based organisations said.
The rates were to take effect in December last year, but in a letter dated December 30, NHIF said it had put them on hold to give healthcare providers more time to review their contracts before signing.
“We decided based on numerous requests by healthcare providers to be accorded more time to review the contracts," NHIF chief executive officer Peter Kamunyo said.
Earlier this week, Health CS Mutahi Kagwe complained NHIF had been paying too much to private hospitals, attributing it to medical fraud, including impersonation of beneficiaries.
Claims by contracted facilities jumped from Sh19.7 billion in the financial year 2015-16 to Sh54.6 billion in the financial year 2020-21, Kagwe said.
The NHIF Amendment Bill 2021, which MPs passed on December 21 and is now awaiting President Uhuru Kenyatta’s assent, allows the fund to review rates paid to contracted facilities once every two years.
“It was proposed that we extend the deadline of today and we are pushing it up to the end of March. We have created work teams that will engage with each other so we can come to a good agreement and understanding,” NHIF board chair Lewis Nguyai said.
He added, “The contracts between NHIF and all service providers will be signed after March 31. For implementation we will start the new contracts with the new benefits on the first of July in line with the calendar year for the government.”
(Edited by V. Graham)
