NAIROBI, May 26 – The Ministry of Medical Services is pushing for the adoption of the National Hospital Insurance Fund Bill in Parliament this year in an effort to improve health services to Kenyans.
The aim of the Bill is to increase access to health care services and reduce out-of-pocket expenditure at the point of service.
Minister Professor Anyang’ Nyong’o pointed out on Monday that the Bill would ensure Kenyans spent as little money as possible in the quest for quality health services.
“The amount of money you spend to cover medical bills is a lot more than what you could spend when you have the NHIF scheme,” Nyong’o offered.
He was speaking during the opening of a joint planning retreat where Assistant Minister Danson Mungatana urged all Kenyans, especially those in the informal sector, to avail themselves to the benefit of the NHIF scheme.
“We really want to appeal to Kenyans to join the NHIF and we have even opened it up to people in the informal sector and every individual who wishes to join. Sh150 per month will save you a lot of money,” Mungatana suggested.
NHIF’s core function is to collect contributions from Kenyans earning an income of more than Sh1, 000 and pay hospital benefits out of the contributions to members and their declared dependants (spouse and children).
Whilst ensuring that Kenyans from all walks of life have access to quality and affordable healthcare, NHIF operates under the social principle that ‘the rich should support the poor, the healthy should support the sick and the young should support the old’.
NHIF registers all eligible members from both the formal and informal sector. For those in the formal sector, it is compulsory to be a member. For those in the informal sector and retirees, membership is open and voluntary.
Claims are submitted by hospitals directly to NHIF after the contributors have been discharged from hospitals. The claims are examined by the Fund to ensure validity before payment.
A claim can however be rejected and the hospital informed accordingly to incorporate either the missing documents or to address any anomalies identified.
At NHIF, much of the process is computerised. The Fund strives to pay claims within 14 days upon receipt of the claim from hospitals.
Members who opt to clear the bills with the hospital may launch a general claim directly to NHIF for reimbursement.
Professor Nyong’o emphasised the commitment of the Ministry and the NHIF to come up with a strategy and policies for implementation.
The Minister also stressed the need for the health sector to embrace Information Technology to strengthen health care delivery in the country.
He pointed out that his ministry would ensure standards are enforced and maintained by strengthening health regulation services.
Nyong’o said that towards this end, the ministry would reinforce the arms that inspect and audit private and public organisations.