NHIF sued by Private Hospitals in Bio Metric Registration Dispute.

The National Hospital Insurance Fund (NHIF) is being sued by about850 private hospitals over biometric registration and installation of e-claim systems purposing to tackle fraud and speed up payment of medical claims.

The 850 facilities have stated in a case filed under a certificate of urgency, under Rural Private Hospitals Association that the NHIF board announced the changes without consultation and gave short compliance notice, blocking the public from accessing medical services.

According to the petition, despite the directions having a significant economic burden on the petitioners, public participation was excluded.

The NHIF failed to come up with regulatory impact assessment in line with Section 6 of statutory Instruments Act, there making the memorandum/directions illegal, null and void,” the petition read.

NHIF is carrying out mass biometric registration of members and deploying the electronic claims management system to its contracted health facilities. However, operators with healthcare facilities spread across 43 counties argue that the biometric registration and e-claim systems are not recognised by the NHIF Act and its Regulations.

The lobby through lawyer Jennifer Wachira, wants the court to issue a conservatory order against the changes announced on June 14 a move that is pending the determination of the case.

The hospitals argue that the online platform will see them incurring hardware costs for the purchase of scanners and biometric gadgets alongside Internet and e-claim biometric software licence costs. It will also prevent members from using their National ID and NHIF cards as a mode of identification and further locking them out of service in facilities that have not installed the biometric systems.

Operators that run healthcare centres in rural and urban underserved populations like Kangemi, Kayole in Nairobi and Kisauni in Mombasa won’t be able to lodge claims for payment through the manual system that is prescribed and is mandatory under law.

“The petitioners are apprehensive that their already filed manual claims will not be settled by the NHIF as it has indicated that it will not handle any manual claims moving forward,” read the petition.

The e-claims system as installed allows NHIF access to medical info belonging to the patient which is confidential between the healthcare provider and the patient contrary to provisions of the Health Act

NHIF is yet to respond to the claims.

By Philly Opere.