Health ministry and the Medical Practitioners and Dentists Board will now be accrediting health facilities, in the proposed reforms.
“NHIF will move away from issues that are peripheral to it. The Ministry of Health and the board will carry out the work,” Health Cabinet Secretary Sicily Kariuki said.
This comes as part of new reforms aimed at delivering Universal Health Coverage (UHC) by 2022.
She said after accreditation, hospitals will be gazetted and the insurance provider will pick it up from there.
UHC is expected to herald the transformation of the country’s health sector, which has been marked by inequalities because of poverty and low uptake of medical insurance.
President Uhuru Kenyatta launched the initiative on December 13 2018.
He ordered that NHIF and the Kenya Medical Supplies Authority be reformed.
Currently, NHIF is responsible for accrediting and reimbursing hospitals.
But there have been a lot of complaints that hospitals are colluding with the insurer to generate false medical bills for people who have not sought treatment. The Directorate of Criminal Investigations (DCI) is looking into how NHIF officials pocketed up to Sh12 billion from beneficiaries who had not sought medical treatment from any hospital.
Investigations revealed rogue NHIF officials might have colluded with hospitals to generate the false claims.
Detectives had obtained a court order requiring the hospitals to produce books of accounts, invoices and claims for payment by NHIF from 2013 to date.
When they take over, the Health ministry and the medical board will monitor payments to hospitals, assess the quality of services Kenyans are getting and the competencies of the facilities.
Ms Kariuki said that with the reforms, every shilling spent by the insurer will cover two or three people.