Govt to Launch Ksh 5B Digital System in Ruto’s Social Health Insurance Fund
The Ministry of Health plans to introduce a fresh digital platform as part of the recently established Social Health Insurance Fund (SHIF) aimed at addressing the growing instances of insurance fraud.
The government is expected to invest Ksh5 million in the Centralized Healthcare Provider Management System (CHPMS), which is designed to improve the gathering of monthly contributions from citizens for the SHIF.
Additional tasks involve the enrollment, verification, and handling of healthcare claims that are filed by patients through authorized medical facilities.
As per the preliminary Regulatory Impact Statement for the Social Health Regulations 2023, the ministry stated that the implementation of the system is expected to reduce false or overstated claims made by policyholders by 10 to 20 percent.
Moreover, the transparency of the accreditation system for hospitals will be improved through the utilization of a platform for entering patient information and documenting SHIF claims. This will enable the retrieval of an audit trail for reference purposes.
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“The system will permit user rights to authorized persons and apply to the board for rights and access to the system in line with the Data Protection Act 2019,” the ministry noted.
SHIF took over from the disbanded National Health Insurance Fund (NHIF), which had been associated with instances of fraud and corruption, leading to financial losses amounting to millions of shillings.
In November 2023, the High Court temporarily stopped the execution of the new healthcare scheme following a legal challenge by entrepreneur Joseph Enock Aura, who contested certain provisions of the plan.
On January 19, the Court of Appeal revoked the order temporarily, awaiting a decision in an appeal submitted by the State.
“We hereby suspend the orders of the High Court restraining the implementation and or enforcement of The Social Health Insurance Act, 2023, The Primary Health Care Act, 2023,’’ a three-judge bench ruled.
Health Cabinet Secretary Susan Nakhumicha, addressing a local media outlet on Wednesday, supported the health strategy, emphasizing that it focuses on prevention and promotion, in contrast to NHIF, which primarily deals with curative measures.
Govt to Launch Ksh 5B Digital System in Ruto’s Social Health Insurance Fund