Bernard Konga, the NHIF director general, told journalists yesterday in Dar es Salaam that the meeting is expected to strike an agreement with private health service providers over fair NHIF cost covering for its beneficiaries.
He stated that seven private hospitals earlier boycotting NHIF card holders the service are the key interested parties in the meeting, having accepted to provide services to NHIF card holders while the key contentions are worked out.
“We are going to host a consensus meeting on Monday for the interest of our scheme beneficiaries,” he said, underlining that 87 private facilities didn’t boycott the new package.
They are attending patients with NHIF cards, he said, noting that the new package targets enabling health service providers to serve its members anchored in different economic backgrounds at competitive market prices.
The new consultation fee package will see NHIF paying 25,000/- for its beneficiary to see an experienced specialized medical doctor at a regional referral hospital. The fee has been increased from 15,000/- that was previously paid for the same service, he elaborated.
The new package is meant to enable health facilities provide services at a competitive market rate thus serving many beneficiaries, he emphasized, highlighting that NHIF shall pay 20,000/- for seeing a specialized doctor at regional referral hospital or equivalent up from 15,000/- charged earlier.
NHIF will similarly pay a district hospital or equivalent in the private sector attending a patient with appendectomy 150,000/- for surgery, up from the current 110,000/-, pay 130,000/- for caesarean section and BTL, a surgical procedure that creates permanent contraception, or sterilization from 110,000/-earlier.
Rebuffing arguments of the major private hospitals he said that NHIF “has come to learn that some payments we used to make were overestimated compared to market realities,” implying that upper level private hospitals ought to charge the same as regional referral hospitals.
“In that case, some changes have been made on the value of payments to health providers,” he said, expecting that NHIF members will be able to make use of private health facilities in the same manner as any referral hospital.
NHIF has placed 200,000/- charges, down from 240,000/- to any service provider for a single case of haemodialysis (treatment of advanced kidney failure), and pay 14,900/- down from 33,000/- to a health facility conducting erythropoietin (an injection under the skin) 2,000 IU for its beneficiary.
It will further pay 15,000/-, down from 66,000/- , to whatever health facility that offers an NHIF member with erythropoietin 4,000 IU section.
Through the new package, NHIF will provide 124 medicines from the national essential medicines list for Tanzania Mainland (NEMLIT), while imposing alternatives for 309 medicines routinely prescribed to align prescriptions with NEMLIT.
An addition of strength and formulation medicines to the list is expected in consideration of their availability on the market, he added.
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