The Competition Authority has directed the Rural Private Hospitals Association of Kenya (RUPHA) to stop the implementation of a circular that authorized hospitals to reduce the acceptance of National Hospital Insurance Fund (NHIF) policies as a means of payment.
In a cease-and-desist order, the Authority also directed the rural private hospitals to refrain from making any additional recommendations on the prices, fees and terms of trade for patients until ongoing investigations against it are concluded.
“RUPHA, its agents and members are directed to, with immediate effect, cease and desist from implementing the said circular and refrain from making further recommendations regarding prices, fees and terms of trade to any class of its members until the ongoing investigation is concluded and the Authority pronounces itself,” the notice read in part.
RUPHA made the decision in protest over the alleged failure by the Ministry of Health to offset a Ksh29 billion debt.
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RUPHA and NHIF Row
Earlier in December the association made true its threat of halting the provision of some medical services to patients under the insurance cover.
For outpatient services, patients under the NHIF scheme were expected to pay a fee of Ksh1,000 while patients requiring admission for medical cases were directed to pay an admission fee.
“We regret to inform you that due to persistent challenges in receiving payments from NHIF, RUPHA has been compelled to take certain measures to ensure the continued provision of essential healthcare services,
“NHIF patients receiving cancer care will be requested to pay a consultation fee, laboratory testing fees, and procedure fees for any interventions,” read the statement in part.
The Linda Mama Scheme was also affected by the move as patients enrolled in the scheme were required to pay additional charges. Consequently, expectant mothers were charged a fee for normal delivery procedures and a separate fee for Caesarean sections.
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Accusations Against Govt
Rural Private Hospitals Association of Kenya (RUPHA) is an association of privately-owned medical facilities within the 47 counties of Kenya.
Earlier, RUPHA Chairperson Brian Lishenga said that failure by the government to clear the debt had crippled hospital operations.
Furthermore, the Association regretted its decision, reiterating its previous calls to the government to disburse funds for a seamless delivery of services.
“As of 8th December 2023, and for the last 6 months, NHIF has failed to make the required payments to health facilities in strict compliance with the provisions of our Agreement,
“You may request your provider for a copy of your sales receipt and a duly filled reimbursement claim form that you can present to your NHIF branch should you wish to pursue reimbursement for the costs you incur,” he said.
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