NHIF wants a case filed by rural hospital operators over the biometric registration and installation of e-claim systems dismissed saying it was filed in the wrong court.
In a response to the 850 facilities under Rural Private Hospitals Association (RUPHAt), the national health insurer maintains the contract with them is commercial and has nothing to do with constitutional matters.
The National Hospital Insurance Fund (NHIF) wants a case filed by rural hospital operators over the biometric registration and installation of e-claim systems dismissed saying it was filed in the wrong court.
In a response to the 850 facilities under Rural Private Hospitals Association (RUPHAt), the national health insurer maintains the contract with them is commercial and has nothing to do with constitutional matters.
In the suit, RUPHA argues that the NHIF board announced the changes without consultation and gave a short compliance notice, blocking the public from accessing medical services.
“…this Honourable Constitutional Court lacks jurisdiction to hear and determine the complaints raised regarding the commercial contracts,” said NHIF’s Claims Manager James Letangule in the replying affidavit.
The NHIF is carrying out mass biometric registration of members and deploying the electronic claims management system to its contracted health facilities, seeking to tackle fraud and speed up payment of medical claims.
The operators with healthcare facilities spread across 43 counties argue that the biometric registration and e-claim systems are not recognised by the NHIF Act and its regulations.
Through lawyer Jennifer Wachira, the lobby had asked the court to issue conservatory orders against the changes announced on June 14, pending the determination of the case.
In response, the NHIF maintains that contrary to RUPHA’s claims, the e-claim system is not new and has over the years been used by contracted hospitals to request for pre-authorisations before offering services to NHIF members and their beneficiaries.
The system, the NHIF says has also been used in making all visit notifications by NHIF members. According to the insurer, the biometric system will improve efficiency in access to healthcare as well as reduce fraud, abuse, and wastage that rides on impersonation.
“This is because …NHIF will have an opportunity of confirming that the true beneficiary is the one accessing service,” stated the response.
RUPHA members argue the online platform would see them incur hardware costs for the purchase of scanners and biometric gadgets alongside Internet and e-claim biometric software licence costs.
The biometric mode of identification and verification means that members will no longer use their National ID and NHIF cards as a mode of identification.
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