Council of Governors want NHIF mandate divided to three

Thursday, March 12th, 2020 00:00 |
A view of the NHIF offices. /FILE

Governors want the mandate of the  National Hospital Insurance Fund (NHIF), divided into three independent components as part of  reforms at the health insurer to enhance efficiency and accountability.

Through the Council of Governors (CoG), the county chiefs want the parastatal, which is grappling with claims of massive theft by its managers, to have “Social Health Insurance Fund” as a distinct institution which Kakamega Governor Wycliffe Oparanya, who is the council chair, said should be only mandated with mobilising funds.

In the ongoing reforms which governors want expedited, the function which will require legal and regulatory framework to sail through, governors believe will enable NHIF pool resources of its own.

“NHIF reforms are indeed long overdue, the ongoing process is also slow and we recommend that the President sets up an ad hoc committee to fast track this process through a rapid result initiative that produces results within 100 days,” Oparanya said during a press conference at CoG’s office in Nairobi, yesterday.

NHIF, which is key in President Uhuru Kenyatta’s Universal Healthcare Coverage (UHC), governors say should also have an independent institution to manage health insurance review and reimbursement services which has been a subject of controversy.

There has also been simmering row between the NHIF and private hospitals following the former’s decision to reduce capitation for treatment, mostly on surgeries in a move that has seen the hospitals refuse to treat patients depending on the national insurer cover.

The medical scheme is also grappling with accusations of delayed reimbursements and graft where some top managers have been accused of allegedly demanding kickbacks to effect or expedite the payments thus crippling private facilities even further.

The governors want the fund to have an independent institution to deal with accreditation of health facilities and service providers for the purpose of insurance reimbursement services.

“We propose that the NHIF reforms should aim at transforming in to set up strong legal and regulatory framework supporting establishment and functionally of three institutions that will deliver UHC for Kenyans,” said Oparanya, who was accompanied by his Marsabit counterpart Mohamed Kuti.

There has been vicious power struggle between the Health Ministry and NHIF over declaration and contracting of new healthcare providers into the national insurer’s system.

The ministry was reported to have usurped the NHIF’s role of accrediting hospitals and is even deregistering some of the facilities, which had already been approved, triggering supremacy wars that could cripple UHC.

The insurer has been sending a team of officers  from its branches with an assessment checklist for declaration of health facilities for a thorough inspection and which comes with a status report on the respective facilities.

Insurance board

The report is then forwarded to a committee at the headquarters which decides if the facility qualifies, and if it does, the same is forwarded to the insurer’s board for ratification in a process that would ordinarily take three months.

The takeover move was said to have been part of the government’s measures to tame massive graft at the insurer which saw some top managers paraded in court.

As the push for reforms continues, Oparanya asked the Ethics and Anti Corruption Commission (EACC) and Directorate of Criminal Investigations (DCI) to conduct a thorough probe regarding looting at the national health insurer to save it from an imminent collapse.

“Given the current happenings at the NHIF, it is imperative that EACC and DCI  investigate and bring to book all those who will be found culpable of mismanaging the institution leading to plunder and loss of public funds. We should stop the hemorrhage before the institution collapses,” he said.

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