All hospitals across the country will be recategorised ahead of the rollout of the Social Health Insurance Fund, Health CS Susan Nakhumicha has said.
Appearing before the National Assembly Health Committee on Thursday, the CS said the move seeks to ensure facilities meet requirements for their categorisation.
The committee is investigating how NHIF colluded with various hospitals for the payout of fraudulent claims amounting to billions.
She said many hospitals across the country had been gazetted as having been classified at a certain level yet they did not meet the qualifications required for the same.
Nakhumicha said the reclassification process would now help the state upgrade or downgrade some health facilities.
“I have for instance visited Kakamega county where a hospital has been upgraded to a Level 4 hospital yet it has no single theatre,” Nakhumicha said.
Currently, health facilities are categorised from the lowest — Level 1 to the highest which is Level 6 with the five categories being under the management of counties.
In Level 1s are community health facilities while Level 2 are medical clinics. Level 3 are health centres, Level 4 are full hospitals while Level 5 are County Referral Hospitals and National Referral Facilities fall under Level 6.
The CS further told the committee that there were over 2,000 facilities which are operating in higher levels yet they do not qualify.
Efforts to nab those running the facilities, she added, have been futile because the owners run away during planned inspections only to re-open afterwards.
The sentiments by the CS were in response to a query by the Health committee chairperson Robert Pukose who sought to know why the NHIF had been paying out claims to hospitals which were wrongly categorised.
“Wrong categorisation of hospitals has led to the loss off public funds through NHIF. This is because hospitals have been making claims according to a certain level that they do not qualify for," Pukose said.
This committee needs to be told why the Ministry of Health and NHIF has allowed the operation and payment of wrongly categorised hospitals,” he said.
“The recategorisation of hospitals in the country should be done so that we do not transition to SHIF with wrongly classified hospitals. We do not intend to allow the further loss of public funds,” he added.
Kenya Medical Practitioners and Dentists Council chief executive officer David Kariuki submitted to the committee that the issue of wrong categorisation had been thrust to the fore thanks to a recent joint inspection of health facilities by the various health bodies.
He decried being short staffed in terms of having officers to carry out the hospital inspections but vowed to ensure that the recategorisation is complete within six months.
“We are going to continue working with the limited resources we have and ensure that within the next six months the recategorisation of hospitals will be complete,” Kariuki said.
Prior, the House team had taken Acting NHIF CEO Elijah Wachira to task over the fraudulent claims made to various hospitals.
