More than 800 hospitals have sued the NHIF over the biometric registration and installation of e-claim systems that seek to tackle fraud and speed up payment of medical claims.
In a case filed under a certificate of urgency, the 850 facilities under Rural Private Hospitals Association say the NHIF board announced the changes without consultation and gave short compliance notice.
More than 800 hospitals have sued the National Hospital Insurance Fund (NHIF) over the biometric registration and installation of e-claim systems that seek to tackle fraud and speed up payment of medical claims.
In a case filed under a certificate of urgency, the 850 facilities under Rural Private Hospitals Association say the NHIF board announced the changes without consultation and gave short compliance notice, blocking the public from accessing medical services.
The NHIF is carrying out mass biometric registration of members and deploying the electronic claims management system to its contracted health facilities.
“The memorandum/directions despite having a significant economic burden on the petitioners were not formulated through public participation of the petitioners nor did the NHIF come up with regulatory impact assessment in line with Section 6 of statutory Instruments Act, there making the memorandum/directions illegal, null and void,” the petition stated.
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 wants the court to issue conservatory orders against the changes announced on June 14, pending the determination of the case.
The NHIF is yet to respond to the suit.
The hospitals 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.
The hospitals said the public with valid NHIF cards would, therefore, be locked out of service in facilities that have not installed the biometric systems.
It also means the operators that run healthcare centres in rural and urban underserved populations like Kangemi, Kayole in Nairobi and Kisauni in Mombasa will not be able to lodge claims for payment through the manual system that is prescribed and is mandatory under law.
“The petitioners are apprehensive that their already filed manual claims will not be settled by the NHIF as it has indicated that it will not handle any manual claims moving forward,” read the petition.
The e-claims system as installed allows NHIF access to medical info belonging to the patient which is confidential between the healthcare provider and the patient contrary to provisions of the Health Act
“We are apprehensive in the manner in which the NHIF has chosen to enforce the e-claim and biometric login system,” said RUPHA chairman Brian Lishenga in a sworn affidavit
The association has in the past complained that NHIF payments to hospitals have been erratic and in minimal amounts.
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