Rural hospitals effect Ksh.1000 fee for NHIF beneficiaries seeking outpatient services

The move comes after the Rural Private Hospitals Association of Kenya (RUPHA) made true its threat last week to halt the provision of some medical services under the NHIF cover over delays by the government to disburse funds for the last six months.

According to a statement by RUPHA, the association had reached a deadlock with the government on its failure to reach its end of the bargain thus the decision.

Among the key services affected include the outpatient services where NHIF beneficiaries must cough out Ksh.1000 for treatment.

Other key services which will be paid for include surgery where patients will pay for theatre fees and cancer care where beneficiaries will pay for a consultation fee, laboratory testing fees, and procedure fees for any interventions. 

Patients using the Linda Mama Scheme will also be requested to pay a procedure fee for normal delivery and a theatre fee for a Caesarean section.

RUPHA however notes that members of the Emergency and Critical Situations section will not be affected and that hospital facilities will continue to attend to patients without any changes. 

“We regret to inform you that due to persistent challenges in receiving payments from the National Hospital Insurance Fund (NHIF), the Rural Private Hospitals Association of Kenya (RUPHA) has been compelled to take certain measures to ensure the continued provision of essential healthcare services,” reads the notice.

“In light of the above, please be advised of the following changes to access to services for WHIP beneficiaries, effective December 20, 2023.”

While regretting the decision which affects the public, the Association has reiterated its previous calls to the government to disburse funds for a seamless delivery of services.

RUPHA Chairman Dr. Brian Lishenga in a letter to NHIF Board Chair Eng. Michael Kamau issued a seven-day notice to the government last month to disburse the funds, arguing that the delay violated the law.

“It has come to our attention that as of 8th December 2023 and for the last 6 months, the Board has failed to make the required payments to health facilities in strict compliance with the provisions of our Agreement,” he stated.

“This non-payment of healthcare providers represents a persistent and clear breach of our agreement with NHIF.”