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Employers who fail to remit workers’ contributions to the health insurance fund will be liable to a fine not exceeding Sh2 million if MPs pass the Social Health Insurance Fund bill.

Those who make false statements or representation, and those who knowingly make any deduction from the wages of an employee in respect of any contribution as a contributing employer will also be liable on conviction to a fine not exceeding Sh 2 million or to imprisonment for a term not exceeding three years, or to both.

A healthcare provider or health facility which knowingly or fraudulently alters or falsifies any information with intent to defraud the Authority will be liable on conviction to a fine of Sh2 million up from Sh500,000 that had initially been proposed in the bill.

A person who misappropriates any of the funds or assets of the Fund, or assists or causes any person to misappropriate or apply funds, otherwise than in the manner provided in the Act, commits an offence and shall upon conviction, be liable to imprisonment for a term not exceeding five years or to a fine not exceeding Sh10 million or to both.

Further, a person who with intent to obtain the payment of any benefit, impersonates any person whether living or dead, commits an offence and will be liable on conviction to a fine not exceeding Sh1 million or to imprisonment for a term not exceeding three years, or to both.

MPs have also changed the name of the new health body by removing the word National to read, Social Health Authority (SHA).

According to a report currently before the National Assembly, the health authority will have the powers to empanel and contract health care providers and health facilities upon inspection, licensing and certification of the health care providers and healthcare facilities by the relevant body.

“The justification for this is to specify that the social Health Authority will be responsible for empanelment and contracting of health care providers and health care facilities while the relevant body contemplated under clause 33 (body responsible for accreditation for quality of care) will be responsible for inspection, licensing and certification of healthcare providers and healthcare facilities,” reads the report by the Health Committee.

Despite making it mandatory for Kenyans to register with the fund, the MPs, however, came to the rescue of defaulters after it reduced the penalties from ten per cent to two per cent on grounds that it was too punitive.

Reads the report: “The proposed penalty of 10 per cent for failure to pay contributions is too punitive.”

Covid-19

Lawmakers have also proposed an amendment that will require any person who is a non-Kenyan and intends to enter into the country for a period of less than 12 months to possess a travel health insurance cover.

The MPs say the proposal is in line with other countries such as Egypt, Rwanda, United Arab Emirates, Russia, Saudi Arabia and the entire Schengen region which implemented mandatory travel insurance especially after Covid-19 pandemic.

 “It makes mandatory for all foreign nationals visiting Kenya on a short term stay (less than 12 months) to have travel insurance cover for purposes of protection of public health especially during health related emergencies,” states the report.

Regarding the benefits every beneficiary will be entitled to, the MPs proposed that the SHA with the approval of the board and in consultations with the Cabinet Secretary provides for enhanced benefits schemes and packages.

This, the committee noted, is to make provisions for enhanced benefits schemes and packages for retired civil servants and public officers who may not be covered by private medical insurance providers.

To ring-fence the monies administered under the Primary Healthcare Fund, the social Health Insurance Fund and the Emergency Chronic and Critical Illness Fund, the MPs seek to ensure that money accrued under these funds shall only be used for the purposes they were established.

“The administrator of the funds under subsection (3), shall ensure that the monies held in the three funds, including any earnings or accruals are spent only for the purposes for which the funds are established,” the lawmakers concluded.

The authority upon the implementation of the new law, will not be allowed to hold surplus funds as all funds will be expanded towards the provision of health services.

To increase representation of counties, the committee has proposed the inclusion of a representative of the County Executive Committee health caucus to sit on the board of the authority.

And to ensure that a person found culpable by Parliament for contravening Chapter Six of the Constitution as a member of the board of the Social Health authority, the MPs proposed the inclusion of parliamentary reports as a condition to where an individual will not assume such a position if Parliament had previously pronounced itself on such a matter.