NHIF must settle Sh29bn debts before exit— Nakhumicha

Ministry of Health says the National Health Insurance Fund must settle all claims it owes service providers before winding up in October.

Health CS Susan Nakhumicha said the debts have been caused by unpaid premiums, currently about Sh28 billion.

The NHIF services were last week extended until the new Social Health Authority is ready.

Consequently, NHIF extended contracts with about 8,000 health facilities until end of September.

“As at May 31, 2024 the Fund owed medical claims of Sh20 billion and Sh9.3 billion to co-insurers. The outstanding premiums owed to the fund were Sh28 billion. The Ministry of Health and the authority have put in the following measures to ensure the claims are settled before the end of the transition,” she told the Senate Health Committee on Tuesday.

She said they are pursuing unpaid premiums by government ministries, departments and agencies through the National Treasury.

“The board has reduced administrative expenditures and skewed payments to the settlement of claims,” she said. “There is reconciliation and verification of claims to ensure only authentic claims are paid.”

Last week, acting CEO of Social Health Authority Elijah Wachira wrote to contracted health facilities telling them to continue providing services under NHIF terms until end of September.

“In order to fully comply with the provisions of the SHIF Act, the Cabinet Secretary has directed that the payment and access to the new benefit package under the authority is now scheduled to begin from October 1, 2024. Therefore, the existing NHIF contributions and benefits will continue until September 30 to ensure seamless service delivery,” Wachira wrote to all contracted service providers.

On Tuesday, the CS said 8,409 health facilities will provide health services under SHA.

These are 494 public health facilities, 6,648 private facilities, 734 faith-based facilities.

Under the National Authority for the Campaign Against Alcohol and Drug Abuse accredited are 100 facilities, 433 under the nursing council.

“All Government of Kenya facilities will be contracted directly under the government to government contracting arrangement,” she said.

“SHA has applied and the National  Treasury  has  approved special permitted procurement in the contracting of private and faith-based hospitals,” she said.

Nakhumicha also said the current NHIF employees are working as SHA workers until the draft human resource instruments are approved.

She said they are currently under discussions with State Corporation Advisory Committee and Public Service Commission for subsequent approval and implementation.

“The staff are currently under the fiduciary responsibility of the SHA Board and continue to execute in their roles as guided by the mandate set out in the SHIF of Act 2023. They have continued to receive updates on the transition  process  and  psychosocial  support  when  necessary,” she said.