Members of the public have until Friday to submit their memoranda to Parliament on questionable dealings at the National Hospital Insurance Fund (NHIF).
The National Assembly has launched a public inquiry into the fraudulent payment of medical claims and irregular tendering processes at the insurer.
The inquiry will also cover the failure of the public fund to remit capitation payments to hospitals that provide services to NHIF card holders, and allegations of collusion between senior officials at the fund and owners of private hospitals to fleece contributors.
The 90-day inquiry will be conducted by the House Committee on Health chaired by Endebess MP Dr Robert Pukose, according to a notice issued by the Clerk of the National Assembly Samuel Njoroge.
The public inquiry follows outcry over mismanagement of contributors' money in the form of excessive payments without following prudent guidelines and corruption, among other malpractices.
While inviting public submissions, Mr Njoroge said the inquiry will determine the current financial status of the NHIF and assess the efficiency and effectiveness of the selection of service providers.
“The committee hereby invites members of the public to submit memoranda on the specific terms of reference of the inquiry as outlined and on any relevant issues they may wish to bring to the attention of the committee,” reads Mr Njoroge’s notice to the public.
Dr Pukose’s committee has already scheduled evidence sessions for next week and will later submit a report with recommendations to the government.
The National Assembly’s move to initiate the inquiry is in line with Article 118 (1) (b) of the Constitution.
The article states that Parliament shall facilitate public participation and involvement in the legislative and other business of Parliament and its committees.
During the investigations, the committee will also assess the efficiency and effectiveness of the NHIF's quality assurance mechanisms and human resource management.
The problems at NHIF are compounded by the widespread refusal by hospitals across the country to accept NHIF cards from Kenyans seeking treatment, causing them untold suffering.
Dr Pukose said the public inquiry is not a witch-hunt, but an exercise to address the ‘deep-rooted’ problems within the beleaguered insurer.
“As a parliamentary committee, we will hold NHIF accountable because it is one of the key institutions this government intends to rely on to deliver universal health coverage to Kenyans,” Dr Pukose said.
Universal Health Coverage (UHC) is a key pillar of Kenya Kwanza Manifesto, and its success is dependent on an efficient and reformed NHIF.
Dr Pukose said his team will also scrutinise NHIF’s procurement system, particularly in the wake of the cancellation of a tender following irregularities in the tender documents, which NHIF acting CEO Dr Samson Kuhora admitted was an internal matter.
The tender was due to close on June 14, 2023.
“We also want to look at NHIF procurement. What is it that NHIF is procuring? Are they procuring at the expense of patients? Are they relevant to the institution in terms of their mandate,” Dr Pukose said.
The tenders affected by the cancellation include Tender No. NHIF/035/2022-2023, which was for the provision of co-insurance and facultative insurance services (consortium) for Group Personal Accident (GPA) and Work Injury Benefits Act (WIBA) for the 120,047 civil servants and NYS employees.
Also affected were Tender No. NHIF/037/2022/2022-2023 for the provision of emergency road evacuation services for NHIF scheme members; Tender No. NHIF/032/2022-2023 for the provision, supply and implementation of an endpoint solution and email security; and Tender No. NHIF/002/2022-2023 for the provision of consultancy services for the provision of actuarial services.
At a previous meeting with the Health committee, Medical Services Principal Secretary Harry Kimutai, under whose ministry the insurer falls, acting CEO Kuhora and board chair Michael Kamau could not disclose how much NHIF collects.
By law, NHIF's income comes from annual statutory and voluntary contributions, penalties and those who pay upfront.
