KENYA : Private hospitals remain firm on suspending Social Health Authority (SHA) cover services, despite the Ministry of Health’s pledge to verify claims before processing payments.
This comes after a meeting with the Ministry of Health aimed at resolving the suspension, leaving patients without access to care.
The hospitals demand payment of Ksh30 billion in arrears owed by the defunct National Health Insurance Fund (NHIF).
Principal Secretary for Medical Services Harry Kimtai convened the meeting to deepen hospitals’ understanding of the payment mechanism.
He acknowledged the debt and promised it would be cleared, following verification. Verified claims have increased to Ksh24 billion as of February.
The meeting also discussed the Global Budget Payment model, aiming to improve efficiency and transparency.
Meanwhile, The Government through the Ministry of Health has announced several changes in the implementation of Kenya's new health scheme.
Recently, the Health Ministry raised concerns over low contribution rates to the Social Health Insurance Fund (SHIF), with only 3.3 million out of 19.4 million registered Kenyans actively contributing to the scheme.
Health CS Deborah Barasa and DG Patrick Amoth highlighted this critical funding gap during their weekly briefing at Afya House.
To address ongoing challenges, the Ministry, In a Statement on Tuesday, February 18, announced major reforms to the Social Health Authority (SHA) following public outcry over implementation challenges.
The Ministry of Health has proposed changes in a targeted campaign to increase Social Insurance Fund (SHIF) contributions by self-employed and unemployed Kenyans.
The Ministry announced it would now track mobile money transactions, electricity bill payments, vehicle ownership records, tax returns, among others to better assess SHIF contributions from the unemployed and the self employed class.
The data will be incorporated in the means testing tool being developed with the ministry saying it had already requested for relevant data from institutions such as National Transport and Safety Authority (NTSA), KRA, Communications Authority, among others.
The reforms will also allow Kenyans with irregular incomes to use loans from the Hustlers Fund to pay for The initiative aims to support the informal sector through Insurance Premium Financing (IPF).
Additionally, ICU funding is set to increase from Ksh4,448 to Ksh28,000 per day, while cancer treatment coverage may rise from Ksh400,000 to Ksh550,000 per household per year.
