Kidney patients facing life-threatening uncertainties due to SHA disorientation, association says

The kidney practitioners say that the now-defunct National Hospital Insurance Fund (NHIF) left a debt of over Ksh.10 billion to dialysis service providers without any formal mechanism in place to address the debacle.

"We are deeply concerned by the NHIF's failure to adjust reimbursement rates to match market conditions and to fully remit claims. This financial shortfall has forced several dialysis units to shut down, undoing much of the progress made," read a statement in part.

The association said that patients are currently facing life-threatening uncertainty as many have been unable to register under SHA, forcing them into out-of-pocket payments. 

"Dialysis providers are without formal contracts as dictated by SHA regulations. The promised digital contract system has yet to be implemented, leaving providers uncertain about their legal standing," added the statements.

"Providers have been threatened with consequences if they ask patients to pay out-of-pocket for dialysis, despite there being no operational digital claims system under SHA. The use of the old NHIF claim system poses a financial risk to providers, as they are dealing with a defunct entity."

The association has therefore submitted multiple recommendations to SHA to address critical gaps in kidney health services.

They want SHA to provide clear, consistent guidelines for both patients and dialysis service providers to ensure uninterrupted and reliable service delivery. 

They also want formal contracts between SHA and dialysis service providers must be executed without further delay. 

"In the interim, temporary contracts should be established with dialysis service providers to provide legal assurance to all parties involved, including the patients," they added.

They also want the debt owed by NHIF to be paid to health care providers to enable them to continue the provision of this critical service.