15 June 2012

Kenya: NHIF Drops Meridian, Clinix From New List

The National Hospital Insurance Fund has now terminated its contracts with Meridian and Clinix . NHIF has circulated a list of new facilities excluding the two companies for the controversial medical insurance scheme for civil servants and military personnel . NHIF had engaged both Clinix and Meridian on a pilot basis for one year starting in February this year.

In the new list seen by the Star, NHIF excluded Clinix and Meridian saying the two are under investigation and asked members to choose alternatives.The new list includes several government, private and mission hospitals across the country.

A senior NHIF official said yesterday that they would publish the list in the newspapers. "What you may have seen is not conclusive and authoritative. As early as next week, we will give you the new list of service providers," said the manager.

"Members are advised to continue accessing OPC services in the currently capitated facilities for the next one month. However, for those who are currently accessing outpatient healthcare services at Meridian and Clinix, they are directed to seek healthcare in any of the facilities listed," the list sent to government ministries reads in part. The Union of Kenya Civil Servants has already raised a red flag over the new list accusing NHIF of not following the law.

NHIF was supposed to advertise the tender and pre-qualify health providers, before publishing pre-qualified facilities for civil servants to choose from. "It has come to our notice that the period for choosing has commenced and the list of health-care providers and their facilities will be advertised in due coarse," UKSC Executive director Wilson Asingo wrote to NHIF on June 8.

The union warned that existing provider contracts cannot be cancelled. "Our members are desirous that all facilities that are currently are in your panel are included. Currently our members in Nairobi are being served by the two private providers namely Clinix and Meridian. It is therefore of utmost importance that all accredited branches of the two main providers named above be included in the list to be published in the dailies alongside all the others," Asingo's letter adds.

Meridian and Clinix were probed by the parliamentary Health committee led by Nyaribari Chache MP Robert Monda. The committee has recommended that ministers Dalmas Otieno and Anyang Nyong'o be investigated by Ethics and Anti Corruption Commission.

The committee also recommended that Attorney General Githu Muigai reports to Parliament within three months on the identity of the shareholders and directors of both Clinix and Meridian.

The scheme started in June 2010 when NHIF carried out an out-patient pilot study for the rollout of the national out-patient scheme in January 2011. The report is still in Parliament. The pilot was supposed to be carried out in Nairobi and Mumias with 200,000 participants from various companies and parastatals.

The project was initiated by an advertised open tender where Clinix, Meridian, Thika Nursing Home and Mumias Clinic were pre-qualified as private outpatient providers. However Cotu blocked the increment in NHIF contributions to finance the extra outpatient burden so the pilot project did not take off.

In September 2011, the Public Service ministry advertised the civil servants insurance medical scheme to provide both in and out-patient cover for about 900,000 members and dependents.

However, allegations that ghost facilities received payments led to the suspension of the entire NHIF board. MPs are yet to debate the report of the probe committee.

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