NHIF beneficiaries to pay cash in private hospitals. The Rural Private Hospitals Association of Kenya executive committee chairman Brian Lishenga has said National Hospital Insurance Fund beneficiaries in rural areas will now be forced to pay cash when they visit their member hospitals.
The chair said this is because the insurer failed to fulfil its financial obligations outlined in the agreement with healthcare providers.
The chairperson said owing to the board’s failure to honour its financial obligations, health facilities under RUPHA will now require patients that are beneficiaries of the NHIF Capitated Schemes to pay in cash to receive services starting end of May.
He added that RUPHA regret having to take this step, but it is important so as to ensure the continued provision of quality healthcare services to our patients.
He said NHIF particularly breached clauses 1.3.1 and 1.3.2 of Schedule 1, pertaining to capitation payments.
The two Clauses states that NHIF should pay to the health facility for a Beneficiary of the National Scheme, a capitation amount of one thousand shillings and two thousand eight hundred and fifty shillings respectively for beneficiary per annum within the first 30 days of the capitated period.
RUPHA chairperson has noted that for the April-June 2023 quarter, the national scheme has not remitted any payments to health facilities as of May 29. This amounts to breach of agreement.
Lishenga said that despite receiving several letters and assurances from the NHIF since last month indicating that the payments would be made, they have not receive any payments.
Lishenga called for immediate action to rectify the breach of the agreement.
He said the outstanding capitation amounts for the April-June 2023 quarter should be paid to RUPHA member health facilities within the next seven business days. Failure to which they will take other actions to protect their facilities and clients.
NHIF beneficiaries to pay cash in private hospitals
