Kenya’s National Assembly Committee on Health has sounded an alarm over the mounting debt owed by the National Health Insurance Fund (NHIF) to healthcare facilities across the country, urging the insurer to expeditiously settle the outstanding KES 24 billion in a bid to avert a deepening crisis in the healthcare sector.
Lawmakers expressed grave concerns that several public and private hospitals are grappling with operational challenges, with some already closing or scaling down services due to the NHIF’s failure to reimburse them for services rendered. Dr. Robert Pukose, the committee’s chairperson, lamented that NHIF beneficiaries are being turned away from empanelled hospitals due to the unpaid debts.
“Several private, mission hospitals and other health facilities have either closed or scaled down operations due to NHIF’s failure to reimburse them the capitation,” Dr. Pukose said, adding that some hospitals have resorted to demanding cash payments from patients, refusing to accept NHIF cards.
The lawmakers also expressed distress over reports of hospitals holding patients hostage until their bills are settled, exacerbating the healthcare crisis. Anthony Kibagendi, a member of parliament, alleged a “deliberate scheme” by NHIF’s top management to prioritize payments to hospitals that offer bribes, while those that resist such practices face indefinite delays.
In response, NHIF Chief Executive Officer Elijah Wachira appealed for assistance in raising awareness among public hospitals to expedite claims processing, noting that many fail to do so promptly, leading to a disconnect in the payment system.
The Medical Services Principal Secretary, Dr. Harry Kimutai, revealed that the government is actively engaging with the National Treasury to address the outstanding payments owed to NHIF by various ministries, departments, and agencies, which amount to nearly KES 28 billion. He disclosed that the Ministry of Health had already received approximately KES 4 billion this week to facilitate the settlement of NHIF’s claims, with an additional KES1.5 billion expected from the public service.
