KENYA— Cabinet Secretary, Nakhumicha S. Wafula, has suspended eight National Health Insurance Fund (NHIF) branch managers on the grounds of fraudulent dealings.
CS Wafula has also ordered the board of the NHIF to conduct investigations into the allegations and present a preliminary report to her in 48 hours.
She has also called on any individual with pertinent information on the purported syndicate to come forward and share that information with the board.
CS Wafula added, “I have further made a special request to EACC to lias with NHIF and carry out comprehensive investigations to find out how these cartels syphon resources from Kenyans and NHIF specifically and I hope this can be availed within the next seven days.”
The State will also conduct a lifestyle audit on all the NHIF staff, in a crackdown on fraud that has cost the public insurer millions of dollars.
Health Cabinet Secretary Susan Nakhumicha said the exercise would target all 1,835 employees attached to the fund.
The Ethics and Anti-Corruption Commission (EACC) is expected to assist with verifying the wealth held by each of the employees, in an exercise which will exclude contractors doing business with the NHIF for now.
The exercise is expected to send shock waves among staffers at the fund currently rocked by numerous corruption scandals.
“We are going to commence an elaborate lifestyle audit on all staff of NHIF. This is to ensure that each member of staff can explain their wealth portfolio inconsistent with their earnings,” said CS Wafula.
The upcoming lifestyle audit is geared towards ascertaining that workers’ salaries match their lifestyles.
The NHIF board under the weight of the scrutiny under it, has cancelled six tenders after media outlets exposed flaws in a US$12 million tender for civil servants’ insurance cover.
The cancellation was occasioned by media outlets questioning the national insurer’s intention to spend more on covers for civil servants rather than renewing the existing services at a cheaper cost.
Exposing the extent of the rot
CS. Wafula’s move follows a public outcry after an exposé detailing how dishonest private health facilities stole millions of dollars from unsuspecting ageing patients in Meru, Embu, Kiambu and Nairobi counties.
Nation Media, one of the country’s leading media houses, exposed the medical fraud in various hospitals.
It was unearthed how men and women disguised as healthcare providers preyed on villagers, promising to rescue them from arthritis complications.
They used the name of the National Health Insurance Fund to sway unsuspecting Kenyans.
Salesio Mutuma, one of the whistleblowers, elaborated, “The rogue medics target elderly women and men with leg or knee problems. After this lady identifies them deep in the villages, she enquires if they are NHIF members and if their cards are up to date.”
Mutuma also told NTV, “If the patients meet these criteria, she convinces them that they need medical help. These people are called to a chief’s camp, so if you’re called to a chief’s camp for such a meeting, you know that the government knows about it, and then they say the programme is being run by the president. So, it is very easy to be taken in.”
The NHIF officials are accused of using the tactic to fleece Kenyans and the government of an estimated US$11.4 Million.
Some of the hospitals named in the scheme include Afya Bora Hospital, Amal Hospital Limited, Beirut Pharmacy and Medical Centre, Jekim Medical Centre, Joy Nursing and Maternity Eastleigh, St Peter’s Orthopedics and Surgical Speciality.
NHIF cash strapped amid scandal
The NHIF has been struggling to remain afloat due to the huge amount of money owed to it by the Treasury.
She also revealed that the Ministry has embarked on a nationwide verification exercise of all payments to flag any inconsistencies that may have been used to abuse resources.
Early this year, all rural private hospitals were forced to stage a go-slow to demand the release of their funds to the facilities for the April and June 2023 quarters before they can continue rendering their services.
The hospitals were forced to take cash from patients after several attempts to engage the NHIF board bore no fruit.
The consensus is that the organisation that was meant to ensure social protection and cushion families against the heavy burden of medical care, has become a citadel of graft and self-enrichment.
It is apparent that besides governance, the institution requires structural re-organisation and a proper regulatory framework.
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