The National Health Insurance Fund (Accreditation) Regulations

Legal Notice 186 of 2003

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Citation
Legal Notice 186 of 2003
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National Health Insurance Fund Act
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Legal Notice
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LAWS OF KENYA

NATIONAL HEALTH INSURANCE FUND ACT

THE NATIONAL HEALTH INSURANCE FUND (ACCREDITATION) REGULATIONS

LEGAL NOTICE 186 OF 2003

  • Published in Kenya Gazette Vol. CV—No. 120 on 5 December 2003
  • Commenced on 5 December 2003
  1. [Amended by National Hospital Insurance Fund (Accreditation) (Amendment) Regulations, 2005 (Legal Notice 17 of 2005) on 4 March 2005]
  2. [Revised by 24th Annual Supplement (Legal Notice 221 of 2023) on 31 December 2022]
1.These Regulations may be cited as the National Health Insurance Fund (Accreditation) Regulations.
2.In these Regulations, unless the context otherwise requires—"prescribed Form" means such form as the Board may, from time to time, prescribe for the purposes of these Regulations;"District Health Management Board" means the District Health Management Board existing administratively under the Ministry of Health.
3.(1) Every hospital or health care facility wishing to avail itself of the claims and benefits from the Fund shall apply to the Board for accreditation, registration and gazettement, by filling the prescribed Form.
(2)The prescribed Form shall contain information on, such facilities and issues as are necessary for the delivery of the services for which the institution seeks accreditation, registration and gazettement.
(3)The information referred to in paragraph (2) shall include—
(a)general information on the type of buildings, environmental, suitability, floor area and such other information etc;
(b)facilities such as wards, pharmacy, laboratory, theatres, ear, nose and throat clinic, dental services, drug store, service room and, toilets;
(c)servicing such as training school, ambulance, family planning, and maternal child health;
(d)equipment such as x-ray, standby generator, scanning machine, test equipment, incubator, radiological unit, wheelchair, stretcher and, trolley;
(e)staff; and
(f)bed capacity, including baby cots.
4.(1) Upon receipt of the filled application form, the Board shall cause the institution to be examined by the District Health Management Board or such other body as the Board may deem appropriate, for the purposes of verifying the information in the application form, and determining whether or not to accredit the institution and its category for the purposes of ascertaining the daily claim rates to be applicable.
(2)No benefit shall be payable to a hospital or health care facility that is not accredited in accordance with these Regulations, except as may be provided for in the National Health Insurance Fund (Claims and Benefits) Regulations.
5.An institution whose accreditation and registration is obtained through false or fraudulent information, or violates the provisions of the Act or any of the Regulations made there under, shall—
(a)be de-registered by the Board;
(b)be liable to the penalty provided for by section 25(4) of the Act
6.(1) Where an institution has been de-registered under regulation 5, it may apply for fresh accreditation and registration, at the end of two years from the date the de-registration takes effect.
(2)An institution seeking accreditation under paragraph (1) may be accredited and registered under such terms and conditions, as the Board may deem appropriate.
7.The Board shall, at least once every year, inspect every accredited institution to ensure compliance with the provisions of the Act and these Regulations:Provided that for the purpose of this regulation, the Board may appoint, as its agent, any competent person, institution or authority, and such person, institution or authority shall have the same powers as those of an inspector under section 32 of the Act.
8.The Board shall order for a comprehensive inspection report to be done on any institution applying for accreditation by the management.
9.Repealed by L.N. 17/2005, r. 2.
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History of this document

31 December 2022 this version
04 March 2005
Read this version
05 December 2003
Commenced
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