The National Hospital Insurance Fund (NHIF) is banking on Parliament to amend the law to establish provisions on how pandemics and epidemics such as Covid-19 will be covered in the future.
The chief executive Peter Kamunyo told Senators that there is no law currently that defines how pandemics and epidemics are to be covered by insurers.
Dr. Kamunyo told the Senate Health Committee that the NHIF (Amendment) Bill, 2021 should be amended to include the provisions.
“It is expected that after the review of Kenya’s legal framework on health insurance through amendment of the NHIF Act,
regulations and policies will be put in place to create provisions on coverage of pandemics such as Covid-19,” he said.
Dr. Kamunyo said NHIF currently only covers frontline workers from critical illnesses like Covid-19 following a presidential directive.
He said the average cost of Covid-19 admissions in hospitals is Sh603,130.
He added that it costs the financier up to Sh82,584 per day of admission to treat Covid-19 patients in non-government designated institutions.
This is further compared to Sh62,222 for the per-diem reimbursement.
The cost rises to Sh241,468 for the market rate reimbursement per day of treatment.
He said the NHIF would require Sh10.5 billion for the six million projected utilization.
“From the projections, the Fund would need at least Sh1,086,309,745 to cover the population for the next six months.
When restricted to NHIF beneficiaries, this translates to Sh330 million, Sh1.4 billion, and Sh3.6 billion .
This is in the three scenarios of non-government designated facilities, designated facilities, and market-rate facilities,” he said.
He said due to the enormous financial outlay that would be required to cover members for the pandemic.
This is coupled with the fact that the risk exposure of Covid-19 cannot be accurately determined.
The Hospital fund has not been able to undertake the costs related to Covid-19 management according to Business Daily.