Rédaction Africa Links 24 with JULIUS OTIENO
Published on 2024-01-31 19:00:00
A parliamentary committee is currently investigating the issue of fake NHIF claims by certain private health facilities and has summoned the Kenya Medical Practitioners and Dentist Council to be involved in the probe.
The committee discovered that some of the flagged facilities were actually licensed by the council, despite not meeting the basic conditions. This has raised concerns regarding a potential collaboration between the KMPDC, the National Hospital Insurance Fund (NHIF), and the private facilities in defrauding Kenyans through false claims.
Ndhiwa MP Martin Owino, who temporarily chaired the committee during its visits to various facilities in Nairobi, stated that they will be broadening their investigation to include all agencies that aided the operations of these facilities without meeting the necessary requirements. This will also involve looking into the role of the KMPDC, which is responsible for accrediting health facilities.
Upon visiting several facilities in Eastleigh, Nairobi, such as Joy Nursing and Maternity Home, Amal hospital, and Beirut hospital, the committee found that some of these facilities were operating as Level 4 hospitals despite lacking basic equipment and facilities required for accreditation. In fact, at Joy Nursing Home, the facility was operating with insufficient beds and lacking essential facilities, leading to the closure of the hospital by KMPDC after revelations of fraud emerged.
Despite the lack of necessary equipment and facilities, the facility managed to make claims worth over Sh400 million to NHIF in the last four years, with accusations of falsifying data to inflate the claims. The facility’s proprietor, Kennedy Otieno, denied these claims and stated that assessments were conducted by both the council and NHIF officials before accreditation.
The committee is also investigating the connections between the Joy hospital and specific facilities in Meru, Machakos, and Narok that have been referring their patients to the facility. There are suspicions of collusion between rogue KMPDC and NHIF officials, as well as the facilities involved in the fraudulent claims.
The committee also visited Beirut and Amal hospitals, where they found that both facilities were closed on the day of the visit. This has raised further suspicions and the owners of these facilities will be summoned to appear before the committee for questioning.
Additionally, the committee raised concerns about abnormal claims filed by the Equity Afia facility in Buruburu, in relation to the Edu Afya scheme. NHIF discovered alleged fraud and demanded a refund from the facility. The committee is taking action to address these issues to prevent further exploitation of Kenyans.
Ultimately, the committee is determined to get to the bottom of this issue and hold the responsible parties accountable. They have also visited St Peter’s Orthopedic hospital in Kangemi, which has also been accused of involvement in alleged fake claims. The investigation is ongoing and the committee is committed to ensuring the integrity and transparency of the health care system in Kenya.
Read Original article on The Star
