Kidney healthcare practitioners under their umbrella body, the Kenya Renal Association (KRA) are demanding over Ksh10 billion owed to dialysis service providers as the Social Health Insurance Fund (SHIF) comes into effect.
In a statement to the press, the association stated the now-defunct NHIF owes dialysis service providers more than Ksh10 billion, with no formal mechanism in place to address this crippling debt.
“We are deeply concerned by the National Health Insurance Fund’s (NHIF) failure to adjust reimbursement rates to match market conditions and to fully remit claims,” read part of the statement.
This financial shortfall has forced several dialysis units to shut down, undoing much of the progress made in the healthcare industry.
A hospital ward in Kenya.
Photo
Kenyans.co.ke/Murang’a GH
“With the rollout of the Social Health Authority (SHA), we had hoped for improvements in dialysis service delivery and the establishment of a clear and transparent framework for reimbursements,” they noted.
The Association revealed providers have been threatened with consequences if they ask patients to pay out-of-pocket for dialysis, despite there being no operational digital claims system under SHA.
“It is therefore, with dismay that we witness the chaotic rollout of SHA, particularly regarding dialysis services,” they lamented.
As it stands, dialysis providers are without formal contracts as dictated by SHA regulations. The promised digital contract system has yet to be implemented, leaving providers uncertain about their legal standing.
“Patients are currently facing life-threatening uncertainty due to the disorganized SHA rollout. Many have been unable to register under SHA, forcing them into out-of-pocket payments,” the Kenya Renal Association observed.
Additionally, non-citizens are excluded from registration, and new patients cannot access dialysis services.
Despite the Association submitting multiple recommendations to the SHA to address critical gaps in kidney health services, little has been done since the roll out of SHIF which went into effect on October 1.
The Kenya Renal Association has worked closely with the National Hospital Insurance Fund (NHIF) for over two decades to provide and promote quality healthcare for patients with kidney disease.
The Association has urged the government to make clear guidelines and fast track signing of formal contracts.
“The SHA must implement our previous recommendations to improve kidney health coverage in Kenya. This includes extending dialysis cover to three sessions per week, expanding transplant services, implementing peritoneal dialysis coverage, ensuring adequate vascular access, and enacting a comprehensive kidney disease prevention program,” the Association proposed.
President William Ruto during the signing of the Social Health Insurance Health Bill into law at State House on October 23, 2023.
PCS
