The Social Health Authority (SHA) CEO Elijah Wachira has directed all contracted healthcare providers to continue offering dialysis and cancer services even as the government plans to transition from the National Health Insurance Fund (NHIF) on October 1, 2024.
In an announcement to all the branch managers, Wachira said hospitals should also provide maternity and provide services to all individuals with active schemes.
“Further to my earlier letter on the above subject matter, kindly further note that: no member will be denied Dialysis and Cancer services, maternity services should not be denied in KEPH level 2 and 3 and active Managed schemes should continue accessing services,” Wachira said.
Wachira had earlier explained that SHA is mandated to contract licensed and empaneled Healthcare Providers (HCPs) and Healthcare Facilities (HCFs).
He announced that the Authority intended to contract HCPs and HCFs for the provision of health care Services to SHA beneficiaries.
Wachira said the HCPs and HCFs shall within two days from the date of receiving the contract, peruse and accept the terms and conditions of contract.
Afterwards, they will append the electronic signature of the person authorized to sign on behalf of HCP or HCF, and thereafter submit the contract
“The submitted signed contract will be received by SHA electronically and executed by the Accounting Officer through an Electronic Signature. The executed contract will be accessible to the HCP or HCF electronically in an encrypted format that cannot be edited,” Wachira said.
National Assembly Health Committee
Health Cabinet Secretary (CS), Dr. Deborah Mlongo Barasa, appeared before the National Assembly Committee for Health on Monday, September 30.
The CS reassured members that the Ministry has taken all necessary steps to ensure a smooth transition and effective rollout of services.
Dr. Barasa highlighted key milestones, including the passage of relevant laws, the development of the benefits package, and the establishment of a comprehensive digital platform.
She acknowledged the committee’s input and the National Assembly’s support throughout the process.
Also Read: Health CS Fumbles to Explain SHA Deductions Hours Before Rollout
Barasa urged members to continue backing the SHA implementation, emphasizing its importance in achieving Universal Health Coverage (UHC) and ensuring accessible, high-quality healthcare for all.
However, the CS was unable to explain how the SHA will be making deductions from Kenyans in the informal sector for the medical scheme.
The committee questioned how the Ministry of Health would categorize various individuals with different businesses and ways of life in the informal sector.
Dr Barasa struggled to explain how that would be done, saying that her ministry was 95 percent sure that their methodology was accurate.
Nonetheless, the Committee cleared the scheme, stating it had addressed its queries regarding the multi-billion health digitization project.
Also Read: Govt Decides Fate of 1,800 NHIF Employees
Govt Sends SHA Commodities to Counties
Barasa later flagged off medical commodities to various counties ahead of the SHA rollout at the Kenya Medical Supplies Authority (KEMSA) National Supply Chain Centre.
The CS said the move is key towards enhancing access to quality and affordable healthcare for all Kenyans.
She explained that that the initiative shows the government’s dedication to delivering on the Bottom-Up Economic Transformation Agenda (BETA), which prioritizes uplifting the vulnerable and marginalized groups, especially in the health sector.
“Through the distribution of Health Products and Technologies to Counties across the country, we are taking decisive steps to expand healthcare access to every Kenyan,” remarked Dr. Barasa.
She urged Kenyans to register for SHA services and promote health-seeking behavior in their communities to build a healthier nation.
Benefits Package
SHA published the Benefit Package and Provider Payment methods that will be applicable with effect from 1 October 2024.
The benefit package includes inter alia: – outpatient services, inpatient and critical care services, dialysis, assistive devices, last office services, accident and emergency services, overseas treatment, maternity services, surgical services, optical services, dental healthcare services, oncology services, pharmacy benefits package, mental health service, rehabilitative services, medical imaging services, specialized essential diagnostic services, and screening for common diseases.
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