Lawmakers want three hospitals delisted over Sh7bn NHIF scandal
The National Health Insurance Fund (NHIF) building in Nairobi on June 5, 2024.
What you need to know:
- The licences of six hospitals were suspended for 90 days in June last year.
- MPs also wants disciplinary action against NHIF staff involved in the scandal.
A parliamentary committee wants the State to immediately de-register three major hospitals and reinstate the licences of four others following an inquiry into a multibillion-shilling scandal at the National Health Insurance Fund (NHIF).
The National Assembly’s Health Committee wants the Ministry of Health to cancel licences for Amal Hospital, Joy Nursing and Maternity Eastleigh Limited and Beirut Pharmacy and Medical Centre over the NHIF saga.
An NTV exposé saw the licences of six hospitals suspended for 90 days in June last year following claims of medical fraud.
The NHIF board, following an independent inquiry, suspended the licences of Afya Bora Hospital, Afya Bora Annex Hospital, Jekim Medical Centre in Nkumbu, Joy Nursing and Maternity Eastleigh and St Peters Orthopedics and Surgical Specialty, prompting a parliamentary inquiry on alleged fraudulent claims worth over Sh7 billion.
The cancellation of the licences followed a yearlong inquiry into claims that private hospitals took advantage of the elderly persons to make fictitious claims at the NHIF, raking in millions of shillings.
The committee let three other hospitals off the hook and directed the Pharmacy and Poisons Board (PPB) and the NHIF to immediately lift their suspensions and pay verified pending bills.
The committee that is chaired by Endebess MP Robert Purkose has recommended the immediate cancellation of licences issued to Amal Hospital, Joy Nursing and Maternity Eastleigh Limited and Beirut Pharmacy and Medical Centre but reinstated those of Afya Bora Hospital, Afya Bora Annex Hospital, Jekim Medical Centre, Joy Nursing and Maternity Eastleigh and St Peters Orthopedics and Surgical Specialty.
“That the Kenya Medical Practitioners and Dentist Board Council (KPMDC) permanently close Joy Nursing and Maternity Eastleigh Limited permanently,” the committee recommended in its report.
“The Directorate of Criminal Investigations, within three months do finalise investigations on Beirut Pharmacy and Medical Centre and take appropriate action against all parties involved in lodging and payment of the unverifiable claims by the facility.”
The committee also wants the NHIF to, within the next 90 days, take necessary disciplinary action against all NHIF staff involved in the verification of claims including the claim managers, the branch manager and the quality assurance manager at the branch.
“The committee, in light of the terms of reference, makes the following recommendations: The national health insurer immediately lifts the suspension of Afya Bora Hospital Annex, Afya Bora Hospital and pays the outstanding verifiable claims,” Mr Purkose said in a report tabled in the House.
The committee also wants the NHIF to pay the outstanding verifiable claims of chest and skin clinics and other hospitals whose licenses were also cancelled.
“The Ethics and Anti Corruption Authority (EACC) to, within three months, conduct investigations on the audit team that audited the Edu Afya Scheme and school administrators to ascertain whether the audit team solicited bribes from hospitals and school administrators not to put them in the audit report,” the committee says.
The Nation last June uncovered a scheme in which fraudsters posing as health care providers, in the name of the NHIF, duped hapless residents in villages scattered across Meru County, promising to save them from the vagaries of arthritis complications.
The report accused officers at the NHIF of colluding with hospitals to rip-off the national health insurer.
