As the government transitions from the National Hospital Insurance Fund (NHIF) to the Social Health Authority (SHA), CEO Elijah Wachira has issued a directive to patients currently enrolled under NHIF.
In a circular sent to all contracted healthcare providers, CEO Elijah Wachira directed that payments for patients admitted during the period ending September 30 will be processed through NHIF, regardless of their discharge status.
“Claims for patients admitted during the period preceding 30th September 2024 regardless of status of discharge will be processed through NHIF,” read the statement in part.
At the same time, Wachira had earlier announced that the last date for NHIF admissions was on Sunday, September 30.
However, payments made by Monday, October 9, will be credited to NHIF, while remittances from Friday, November 9, onwards will be credited to SHA.
Hospitals to Provide Dialysis and Cancer Services Under SHA
The CEO also stated that no member would be denied dialysis and cancer services during the transition to the Social Health Authority (SHA).
Additionally, he directed that maternity services should not be denied at Kenya Essential Package for Health (KEPH) level 2 and 3 facilities.
Wachira further confirmed that actively managed schemes would continue to access healthcare services without interruption, ensuring ongoing support for patients as the government shifts from NHIF to SHA.
Also Read: Why Omtatah Wants SHA Rollout Stopped
What happens to NHIF contributions as Kenyans migrate to SHIF
Earlier Health PS Harry Kimtai PS Kimtai allayed fears of funds disappearing stating that the funds will also be transferred to the new scheme upon migration.
“No one needs to worry about losing even a single shilling with these changes. Every contribution will be accounted for and carried forward to SHA,” he said.
“We shall check the balance and then transfer to new contributions under SHA.”
SHA CEO said the system rollout will be shared via a URL link and only contracted providers will be eligible to receive and process patients.
Furthermore, he urged all the contracted healthcare providers to escalate their concerns to a designated SHA branch manager for swift assistance.
“Please encourage all patients visiting your facility to register with SHA to ensure SHA covers their healthcare expenses,” he said.
Also Read: What Salaried Kenyans Will Contribute Monthly and Annually to SHA
About the New Health Scheme
The Social Health Insurance (S.H.I) Act 2023 came into effect on 22nd November 2023 repealing the National Health insurance Fund (N.H.I.F) Act no. 9 of 1998.
SHA has assumed all functions and operations previously managed by the Board of Management of NHIF.
According to Section 25 of the Act, SHA is responsible for purchasing healthcare services and ensuring that quality healthcare is provided to beneficiaries at the Healthcare Providers (HCPs).
The new health scheme is based on risk and resource pooling to increase the efficiency of the healthcare system and ensures that people pay for premiums into a pooled fund that can be used for those who need the services at no cost when they need the services.
The rollout of the SHIF comes amid various concerns raised by Kenyans over the government’s readiness to implement the program.
With the introduction of SHIF, Kenyans will be required to pay 2.75 percent of their income. Employed individuals will pay this monthly, while those in the informal sector will make an annual payment in one installment.
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