The National Hospital Insurance Fund (NHIF) has added 204 public, private and faith-based hospitals and dispensaries to its list of accredited facilities, offering Kenyans more places to access healthcare.
The move comes amidst a prolonged nationwide nurses’ strike that has seen more than 50 per cent of public health facilities remain closed since June, causing suffering and deaths, especially of hundreds of mothers during childbirth.
If the strike comes to an end, it means that the over 6.5 million NHIF members would have more places to access both inpatient and outpatient services.
At least nine sub-county hospitals have been NHIF-accredited to offer both inpatient and outpatient services.
Some of the country’s top hospitals such as Aga Khan Hospital Kitengela, Gertrude’s Garden Children’s Hospital Nairobi West Clinic, Getrude’s Garden Children’s Hospital Nyali Medical Clinic and the Texas Cancer Centre Eldoret are among those listed for outpatient and inpatient services.
“The newly added facilities met the requirements for accreditation and the Fund is set to sign contracts with them so that they start offering services,” NHIF chief executive Geoffrey Mwangi said.
“We are geared towards providing more services and the more the hospitals the more the access to quality healthcare.”
Out of the new total, 18 facilities will cover eye, radiology, dental and laboratory services.
NHIF has also revised upwards the rebates for three facilities out of the 204. Rebates are the amount payable to a facility per bed per day.
The list includes Jumuia Friends Hospital in Vihiga (from Sh2,200 to Sh3,000), Lumakanda County Hospital in Kipkaren (from Sh800 to Sh1,600) and Woodlands Hospital in Mandera from (Sh1,400 to Sh1,800).
“We have increased the amount payable to the three hospitals as they can now see our members comprehensively as medical inpatients,” said Mr Mwangi.
In August, NHIF launched a crackdown on hospitals making fake claims especially on digansotic services such as magnetic resonance imaging (MRI) and the computed tomography (CT) scan.
Mr Mwangi earlier said that hospitals were taking advantage of the insurer’s quick settlement of claims to make money fraudulently.
Facilities now have to send a pre-authorisation request for specialised services to the Fund through an online platform before conducting any procedure on a patient.
“This was rolled out to curb fraud,” Mr Mwangi said.
“There is no way we can stop giving services to our members who remit their money every month. The problem is with hospitals and not patients. We are taking these measures to ensure order.”
Salaried NHIF members and banded members earning over Sh100,000 are currently paying Sh1,700 monthly towards the fund while those self-employed pay Sh500 monthly.