Economy

Court declines to stop NHIF from reducing dialysis fees

nhif

NHIF Building in Upper Hill, Nairobi. FILE PHOTO | NMG

The High Court has declined to halt enforcement of a decision by the National Hospital Insurance Fund (NHIF) to cut renal dialysis payments from Sh9,500 to Sh6,000.

Justice Roselyne Aburili refused to grant an interim order requested by Kennedy Omolo Anjejo, a patient, who wanted the court to slam the brakes on the implementation of the decision announced last September by the State-owned insurer after the claims shot to Sh3.8 billion in June 2021.

The NHIF paid the amount for 295,563 claims for patients who sought renal dialysis in the year June 2020 to June 2021, highlighting the growing cases of kidney ailments and non-communicable lifestyle diseases among Kenyans.

The judge said although the case is a serious petition touching on the healthcare of citizens with renal care issues, there is no immediate real threat or prejudice that Mr Anjejo would suffer if an interim order is not granted at this stage of litigation.

“He has not been denied the renal care services and neither has he been asked to pay the extra money Sh3,500 to top up to Sh9,000 capitation previously paid by the NHIF for renal care patients,” said the judge.

The court found that granting such orders when there is a dispute on the status quo regarding an already signed comprehensive contract between the fund and the service providers, would have adversely affected many other renal healthcare seekers who will demand enhanced payments to health service providers contrary to the contract signed.

In opposition to the application for the conservatory orders, the government stated the orders sought by the patient would have negatively affected all the more than 10 million Kenyans under the said cover.





The petitioner wants a declaration that the Ministry of Health and the Fund have violated his rights under the Constitution by reducing the dialysis benefit cover in view of the increase in the cost of treatment for cancer.

Mr Anjejo claims that the reduced dialysis capitation for renal care patients under the said comprehensive contract is a threat to his life and that of the over 5,000 renal care patients in Kenya.

The case will be mentioned before the High Court at Kisumu on January 27, 2022 for directions.

The Fund’s decision to slash payouts for renal dialysis sessions was part of a cost-cutting drive.

Payments for weekly procedure of renal dialysis have more than tripled in the last four years from the Sh1.2 billion it paid for dialysis in the financial year ended June 2017 to Sh3.8 billion in 2021.

NHIF members are entitled to two weekly sessions of dialysis, pushing the total annual payment per patient to an average of Sh960,000 at the current rates.

Over four million Kenyans suffer chronic kidney disease, with a significant proportion of this population progressing to kidney failure.

Out of these, about 10,000 people have end-stage renal disease and require dialysis, yet only 10 per cent of those who need it are able to access the service.