• Senators have accused the public health insurer of starving public facilities of funds, crippling their operations but quick to pay private facilities.
• Mandera Senator Ali Roba accused NHIF of not expeditiously reimbursing government hospitals at the same speed they do for private ones.
Image: NHIF
The management of NHIF is on the spot over delays by the insurer to pay claims made by public health facilities.
Senators have accused the public health insurer of starving public facilities of funds, crippling their operations but quick to pay private facilities.
“There has been a trend that has been set by NHIF where public hospitals are not reimbursed regularly. The delay can take as long as six months,” Uasin Gishu Senator Jackson Mandago said.
Mandago, the chairman of the Senate health committee, said hospitals are unable to sustain their operations, if NHIF continues to hold onto the funds.
“There is a serious problem looking at that trend because you will find that there is no inordinate delay in reimbursing private facilities,” he said.
He said his panel will summon Health CS Susan Nakhumicha, the NHIF chief executive and the entire management, to explain the delay and strike a deal on timely reimbursement to the facilities.
Nominated Senator Catherine Mumma called for the restructuring of NHIF and other parastatals that perform county functions to make them intergovernmental agencies.
“We also need to take care of the NHIF to ensure the money paid by taxpayers, who are public servants, state officers and others, should go towards supporting hospitals like Kenyatta National Hospital,” she said.
The senators spoke after nominated Senator Mariam Omar filed a petition demanding answers on the delays by NHIF in releasing funds to health facilities in Mandera.
The legislator sought a full list of accredited NHIF hospitals and health facilities in Mandera county for both outpatient and inpatient medical services.
“The [health] committee should state capitation amount paid to public and private health facilities registered with the National Hospital Insurance Fund for services rendered to patients for the last three financial years to date,” she said.
“I am also aware that even in the Moi Teaching and Referral Hospital, there is a very serious issue of the NHIF. Right now, patients are no longer getting services at MTRH because these NHIF reimbursements are not happening.”
Nandi Senator Samson Cherargei asked Mandago’s committee to critically look into NHIF operations and recommend proper reforms to restructure the agency.
He said NHIF will be the anchor of the universal health coverage, thus the need for proper reforms.
“If there are any reforms that are needed within NHIF then we must look at them properly,” Cherargei said.
Isiolo Senator Fatuma Dullo said the problems at NHIF hindered the effective rollout out of the UHC by the last regime.
Despite a lot of money being pumped into the programme, not much has been achieved, she said.
“If you look back and see how universal healthcare was rolled out and the way it is being operationalised right now, you will note that there is no change," Dullo said.
“If the CS for Health and the CEO for NHIF can tell us how NHIF is rolled out, its impact, how they are reimbursing the institutions, that would be critical so that we can have a comprehensive report and audit NHIF functions in this country.”
Mandera Senator Ali Roba accused NHIF of not expeditiously reimbursing government hospitals at the same speed they do for private ones.