Private hospitals have announced plans to deny services to all patients depending on the National Hospital Insurance Fund (NHIF) cover from February 1.
The operators say their agreement with the state corporation has expired and no renewal talks have been initiated.
The Kenya Association of Private Hospitals (KAPH) has in recent months mounted pressure on the government to halt changes proposed in contracts for the 2022-2024 period to allow further deliberations.
The healthcare providers are opposed to a review of NHIF guidelines affecting their operations.
According to KAPH Secretary-General Timothy Olweny, the new terms of engagement do not favor their course.
Read: Healthcare Providers Mount Pressure On NHIF To Halt Proposed Changes In New Contracts
“Come Monday, January 31, which marks the end of our seven-month extension of the contract with NHIF, we, the private hospitals, won’t be in a position to offer services to patients depending on NHIF,” Mr. Olweny told the Standard in a recent interview.
The operators are opposed to NHIF’s move to slash the amount of money it pays for claims lodged by private facilities.
In the new terms, the state reduced the cost of services such as dialysis and surgical services by up to 50 per cent.
Read Also: How to Choose, Change NHIF Outpatient Facilities Digitally
“In a previous structure, NHIF would pay Ksh9,500 for each dialysis session. Dialysis patients require at least two sessions a week. In the new review, NHIF says it would charge Ksh6,500 per session,” he said.
The review is done after every three years.
Olweny said private hospitals are reimbursed Ksh32,000 for surgical removal of tonsils from a child, services whose cost ranges from Ksh60,000 to Ksh120,000.
Read Also: Ksh6.3 Billion Scandal Ails NHIF, Ropes In NYS, Civil Servants
“NHIF remits a maximum of Ksh32,000 to private hospitals for the service. That is way below the amount of money that the Kenya Medical Practitioners and Dentists Council recommends,” he noted.
The healthcare provides said in December that the state-backed insurer had not issued them with any draft contract documents that would form the basis of a meaningful engagement or public participation on the cost review as required by law.
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