NHIF calls roundtable with private hospitals

Dr Christopher Lazeck, the NHIF Kinondoni regional manager, yesterday dispatched a letter to the Association of Private Hospital Owners (APHFTA), saying that the meeting will be held tomorrow at the PSSS commercial complex in Kinondoni suburb of Dar es Salaam. Members of the association have recently alerted NHIF that they will not be able to serve NHIF members on the basis of stipulated payments, which they affirmed represent a 25per cent drop in valuation and 36percent drop for various services.

They said they were not involved in preparing the new consultation and treatment pricing schedules, with NHIF saying earlier this month that it had standardised payments.

It had increased amounts the government-run insurer pays for some services and drugs while lowering quotations for others, it said, asserting that the rates were adjusted to reflect the prevailing situation.

While NHIF officials say that various health stakeholders were involved in the review but APHFTA declared early this week that NHIF pronounced the new rates without its formal involvement.

Many privat3e hospitals would be risking closing down due to huge losses if they treat insured patients on the rates billed to take effect January 1, it said, suggesting that a payments increase across the board would have compensated hospitals for payment delays, inflation and the recent drop in the value of the shilling.

NHIF says that the packages indicate services, drug prices and fees covered by the fund, claiming that they were reviewed this year “to take into consideration changes that have taken place since 2016 when the last review was conducted.”

It insists that the review was inclusive and involved key stakeholders, including APHFTA, to which the private health facilities’ body signalled its inability to attend NHIF members were the new rates to take effect as planned.

NHIF says that the payments review began in 2020 and involved various, religious organisations, the Medical Association of Tanzania (MAT), public hospitals and physicians in charge of district hospitals as well as APHFTA, which the association forcefully denies.

All the same NHIF says that consultations were still being pursued, “to make sure that all stakeholders understand the review,” while APHFTA says that much of the review involved price slashing, with costs of 78 percent of medicines and services being cut by an average of 36 percent.

NHIF had similarly asked private hospital operators to install an online system and use it to submit payment claims to NHIF to enable their being settled within 14 days, “but the situation had not changed despite the platform being up and running.”