Parliamentary Committee Launches Probe into NHIF Fraud and Tender Irregularities
A parliamentary committee has launched an investigation into allegations of fraud. In the National Health Insurance Fund’s (NHIF) claims payment and procurement processes.
In the context of NHIF’s failure to remit capitation to hospitals that provide services to its cardholders. And allegations of collusion between some senior NHIF officers and owners of private health facilities to defraud the public insurer. The Health Committee of the National Assembly is conducting an investigation.
In addition, hospitals across the nation refuse to accept NHIF cards from Kenyans seeking treatment, causing them unimaginable suffering.
Yesterday, Medical Services Principal Secretary Harry Kimtai. Whose State department oversees the public insurer, NHIF acting CEO Samson Kuhora, and board chairman Michael Kamau. Were unable to tell the committee how much the fund collects annually in statutory and voluntary contributions. Penalties, and from those who prepay.
The failure to disclose the figures and the vague responses to members’ questions compelled the committee to launch an investigation to determine the truth. The committee chairman, Dr. Robert Pukose, stated that Kenyans cannot continue to suffer while the House team watches.
“When we call for an investigation of this nature, we want to get to the bottom of the problems plaguing the public insurer and determine how to resolve them to reduce the burden on Kenyans. Dr. Pukose stated, “We will ensure that NHIF delivers Universal Health Coverage, its core mandate.”
As he spoke, Mr. Kimtai pledged his full cooperation with the committee’s investigations.
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“This committee can identify NHIF’s loopholes. Mr. Kiptoo stated, “We are prepared to provide all the necessary information to this committee” in response to the committee’s assertion that Dr. Kuhora’s information was insufficient.
But what shocked committee members was the fact that NHIF cannot pay for the treatment of its cardholders despite having a surplus of Sh6 billion in the current fiscal year and over Sh37 billion in various bank reserves.
Dr. Pukose, who is also a Member of Parliament for Endebess, demanded to know if NHIF’s senior management is conspiring with the proprietors of certain private hospitals to fleece Kenyans.
For example, the document NHIF presented to the committee indicates that as of 15 June 2023, the public insurer had spent Sh9.5 billion on EduAfya, Linda Mama maternity cover, and rebates.
Approximately Sh5 billion went to private hospitals, Sh3.3 billion to government institutions, and Sh1.3 billion to mission facilities.
“Many patients experience so much frustration. They are not using NHIF cards to access services. When they go to health facilities, they have turned away, even though some private hospitals are promptly paid enormous sums while others have not been paid for years, the Endebess lawmaker said.
Mr. Kuhora failed to provide the committee with NHIF’s cash flow statements for the previous two years, as well as its financial reserves and reserve policy.
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Duncan Matherge, a representative from Nyeri Town, could not comprehend why the public insurer was unable to pay for services provided to its members while continuing to collect money from Kenyans every month.
“NHIF cardholders want to know why they cannot be cared for despite having their funds deducted,” said Mr. Mathenge, noting that NHIF refused to cover his mother’s cancer-related medical expenses in the country.
MPs also questioned why NHIF is so heavily involved in commercial insurance.
Parliamentary Committee Launches Probe into NHIF Fraud and Tender Irregularities
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