Teachers, police and prison officers have been forced to pay cash to access medical services due to an outstanding medical insurance debt of over Sh11 billion .
Medical Administrator Kenya Limited (MAKL), which oversees the medical insurance schemes for teachers and officers from the National Police Serve and Kenya Prison Service, is yet to pay hospitals Sh11.6 billion accrued from April last year.
Sources within MAKL have revealed that the teachers’ medical scheme has accumulated Sh7.6 billion while the police scheme has arrears of up to Sh4 billion.
In an April 9 letter to hospitals, MAKL acknowledged the backlog in payment and blamed this on delayed disbursements from the National Treasury.
“This has been prompted by a delay in remittance of funds by our mutual client. In light of the above, Medical Administrator Kenya Limited (MAKL) wishes to reaffirm our commitment to making payments as of when we receive the anticipated funds from our mutual client,” MAKL said in the letter.
“We humbly request your understanding and patience as we work diligently to resolve this administrative challenge. We highly value our partnership with your establishment and assure you that payment regularisation is our utmost priority,” it added.
The last payments towards the medical schemes of both teachers and the security officers were in September 2023, meaning that no fresh disbursements have been made in seven months.
The National Police Service Commission (NPSC) and the Teachers Service Commission (TSC) are responsible for transferring money to MAKL, which then disburses it to the hospitals. For teachers, the money goes from Treasury to the Ministry of Education, to TSC, to Minet and finally to MAKL. For the police, the money goes from the Treasury to NPSC, then to APA/Minet, and then to MAKL.
TSC awarded Minet the contract in November 2022 for three years, despite numerous requests from teachers to be covered by the National Health Insurance Fund.
Seven days ago, MAKL announced changes in the administration of the police and prison officers insurance scheme, with APA Insurance replacing CIC as the lead insurer of the Sh8.67 billion scheme.
The administrator has yet to give a reason for the change, but there have been complaints from police and prison officers, with many expressing frustrations over claims being rejected or delays in processing accepted ones.
Last year, the Senate launched an investigation into the loss of Sh176.1 billion allocated to medical schemes for teachers, police, and prison officers over the past nine years.
The Senate investigation was prompted by frustrations faced by teachers, including lack of access to medical services, forcing them to dig deeper into their pockets to meet treatment costs.
The government is currently dogged by liquidity challenges, affecting key issues including remission of statutory deductions. For instance, the State skipped remitting pension for civil servants in the six months to December 2023.
Controller of Budget Margaret Nyakang’o revealed that the Treasury only managed to settle arrears of Sh4.59billion which it had skipped remitting to the Public Service Superannuation Scheme between May and June 2023.
