Health insurer interdicts five senior staff in Sh1.6 billion scandal purge
By George.Kebaso, June 22, 2023The National Health Insurance Fund (NHIF) has interdicted five staff members who earlier in the week had been suspended to pave the way for investigations, acting Chief Executive Officer, Samson Kuhora (pictured) has announced.
He said in a note to newsrooms yesterday that the NHIF Board move is in line with the Human Resource Procedure Manual.
The five are accused of colluding with persons disguised as healthcare providers to con unsuspecting patients, most of them, elderly and also defrauded the Fund.
On Monday, Health Cabinet Secretary Susan Nakhumicha endorsed their suspension after the Board recommended, in a move she explained was meant to facilitate smooth investigations.
Along with the interdiction, six of the eight health facilities that were recently exposed for involvement in defrauding the NHIF and fleecing unsuspecting Kenyan patients of their monies valued at Sh1.6 billion, are the first casualties in the initial investigations.
Alternative healthcare
“NHIF has already notified all members receiving outpatient services at these facilities to select alternative healthcare providers from the list of NHIF contracted facilities,” Kuhora revealed.
Yesterday, the NHIF Board moved to suspend the six healthcare providers for 90 days based on the conditions of their contracts, pending further investigation.
Further, the Board also announced it will re-advertise the vacant positions of the Fund’s Chief Executive Officer and the six Directors on June 27, 2023. The process was stopped last week by Health Cabinet secretary, Susan Nakhumicha on the recommendation of the Board.
The facilities that have been suspended include; Afya Bora Hospital, sister hospital; Afya Bora Hospital Annex, Jekim Hospital Nkubu Ltd’ its affiliate;Jekim Medical Centre; Joy Nursing & Maternity Eastleigh in Nairobi’s Kamukunji subcounty and St. Peter’s Orthopedics and Surgical Specialty Center Ltd in Kikuyu, Kiambu.
On Monday, the CS gave the facilities 24 hours – a deadline that expired yesterday afternoon – to transfer their inpatients and evacuate their medical processes.
“This will allow Kenya Medical Practitioners and Dentists Council- KMPDC to commence their inspections, thereafter our teams will enforce the directive for closure should they find them culpable, and they will remain closed until investigations are concluded,” the CS said.
And yesterday Kuhora revealed that the Board had taken similar action in the recent past and suspended the contracts of Amal Hospital Limited and Beirut Pharmacy and Medical Centre.
“The Board will continue to review the healthcare providers’ performance to ensure quality delivery of services to NHIF beneficiaries,” Kuhora said.
He termed the weekend media expose on the scandal, a turning point in restoring public trust and building of a stronger NHIF.
“The Board of Management of NHIF is committed to transforming and strengthening the organization to deliver Universal Health Coverage (UHC) to all Kenyans,” he emphasised.
In line with this objective, he pointed out that recently the Board approved an organizational structure and policy guidelines for the Fund’s operations, preparing it for UHC delivery, and it cannot afford to backtrack on it.
He also explained why the recruitment of the Fund’s substantive CEO and six directors was put on hold.
Kuhora said the suspension of the process was informed by the feeling by the Board that the outcomes of the recruitment would not align with the vision of transformative leadership for the Fund.
“Consequently, the Board unanimously resolved to terminate the recruitment and will initiate a fresh process.
“The re-advertisement for will be on 27th June 2023,” he said.
The Board also condemned all forms of malpractice and fraudulent activities, including those perpetrated by NHIF staff and healthcare providers.
Since the story came into the public limelight there has been a public outcry on the extent at which the facilities cheated unsuspecting aging patients, in the process stealing more than a billion shillings from them through persons in Meru, Embu, Kiambu and Nairobi.
To ensure that facilities suspected to be engaging in malpractice do not continue with their activities, Nakhumicha further instructed the KMPDC and the Pharmacy and Poisons Board (PPB) to commence investigations immediately.
Their report on the families mentioned in the Sunday local television expose, is expected to be handed over to the CS this afternoon.