850 private hospitals sue NHIF over biometric registration dispute

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Economy

850 private hospitals sue NHIF over biometric registration dispute


NHIF building in Upperhill, Nairobi. PHOTO FILE | NMG

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Summary

  • More than 800 hospitals have sued the NHIF for biometric registration and the installation of electronic claims systems that aim to combat fraud and speed up the payment of medical claims.
  • In a dossier filed under an emergency certificate, the 850 establishments under the Association of Rural Private Hospitals said the NHIF board of directors announced the changes without consultation and gave brief notice of compliance.

More than 800 hospitals have sued the National Hospital Insurance Fund (NHIF) for biometric registration and the installation of electronic claims systems that aim to combat fraud and speed up payment of medical claims.

In a dossier filed under an emergency certificate, the 850 establishments under the Association of Rural Private Hospitals said the NHIF board of directors announced the changes without consultation and gave brief notice of compliance, preventing the public from accessing medical services.

The NHIF performs mass biometric registration of members and deploys the electronic complaints management system in its contracted health facilities.

“The memorandum / instructions, despite a significant economic burden for the petitioners, were not formulated through the public participation of the petitioners and the NHIF did not propose a regulatory impact assessment in accordance with Article 6 of the Statutory Instruments Act, which makes the memorandum / instructions illegal. , null and void, ”says the petition.

Operators of healthcare facilities in 43 counties argue that biometric registration and electronic complaint systems are not recognized by the NHIF Act and its regulations.

Through lawyer Jennifer Wachira, the lobby wants the court to issue protective orders against the changes announced on June 14, while waiting for the case to be decided.

The NHIF has yet to respond to the complaint.

Hospitals claim that the online platform would incur hardware costs for the purchase of biometric scanners and gadgets, as well as Internet biometric software license costs and e-claim.

Biometric identification and verification mode means members will no longer use their national ID card and NHIF card as their identification mode.

Hospitals said the public with valid NHIF cards would therefore be decommissioned at facilities that did not have biometric systems installed.

It also means that operators who run health centers in underserved rural and urban populations like Kangemi, Kayole in Nairobi and Kisauni in Mombasa will not be able to file payment claims through the manual system prescribed and mandatory by law. .

“The petitioners are concerned that their already filed manual claims will not be resolved by the NHIF, as it has indicated that it will not process any manual claims in the future,” the petition reads.

The electronic complaints system as installed allows NHIF to access medical information belonging to the patient which is confidential between the health care provider and the patient, contrary to the provisions of the health law.

“We are concerned with the manner in which the NHIF has chosen to implement the electronic claims and biometric login system,” RUPHA President Brian Lishenga said in an affidavit under oath.

The association has complained in the past that NHIF payments to hospitals were irregular and small.


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