Kenyans can use NHIF card at private hospitals, says Dr Mwangangi

Kenyans will continue using their National Hospital Insurance Fund (NHIF) cards at private hospitals after the Ministry of Health moved to resolve a standoff between the facilities and the State. 

This is according to Health Chief Administrative Secretary Dr Mercy Mwangangi, who made the announcement on Monday afternoon following a closed-door meeting between top officials from the Ministry of Health and private hospital CEOs.

The healthcare providers had moved to halt services to NHIF patients after the national medical insurer slashed doctors’ fees, with private hospitals accusing NHIF of hurting patient care, saying the move was not viable for the facilities.

They had also demanded that the extension of contracts be awarded to the facilities before they commence any engagement.

The closed-door meeting, held via zoom, was attended by Cabinet Secretary Mutahi Kagwe, CAS Dr Mwangangi, NHIF boss Dr Peter Kamunyo and various hospital bosses.

After the meeting, Dr Mwangangi revealed that the existing contracts have been extended for five more months, meaning Kenyans can continue to use their NHIF cards at private facilities until June 30. Negotiations are ongoing, and is expected that the State and private hospitals will have reached a new deal by then.

The Kenya Association of Private Hospitals (KPHA) had on Friday threatened to turn away patients under the national medical insurance starting today.

The hospitals had resolved that patients with NHIF cards will be locked out of service until further notice.

KPHA secretary-general Dr Timothy Olweny said the new contracts were hurriedly executed without adequate time for perusal, and implementation would be counterproductive.

He said that in the new contract for 2022-2024, which they said they had not examined, the input of private hospitals was not sought, save for a few providers, and the contents of the contracts currently being circulated for execution will not work for them.

The documents, seen by the Nation, dictate what the doctors are supposed to charge, the cost of the procedures and what other specialists should be paid.

“The charges are even lower than what was proposed by the Kenya Medical Practitioners and Dentists Council in 2016. We are not going to sign the contract until they are reviewed,” Dr Olweny said.

For instance, in the new contract, for an appendectomy (a surgical operation to remove the appendix) the combined rate proposed by the NHIF suggests that doctors’ fees and hospital charges should not exceed Sh40,000. 

However, under KMPDC guidelines, doctors’ fees range between Sh60,000 and Sh120,000, while anaesthetists are allocated Sh20,000.

For haemorrhoid surgery (to remove swollen blood vessels inside or around the anus and rectum), KMPDC guidelines suggest doctors’ fees of between Sh70,000 and Sh150,000, but for NHIF, the services should not exceed Sh24,000.

He said the process of developing the contracts was unprocedural, lacking the meaningful engagement of healthcare providers, adding that with only four days left to the expiry of the extended contract, Kenyans would be on their own.

Dr Olweny said that the initial contract, for three years, expired in June last year and was to be renewed in July until June 2024. However, all they have been getting are one-month extension contracts from NHIF.